Ashraf Quamrul H, Lester Ashley, Weil David N
Department of Economics, Brown University, 64 Waterman Street, Providence, RI 02912,
Dept. of Economics, Box B, Brown University, Providence, RI 02912,
NBER Macroecon Annu. 2009 Apr;23:157-204. doi: 10.1086/593084.
We assess quantitatively the effect of exogenous health improvements on output per capita. Our simulation model allows for a direct effect of health on worker productivity, as well as indirect effects that run through schooling, the size and age-structure of the population, capital accumulation, and crowding of fixed natural resources. The model is parameterized using a combination of microeconomic estimates, data on demographics, disease burdens, and natural resource income in developing countries, and standard components of quantitative macroeconomic theory. We consider both changes in general health, proxied by improvements in life expectancy, and changes in the prevalence of two particular diseases: malaria and tuberculosis. We find that the effects of health improvements on income per capita are substantially lower than those that are often quoted by policy-makers, and may not emerge at all for three decades or more after the initial improvement in health. The results suggest that proponents of efforts to improve health in developing countries should rely on humanitarian rather than economic arguments.
我们定量评估了外部健康改善对人均产出的影响。我们的模拟模型考虑了健康对工人生产力的直接影响,以及通过教育、人口规模和年龄结构、资本积累和固定自然资源拥挤等因素产生的间接影响。该模型通过结合微观经济估计、发展中国家的人口统计学、疾病负担和自然资源收入数据以及定量宏观经济理论的标准组成部分进行参数化。我们既考虑了以预期寿命提高为代表的总体健康变化,也考虑了两种特定疾病(疟疾和结核病)患病率的变化。我们发现,健康改善对人均收入的影响远低于政策制定者通常引用的影响,并且在健康状况初步改善后的三十年或更长时间内可能根本不会显现。结果表明,发展中国家健康改善努力的支持者应依靠人道主义而非经济论据。