BOOSTING LIFE EXPECTANCY ACROSS THE WORLD: Lessons from the diffusion of medical knowledge in the 20th century
- 29 Mar 2017
The potential for achieving high levels of life expectancy via the diffusion of medical knowledge has been created and exploited by some developing countries – Cuba, for example. But the lack of success in many other places is mainly the result of medical inefficiency rather than income. That is one of the conclusions of new research by Daniel Gallardo Albarrán and Joost Veenstra, to be presented at the Economic History Society’s 2017 annual conference.
Their study shows that during the twentieth century, the creation of new medical knowledge required substantial economic resources, although its adoption did not. In this process, there were two phases. First, up to mid-century, Europe and its offshoots set the stage for unprecedented and sustained health improvements, but this knowledge was only applied in high-income countries.
But after 1950, the knowledge developed decades earlier spread to a large number of countries and, as a result, world life expectancy increased by 12 years in roughly two decades (an increase that took almost 40 years in Europe). The fact that medical innovations that were once expensive to develop become cheaper to implement over time gives hope for future catch-up in deprived regions of the world.
The authors explain the findings of their study in more detail:
How does medical knowledge developed in rich societies spread to developing countries? If we look at the enormous differences in life expectancy between Europe and Africa or some parts of Asia nowadays, one might think that health-enhancing knowledge diffuses slowly and to places with relatively high income levels.
But a brief look at the twentieth century indicates the opposite: many developing countries (such as China or India) experienced unprecedented health improvements in the decades after 1950.
While it is widely acknowledged that there are many determinants of citizens’ health, scholars have long pointed out that the stock of medical knowledge in an economy is crucial for the prevention and treatment of diseases.
Moreover, this factor should not be considered in isolation since economic resources often determine the extent to which certain technologies can be implemented (or created). For example, treatments for cardiovascular, lung or cancer illnesses are much more common in rich countries than in developing ones.
The positive link between medical knowledge and economic development is not something recent as it can be traced back to the late nineteenth century when the germ theory of disease was developed in Europe. For this reason, our research takes a long-term perspective to understand how cutting-edge medical innovations originated and diffused from 1900 up to the present.
We also apply a new methodology, which, in contrast with previous research, allows us to identify on a global scale when and where medical innovations emerged as well as their diffusion pattern.
Our results show that during the twentieth century, the creation of new medical knowledge required substantial economic resources, although its adoption did not. In this process, we observe two clearly distinguishable phases.
First, up to mid-century, Europe and its offshoots set the stage for unprecedented and sustained health improvements. Between 1900 and 1935, the insights derived from the germ theory of disease provided the basis for effective preventive measures against infectious diseases. But this knowledge was only applied in high-income countries so that the income level needed for a life expectancy of, say, 55 years was the same in 1935 as in 1900. This figure increased even further after the 1930s with the development of antibiotics.
After 1950, the knowledge developed decades earlier spread to a large number of countries and as a result world life expectancy increased by 12 years in roughly two decades (a similar increase took almost 40 years in Europe). Interestingly, the adoption of new medical innovations took place at a lower level of economic development than needed to develop them in the first place.
In fact, with the income level needed for a life expectancy of 55 years in 1935, countries could attain a life expectancy of 65 in 1980. In the last decades of the twentieth century, the potential for life expectancy increases continued, although at a slower pace because progress against chronic diseases requires more resources.
Given the attention that this topic has received in recent years as three of the eight Millennium Development Goals are geared toward improving health in poor countries, our research contributes to this discussion in two ways:
- First, we show that while the potential for achieving high levels of life expectancy has been created and exploited by some developing countries (Cuba, for example), the lack of success in many other places is mainly the result of medical inefficiency (not income).
- Second, medical innovations that were once expensive to develop become cheaper to implement over time. While the nature of medical technology nowadays is different than in the past, this finding gives hope for future catch-up in deprived regions of the world.
Daniel Gallardo Albarrán (University of Groningen) and Joost Veenstra (University of Groningen)
Daniel Gallardo Albarrán
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