HEALTH, NUTRITION AND ECONOMIC DEVELOPMENT

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HEALTH, NUTRITION AND ECONOMIC DEVELOPMENT

• Aravinda Meera Guntupalli

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Issues

• How health and development are realted to each
  other?
• Why is health so important?
• Different indicators of health
• Measurement of health and problems associated
  with this

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Health and development

• Health increases human potentialities of all
  kinds
• Everyone can benefit from better health in the
  present, and improved health for the young will
  lead to healthier population in the future
• Better child health and nutrition promote future
  productivity growth directly by helping children
  develop into stronger and healthier adults

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Health

• World Health Organization definition of health
  Health is a state of complete physical, mental
  and social well-being
• Health is not simply absence of disease and
  infirmity
• Health statistics generally measure morbidity
  (Sickness) and mortality (Deaths)

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Some common indicators

• Crude death rate
• Life expectancy
• Infant mortality
• Height and weight
• Height for age and weight for age
• Anemia
• Protein Calorie Malnutrition

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Life expectancy at birth by income group, 1990
and 1997
GNP per capita (PPP) 1970 1997
Below 1,000 42 49
1,000-4,000 54 65
4,000-7,000 57 68
7,000-12,000 61 71
Above 12,000 71 74
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Causes of sickness and premature death

• Environmental health problems
• Malnutrition
• Lack of medical care of adequate quantity,
  quality and type
• These are the causes of sickness and death in
  developing countries and they deserve more
  careful examination

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Environmental saniation

• Contamination of water supply and some times also
  food and soil with human waste
• This highlights the fact that many of the
  infectious, parasitic, and respiratory diseases
  that afflict poor countries are water borne
• Housing with insufficient space, ventilation and
  access to sunlight
• This promotes the spread of airborne diseases
  such as tuberculosis

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Access to safe drinking water and
sanitation,1990s (percent of population)
Rural population Safe drinking water Sanitation
Africa 41 81
Asia 74 23
Latin America 41 40
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Malnutrition

• It is a major source of ill health and premature
  death in developing countries
• Most of the malnutrition today is of the type
  known as PCM (Protein Calorie Malnutrition)
• Vitamin A deficiency that can cause blindness and
  iron deficiency anemia are still very common in
  many developing countries

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Anemia

• Anemia is characterized by a low level of
  hemoglobin in blood.
• Iron deficiency is the most widespread form of
  malnutrition in the world, affecting more than
  two billion people ( Stolzfus and Dreyfuss,
  1998).
• In India, anemia affects an estimated 50 percent
  of the population (Seshadri, 1998)

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Percentage of malnourished children by income,
1990s
GNP per capita (PPP) Height for age Weight for age
Below 1,000 45 87
1,000-4,000 40 33
4,000-7,000 16 8
7,000-12,000 13 9
Above 12,000 N.A. N.A.
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Height inequality among Indian men (by occupation)
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Height inequality among Indian women (by Caste)
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Quality of care

• Framework of Bruce (1990)
• Choice
•  Information to give to clients
•  Technical competence of service providers
•  Interpersonal relationship
• Mechanism to envelope continuity
• Appropriate constellation of services

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Measurement of health

• Health is different from other measures of human
  capital like education
• Multidimensional nature of health
• Measurement error problems
• Systematic error that is related to the demand
  for health is an imporant issue

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General Health Status

• Self-perceived
• Four or five discrete categories
• Drawbacks
• Small number of discrete categories
• Measurement problem

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Self-reported morbidity, illness and normal
activity

• Information about illness or specific symptoms
  during a reference period
• Ghanas example
• Another commonly used variant of self-reported
  illness is to ask whether any days of normal
  activity were lost due to ill health

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Self-reported physical functioning

• Activities of daily living ( ADL)
• ADL captures only physical health problems such
  as shortness of breath, joint problems, or back
  problems

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Nutrient-based indicators

• Calorie availability is computed by converting
  food quantities into nutrient intakes, using
  standard composition tables.
• This method suffers from systematic bias.
• Wastage
• Leakage

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Cont...

• Availability or consumption??
• 24 hour recall method
• Multiple visits are more expensive but reduces
  error

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Nutrition-based Indicators Anthropometrics

• Adult stature can be used as an indicator of
  well-being
• Height is predetermined by adulthood and weight
  provides more current indicator of nutritional
  status.
• Height and weight ratio is expressed in terms of
  BMI

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Cont...

• The relationship between BMI and mortality the so
  called Waaler curve is u shaped.
• Inexpensive method
• Random error can be reduced by good field
  procedures

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Multi dimensionality of health status

• Indonesia family life survey
• The relationship between height and ability to
  carry heavy load of those people who reported
  their GHS as fair demonstrates three points.
• Heterogeneity in both height and functional
  limitations even within the group of people in
  fair health
• Taller people have less difficulties in carrying
  heavy load.
• Younger adults have less difficulty than older
  adults and men have less difficulty than women.

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Current research

• Recent innovations have experimented with
  greater reliance on direct observation but the
  relation between health and productivity is still
  unravelled.

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Other issues

• Nutritional intervention
• Infant and children
• Pregnant and lactating women
• Food subsidies and public distribution system
• Supplying medicines to poor countries
• AIDS drugs prices in Africa

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Important books for health and development

• Human development report
• World development report
• Economics of development Perkins, Radelet et al
• Development economics Debraj Ray
• Economics and development Barbara Ingham
• Handbook of development economics Chenery and
  Srinivasan