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Increase in income and life expectancy don’t always go hand in hand

June 4, 2008
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An interesting map (at gapminder) which showed how life expectancy and income per capita have changed over the years – from 1950 to 2005 – caught my eye. The map depicted almost all the countries of the world, but I reduced the clutter by choosing a few countries to compare. To represent the first world I chose the United States as most countries in Europe are more or less similar to it in terms of life expectancy and income. I added Japan because it was way behind in 1950 but rapidly caught up with the first world and is a topper today.

About the map: If you want to stop the scrolling of the slideshow simply move your cursor over the map and it will stop. If you press the sign in between the + sign and the – sign the map will stop scrolling, even if you shift your cursor away from the map. If you press the + sign the chart will move faster and pressing the – sign will make it slow down. And if the images disappear, but you want to view the maps again press the x at the top right hand corner.

Fascinating isn’t it to know that countries like India and China were on par with poor countries in Africa like Nigeria and Kenya in 1950 income-wise, but gradually improved. 35 years ago countries like Nigeria, India and China were almost similar in terms of income per capita.

By 1970 China was well ahead of India in life expectancy (although not income). By 1970, Japan had almost caught up with America.

By 1980 there is a distinct change…China starts to move ahead of India in per capita income. By 1990 India has improved on its per capita income as well, as have most countries, but now China is even further ahead as compared to us. Nigeria has been left behind, even by India.

By the year 2000, China’s life expectancy is on par with Brazil’s and in 2005 China catches up with Brazil in both per capita income and life expectancy.

India’s per capita income and life expectancy has gone up, but what is interesting to note is that while disparities in income have increased, the disparity in life expectancy across different strata of society is not that much. This I got to know from Swaminathan S Anklesaria Aiyar’s column. This is what he says:

Disparities in income have risen substantially between rich and poor countries, and between rich and poor states in India. But disparities in life expectancy have shrunk, sometimes dramatically. In 1950, life expectancy in India (31 years) was less than half that in the US (68 years). But by 2005, India (64 years) was not far behind the US (77 years)…In terms of per capita income, the richest major state, Maharashtra is four times as rich as Bihar. Yet, life expectancy in Bihar (61 years) is only slightly behind that of Maharashtra (66.4 years). Indeed, Bihar is almost on par with the national life expectancy of 62.7 years.

The gapminder map says that India’s life expectancy in 1950 was 37 years and not 31 (one cannot know which figures are more accurate, ours or theirs) and by 1960 it increased to 44 years. This means that when the British left India we were in a pathetic state health-wise, but in ten years managed to take our life expectancy up by 7 years. By 1970 life expectancy went up by another 6 years to 51. This increase in longevity was steady and by 1980 it was up by another 6 years, to 57.

Interestingly, the life expectancy both in Britain and the U.S in 1950 was 69 years.

India’s life expectancy continued to grow after 1980 (although it slowed down) and by 1990 it was 60 years. By the year 2000 it was 63, and by 2005, it was 65. It becomes harder and harder to climb further but here we have to take a lesson or two from China.

China’s life expectancy was 65 as far back as 1975! And this was at a time when China’s per capita income and India’s was almost similar. China had not yet embarked on its economic reforms programme and it is clear that the results it has achieved have everything to do with the good governance of their health system and ofcourse increased health spends. By 1990 China’s life expectancy had gone up to 69 years and was 72 by the year 2000. In 2005 it was 73 years and today it is probably 75. A great achievement for China as the United States and Japan who were far ahead economically for years (and still are) have a life expectancy of 78 and 83 respectively (2005).

Clearly our health system was never as good as China’s. Though we need to give credit to our government as after Independence we managed to pull ourselves up – within 2 decades.

Sure, new drugs, vaccines etc may have had a big impact in increasing life expectancy in India and China, but that doesn’t explain why some countries are still floundering and why China was way ahead of us in 1975.

Another thing that struck me is that per capita income doesn’t really have that strong a connection with life expectancy of a country – well, not as much as I thought. It is dependent heavily on efficient governance (and less corruption) more than anything else. Health spends matter too. Although India is increasing its spending on health on a regular basis, by world standards, the health spends being 1 percent of GDP are very low indeed. And you guessed it, China is spending huge amounts on health…their health spends are almost 5 percent of GDP today and have been steadily increasing over the years.

I wonder what our government is doing with its money…

I think it’s about time India pulled up its socks when it comes to good clean governance of the health system and increased its health spends. Without this our economic growth is bound to falter. The reduction in people’s productivity is one bad effect of a poor health system…and the other…galloping health costs. Reminds me of that age-old adage…a stitch in time saves nine.

Related Reading: Is Poverty declining in India?
Economic disparity not that wide in India.
India to be number two economically by 2050
Budget India 2008
Indians want the government to increase health spends
Growth is not leading to development in India
The health scenario in India and medical tourism
Alternative medicine in India fills the gap in allopathic healthcare

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26 Comments leave one →
  1. Vivek Khadpekar permalink
    June 4, 2008 10:30 am

    Nita,

    A very interesting article. It is of course difficult to draw conclusions by looking at gross data, such as life expectancy or per capita income based on the entire population of a country (especially for large countries such as India or China). They are distorted by the extremes that make up the averages (e.g. how much is the difference between the highest and the lowest income). Comparisons between different strata within a poulation give a more realistic picture. Statisticians use a variety of tools (such as dividing the population into deciles or quintiles, distribution curves etc.) to achieve such a picture.

    An important parameter missing from your write-up is nutrition. The poorest are often undernourished and the rich are malnourished (they get more than enough in terms of calories, but are not necessarily eating wisely). As a traditionally poor population grows more affluent, it tends to compensate for years or generations of undernourishment with excessive intake of the wrong kind of nourishment. This has adverse implications for health, and consequently for life expectancy.

    With particular reference to India, part of the reason for the improvement since independence is our Public Distribution System. With all its ills, it is still doing a better job than it was before independence. In the last six decades there have been several droughts, but we have not had the kind of famines that took a heavy toll of life pre-independence.

    The other important parameter is growth in literacy. It’s not as spectacular as we would like it to be, but we have certainly made considerable headway. And this, while it may or may not have contributed to the overall empowerment of women in society, has certainly made them more aware home makers. In many parts of rural India today environmental sanitation and hygiene is noticeably better than it was 20-30 years ago. In fact it is much worse in some urban areas now than in most rural areas.

    Finally, air and water pollution today are very major concerns that have a bearing on overall quality of life and on life expectancy.

  2. June 4, 2008 10:39 am

    “Reminds me of that age-old adage…a stitch in time saves nine.” Says it all🙂
    There is a strong correlation between literacy and health.
    Investments in education(something beyond mere 3Rs) will be welcomed by the people only when they “know” the importance of good health and longevity.
    This in turns brings in better productivity for the nation.

    So, I would say it all starts with education.

    -Nikhil

  3. June 4, 2008 11:00 am

    as you said we need to pull up our socks,but also need to change our socks from time to time..

    absolutely!🙂 – Nita.

  4. June 4, 2008 12:50 pm

    I agree that good health increases life expectancy. That is the reason, our government has found a better way to improve the health of the citizens by telling the movie stars to stop drinking and smoking in movies.

  5. June 4, 2008 6:33 pm

    Very good point Nita. The more you work the more income, but the more stress and unhealthy living.

    There is more to life than money and things.

  6. June 4, 2008 10:35 pm

    Good point Nita,

    But once the income reach a kink on the graph, the life expectancy rebounds.

    cos that is when you no longer work hard for your income, do the things you love to do and live life filled with zest and inspiration.

    The Three things that matters for me:
    Happiness, Health and Wealth..

  7. June 5, 2008 7:34 am

    Interesting article and graphs, Nita.

    But personally, life expectancy means nothing to me. It does not matter to me whether I die when I am a hundred years old or at the next moment after I post this comment😐

  8. June 5, 2008 9:02 am

    Thanks to all responding to this very serious post! sorry could not reply but had a hectic day yesterday.
    Vivek, thanks for your inputs. very useful indeed!

  9. wishtobeanon permalink
    June 5, 2008 7:13 pm

    Nice post. I was reading an article on the ‘Kerala Model’. It says the life expectancy is 74 – Kerala has low income and employment as compared to other states.

    http://www.nytimes.com/2007/09/07/world/asia/07migrate.html

    wishtobeanon, I found some comments of yours in the spam folder. This happens sometimes for no explainable reason. I will now delete your extra comments if you don’t mind. I am keeping this one with the link. Thanks!
    – Nita.

  10. June 5, 2008 10:05 pm

    wishtobeanon, I read the article. Glad to know that the nytimes has written about these things. It’s all true what they say, about Kerala being great in the fields of education and health but unfortunately the money has so far come from the gulf.

  11. Vivek Khadpekar permalink
    June 5, 2008 11:14 pm

    Nita,

    //…but unfortunately the money has so far come from the gulf.//

    I am responding to your comment without reading the NYTimes article it refers to. In literacy (which partly translates into “education”) and health — as in most indicators of social development — Kerala has been ahead of the rest of India since well before the inflow of gulf money began. In fact gulf money has largely gone into promoting undesirable trends in consumption — especially of junk food and alcohol — which will, in the medium-to-long term, reverse the gains made in health standards.

    The other thing to worry about is that, despite high literacy among the population in general and women in particular, the empowerment of women has not made much progress (except in the area of lowering birth rates). In fact Karnataka, Maharashtra and Gujarat, with lower female literacy levels, have done much better on these counts. I cannot furnish statistics to support my observation, but this is what I am told by a significant number of NGO friends. Even in the traditionally matrilineal communities of Kerala, male dominance continues to be strong.

    Vivek, you don’t need to provide stats as your comment seems logical and I do believe it. Thanks – Nita.

  12. June 6, 2008 9:42 am

    //…but unfortunately the money has so far come from the gulf.//

    Nita, I don’t know why the “mainstream media” wants to spread such false information about Kerala. I don’t care about what the NY Times has to say. Here is some information from wikipedia:

    Agriculture dominates the Keralite economy. Kerala lags behind many other Indian states and territories in terms of per capita GDP (11,819 INR) and economic productivity. Kerala’s per capita GDP of 11,819 INR is significantly higher than the all India average, although it still lies far below the world average. Additionally, Kerala’s Human Development Index and standard of living statistics are the nation’s best. However, Kerala’s Human Development Index and standard of living statistics are the best in India. Indeed, in select development indices, Kerala rivals many developed countries. This seeming paradox — low GDP and productivity figures juxtaposed with relatively high development figures — is often dubbed the “Kerala Phenomenon” or the “Kerala Model” of development by economists, political scientists, and sociologists. This phenomenon arises mainly from Kerala’s unusually strong service sector.

    Kerala’s economy can be best described as a democratic socialist welfare economy. However, Kerala’s emphasis on equitable distribution of resources has resulted in slow economic progress compared to neighboring states. Relatively few major corporations and manufacturing plants are headquartered in Kerala. Remittances from Keralites working abroad, mainly in the Middle East, make up over 20% of State Domestic Product (SDP).

    So only 20% of the money comes from abroad, including the Gulf.

    The remaining 80% comes from Kerala itself! And it has go nothing to do with Communism. Kerala’s model of development goes back to the pre-independence era.

    The service sector (including tourism, public administration, banking and finance, transportation, and communications—63.8% of statewide GDP in 2002–2003) along with the agricultural and fishing industries (together 17.2% of GDP) dominate Kerala’s economy. Traditional industries manufacturing such items as coir, handlooms, and handicrafts employ around one million people. Around 180,000 small-scale industries employ around 909,859 Keralites; 511 medium and large scale manufacturing firms are located in Kerala. A small mining sector (0.3% of GDP) involves extraction of ilmenite, kaolin, bauxite, silica, quartz, rutile, zircon, and sillimanite. Home gardens and animal husbandry also provide work for hundreds of thousands of people. Other major sectors are tourism, manufacturing, and business process outsourcing.

    Kerala’s rural poverty rate fell from 69% (1970–1971) to 19% (1993–1994); the overall (urban and rural) rate fell 36% between the 1970s and 1980s. By 1999–2000, the rural and urban poverty rates dropped to 10.0% and 9.6% respectively. These changes stem largely from efforts begun in the late 19th century by the kingdoms of Cochin and Travancore to boost social welfare. This focus was maintained by Kerala’s post-independence government.

  13. Vivek Khadpekar permalink
    June 6, 2008 5:39 pm

    ராஜ் (Raj / రాజు్),

    //These changes stem largely from efforts begun in the late 19th century by the kingdoms of Cochin and Travancore to boost social welfare.//

    Do that accounts for only the southern half of Kerala, or the former states of Travancore and Cochin. What about north of Shoranur — the Malabar area?

    • nvs permalink
      October 23, 2013 9:28 pm

      @ Khadpekar,Raj,
      The above mentioned developments were limited to Southern Kerala only(communists & missionaries have a way of twisting historical facts & taking credits of progressive Travancore monarchy’s works). I have lived in both South & North Kerala & the difference is evident. Right now living in north, i feel like i have been transported to middle ages ! I too have always wondered y on earth we Let go Kanyakumari & took the good 4 nothing Palaghat . All one gets from there is heat blisters & sunburns !

  14. Raghav permalink
    June 6, 2008 6:53 pm

    A German friend of mine recently went to work in a s/w company in Priceton. He told me most of the employees were Indian, about 50 and out of these 50 only 2 looked fit ppl.
    Well, it is not a surprise even if they are drawing salaries in dollars. We, Indians, are already viewed as fat unhealthy ppl in many Western countries.

    Recently, a survey of employees working in Corporate India said that 41% of us are overweight.

    That is true, a very high percentage of the well-off Indians are overweight and unhealthy. That is because they eat a lot of fatty foods (even if it’s veg) and don’t do much exercise. I have written several articles on this and one of them is here – it’s called 11 reasons why Indians are not healthy.- Nita.

  15. June 6, 2008 8:37 pm

    विवेक (વિવેકભાઈ),

    Good point. The Malabar area was a part of the Madras Presidency i.e. British India before independence. So the conditions there were must have been quite similar to the other parts of British India. So we have to credit the development of those districts with the post-independence governments, especially the governments of Kerala – both left as well as left-of-centre(or centre or right-of-centre).

    Unlike the monarchs in many other princely states, the monarchs of Travancore were always popular with their subjects because they were concernced about the development of their people. It must have had an influence on the governments of Kerala as they could not let down the expectations of the people.

  16. Vivek Khadpekar permalink
    June 6, 2008 9:28 pm

    ராஜ் (Raj / రాజు్),

    I don’t know much about the Travancore royals except

    — that one of them, Swathi Thirunal, created an important niche for Kerala in what would otherwise have remained largely the music of the Andhras, the Kannadigas and the Tamils.

    — that they built one of the most fascinating palace complexes at Padmanabhapuram (now in TN territory, but still under Govt. of Kerala control).

    — that one of them (not a ruler) was the pioneer of European-style realistic portrait painting in India. (Interestingly, most of his models were Maharashtrians, and he is said to have been romantically linked with one of them. We’ll learn more about this, I suppose, when Shyam Benegal’s film on him is released).

    — And, of course, during the years leading up to independence, Chithira Thirunal Balarama Varma, the last ruler, had the vision to employ as his advisor and Dewan the late C P Ramaswamy Iyer, one of the most progressive-minded and yet controversial Indian administrators of the last years of the Raj

    • nvs permalink
      October 23, 2013 9:42 pm

      @Vijay K,
      With the exceptions of couple of rulers, most of the Travancore monarchs were brilliant. Another speciality was the Female Monarchs who ruled the country (yes, Travancore was a different country then) exceptionally well. The monarchy itself were matriarchal/female inheritence based. Only daughters could inherit the properties. This also led to the phenomenal status of women in south Kerala. There is no such thing as asking dowries/preference for son in Kerala, especially in South Kerala.
      Chithira Thirunal Balarama Varma was indeed a visionary & his vision wasn’t limited only to that. During his reign, over 42 mega industrial projects were begun & were running successfully, which the communist & congress managed to bankrupt & close down, post independence. Hence, us malayalis r cursed to lead a migrant life ! All this is conveniently forgotten by the political parties.

  17. June 7, 2008 7:31 am

    विवेक (વિવેકભાઈ),

    The first time I heard about the progressive royals of Travancore was when a friend from one of the southern districts of Tamil Nadu, Thirunelveli (Tinevelly during the days of the raj), talked about the “Malayala Maharajas”.

    Ofcourse, Raja Ravi Varma is very much a part of popular Tamil culture. He is mentioned in several films made in Tamil, which is our national and official language. He is immortalised in more than one Tamil song.

  18. Vivek Khadpekar permalink
    June 7, 2008 8:35 am

    ராஜ் (Raj / రాజు్),

    Thirunelveli district was, in fact, part of Travancore-Cochin. I don’t know what prompted the later Kerala government to give away this lush rice-bowl, and the location of the prized Padmanabhapuram palace, to TN in exchange for the relatively drab terrain of Palakkad [maybe a desire to increase Kerala’s presence in the IAS!🙂 ]

    Incidentally, one of the questionable achievements of the late Sir C P Ramaswamy Iyer, whom I mentioned in an earlier post, was the concept of the Vivekananda Rock Memorial at Kanniyakumari. One probably cannot blame him for the actual design horror that it is, but he paved the way for it,

  19. June 7, 2008 9:53 am

    विवेक (વિવેકભાઈ),

    I have been to Kanniyakumari only once, as a kid, so I don’t remember details of that visit😐

    I agree that Palakkad is not as beautiful as the other parts of ‘God’s Own Country’. Apart from the IAS officers (I am reminded of TN Seshan🙂 ), I guess the state of Kerala wanted to control the mountainous pass, the Palakkad Gap instead of the secondary Padmanabhapuram royal palace. In any case, the royal palace is still a part of Kerala, though it is an enclave in Tamil Nadu.

  20. Vivek Khadpekar permalink
    June 7, 2008 10:00 am

    ராஜ் (Raj / రాజు్),

    “Controlling the mountainous pass, the Palakkad Gap” sounds a humorously mediaeval idea, when there were characters like Shivaji and Tipu around who were to be guarded against (of course both of them had alternative routes available because they had navies!)🙂

  21. June 7, 2008 10:16 am

    विवेक (વિવેકભાઈ),

    The legends of Shivaji and Tipu are a part of folklore as well as popular culture in both Tamil Nadu and Kerala. The people of Tamil Nadu and Kerala do not view Shivaji and Tipu as aliens at all!🙂

    But yes, I guess monarchies are an outdated mediæval concept🙂 There are no more absolute monarchies in South Asia now! Bhutan is a constitutional monarchy with a democratically elected Prime Minister and Parliament!🙂

  22. June 7, 2008 10:17 am

    विवेक (વિવેકભાઈ),

    I guess the modern day threat is from empires of a different kind!😀

  23. June 12, 2008 4:52 pm

    try linking infant morality figures with poverty and you will be surprised with the correlation.

  24. Govind Gadiyar permalink
    August 21, 2010 1:51 pm

    Dear Nita

    Started search to get information about life expectancy of Indian’s in different context. My question to all of us (including me) is if our life expectancy is going up year by year then:
    Why LIC is not reducing my insurance premium, year by year???

    This prima facie looks like a big scam on each one of us.

    Best Regards

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