LIVE LONG AND PROSPER: THE ECONOMICS OF MORTALITY

 

                Mortality statistics are extremely important indicators of economic success and

                failure. That is the contention of Professor Amartya Sen, newly installed Master of

                Trinity College, Cambridge, writing in the latest issue of the Economic Journal. Data

                on how long different groups of people live reflect vital aspects of their quality of life

                and the effectiveness of economic policy. And at times, such data can be the most

                useful indicators for economic policy purposes, including both overall performance

                and distributional concerns about class, gender and race.

 

                Longevity, Professor Sen points out, depends on the physical and social conditions in

                which we live, many of which are influenced by economic policy. For example, the

                availability of health care and the nature of medical insurance - public as well as

                private - are important influences on life and death. So too are other social services

                such as basic education, the orderliness of urban living and access to modern medical

                knowledge in rural communities. The statistics on mortality draw our attention to all of

                these policy issues.

 

                Professor Sen also illustrates how mortality information can shed light on the nature of

                social inequalities, including gender bias and racial disparities. His calculations

                establish, for example, that as a group, African-Americans have a lower chance of

                surviving to mature ages than do the much poorer populations of China or Sri Lanka

                or the Indian state of Kerala. An illustration of gender bias is the estimation of tens of

                millions of ‘missing women’ arising from differentially higher female mortality rates in

                South and West Asia, North Africa and China.

 

                In order to demonstrate the value of mortality as an indicator of economic success

                and failure, Professor Sen addresses some contrary arguments:

 

                First, wouldn’t it be better to look at morbidity rather than mortality since people’s

                suffering relates primarily to illness? Once dead, there is no further agony (or so we

                understand though Dante took a rather different view).

 

                     Good information on morbidity would be extremely useful but typically the

                     morbidity data are very bad. Medical statistics on illness depend on medical

                     care and if a region does not have many medical facilities, then fewer illnesses

                     are reported. This reporting bias leads to a positive correlation between

                     medical care and illness.

 

                     The same perversity applies to people’s perception of illness. In places where

                     medical care is widespread and of good quality, people have a higher

                     perception of morbidity, even though they may be in much better health. For

                     example, the rate of reported morbidity in the state of Kerala (where medical

                     care and education are both very widely shared) is much higher than anywhere

                     else in India. The lowest reporting of morbidity is in states like Bihar, which

                     have very little medical care or basic education.

 

                Second, even if mortality is the right thing to look at, surely it is too sluggish a variable

                to be of much use as an economic indicator?

 

                     In fact, mortality rates can change very quickly. This is obviously true in the

                     case of famine. But even in less extreme conditions, mortality rates can shift

                     with great speed, as shown by the recent rise in mortality in the former Soviet

                     Union and Eastern Europe. Such movements draw attention to the need for

                     policy change, which quite often may not be fully reflected in the statistics for

                     incomes and other standard economic indicators.

 

                Note: ‘Mortality as an Indicator of Economic Success and Failure’ by Amartya Sen

                is published in the January 1998 issue of the Economic Journal. It is the text of the

                first Innocenti Lecture of UNICEF delivered by Professor Sen in Florence (March

                1995).

 

                Professor Sen was installed as Master of Trinity College, Cambridge on 14 January

                1998. Prior to that, he was Lamont University Professor and also Professor of

                Economics and of Philosophy at Harvard University. He has served as President of

                the American Economic Association, the Indian Economic Association, the

                International Economic Association and the Econometric Society.

 

                For Further information: contact Amartya Sen at Trinity College, Cambridge on

                01223-338400 (fax: 01223-338500); or RES/ESRC Media Consultant Romesh

                Vaitilingam on 0171-878-2919, 0117-983-9770 or mobile 0468-661095.