Essays in Honor of Lance Taylor
Edited by Amitava Krishna Dutt
Chapter 4: Poverty is not destiny: comparative life expectancy in Africa
F. Desmond McCarthy and Holger Wolf 1 INTRODUCTION Rising incomes and improving medical technology have lifted health standards in most countries, alongside other indicators of the quality of life (Easterly, 1999). Policies fostering growth are thus accompanied by indirect health beneﬁts. Yet, income per capita is only part of the story. Health indicators diﬀer dramatically between countries with similar income levels located in close proximity: within the group of low-income countries (under $1000 GNP per capita) in Sub-Saharan Africa, life expectancy ranges from 38 in Guinea-Bissau to 58 in Kenya (World Health Report, 1999). These observations provide prima facie evidence that potentially major health improvements can be obtained at unchanged income levels by adopting best practices within the peer group of countries on similar development levels. In this chapter, we explore the size of these potential gains in terms of life expectancy for a sample of African countries.1 We focus on documenting existing disparities and inquiring whether these are related to observable country characteristics. While causality may at times be intuitive (such as for a positive link between life expectancy and access to safe water), it is not our focus, and indeed would be more convincingly tested in a time series/panel framework. 2 A SIMPLE DECOMPOSITION We begin with a simple decomposition aiming to diﬀerentiate the various life expectancies within low-income African countries, all African countries, and all countries worldwide. Our empirical analysis is straightforward. The measure of interest is the diﬀerence between the highest life...
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