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Citation Information

Type Working Paper - Centro Studi Luca D'Agliano Development Studies Working Papers
Title The pace and distribution of health improvements during the last 40 years: some preliminary results
Author(s)
Publication (Day/Month/Year) 2004
URL http://www.dagliano.unimi.it/media/WP2004_194.pdf
Abstract
This paper juxtaposes changes over the last forty years in income growth and distribution with the mortality changes recorded at the aggregate level in about 170 countries and at the individual level in 21 countries with at least two Demographic and Health Surveys covering the last twenty years. Over the 1980s-and1990s, the infant-mortality rate (IMR), under-5 mortality rate (U5MR) and Life Expectancy at Birth (LEB) mostly continued the favourable trends that characterized the 1960s and 1970s. Yet, especially, the 1990s the pace of health improvement was slower than that recorded during the prior decades. In addition, the distribution between countries of aggregate health improvements became markedly more skewed. These trends are in part explained by the negative changes recorded in Sub-Saharan Africa and Eastern Europe, but are robust to the removal of the two regions from the sample. This tendency isobserved also at the intra-regional level, with the exception of Western Europe. Thirdly, DHS data for 21 developing countries point to a frequent divergence over time in the with in-country distribution of gains in IMR and U5MR among children living in urban vs. rural areas and belonging to families part of different quantiles of the asset distribution, while IMR differentials by level of education of the mother show mixed trends. The paper concludes by underscoring the similarities and linkages between changes in income inequality and health inequality and suggests some tentative explanations of these trends without, however, formally testing them.

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