Chapter 8: Health and Longevity Beyond Economic Growth: An Introduction to Sustainable Development By Tatyana P. Soubbotina 1

Overview of Chapter 8: Health and Longevity Global trends  Life expectancy and under-5 mortality rates have improved for most countries Population age structures  How many non-workers must be supported by each worker? The burden of infectious disease  HIV/AIDS, Tuberculosis, Malaria Lifestyle challenges to health and longevity  Smoking 2

How do we measure health and longevity? Two important indicators:  Life expectancy at birth is the number of years a newborn baby would live if prevailing health conditions stay the same  Under-5 mortality rate is the number of newborn babies who are likely to die before reaching age 5 per 1,000 births Exercise: Look at these indicators in Gapminder to see how health has improved over time. 3

Global trends in health and longevity Indicators of health and longevity are  better in high income countries (Figure 8.1)  Improving in all regions (Figure 8.2) as GDP per capita increases Other factors in improving health:  Improvements in medical technology  Better public health services: clean water, sanitation, safe food  Education (especially of girls) Remaining problems: Malnutrition, communicable diseases, maternal mortality 4

Population age structures change over time In countries with high birth-rates and high death rates, much of the population is young  Population pyramid is triangular (Figure 8.3 on left) In countries with low birth-rates and low death rates, more of the population is adult or elderly  Population pyramid is pear-shaped or rectangular (Fig 8.3 rt.) Age structure determines the age dependency ratio, the ratio of non-workers to workers  Low-income countries have “too many” young people  High-income countries have “too many” old people 5

Infectious diseases are a leading cause of mortality in developing countries HIV/AIDS, tuberculosis, and malaria are major killers  No effective vaccines  Treatment is costly (HIV/AIDS) or resistant to drugs (TB) and depends on group behavior (contagion)  Prevention is difficult among poorest people in poorest countries Why no vaccines?  Not profitable for drug companies  Can donor governments and international development organizations fill the gap? 6

Lifestyle choices can affect health Health problems from smoking (and obesity) are driven by choices and can be prevented Much higher prevalence of smoking among males in low-income countries (See Figure 8.4) High-income countries have done much to reduce smoking by using taxes, education, and advertising limits 7