Department of Economics and Sociology, University of Chicago, Chicago, IL.
Hoover Institution, Chicago, IL.
Am Econ Rev. 2005 Mar;95(1):277-91. doi: 10.1257/0002828053828563.
GDP per capita is usually used to proxy for the quality of life of individuals living in different countries. Welfare is also affected by quantity of life, however, as represented by longevity. This paper incorporates longevity into an overall assessment of the evolution of cross-country inequality and shows that it is quantitatively important. The absence of reduction in cross-country inequality up to the 1990s documented in previous work is in stark contrast to the reduction in inequality after incorporating gains in longevity. Throughout the post–World War II period, health contributed to reduce significantly welfare inequality across countries. This paper derives valuation formulas for infra-marginal changes in longevity and computes a "full" growth rate that incorporates the gains in health experienced by 96 countries for the period between 1960 and 2000. Incorporating longevity gains changes traditional results; countries starting with lower income tended to grow faster than countries starting with higher income. We estimate an average yearly growth in "full income" of 4.1 percent for the poorest 50 percent of countries in 1960, of which 1.7 percentage points are due to health, as opposed to a growth of 2.6 percent for the richest 50 percent of countries, of which only 0.4 percentage points are due to health. Additionally, we decompose changes in life expectancy into changes attributable to 13 broad groups of causes of death and three age groups. We show that mortality from infectious, respiratory, and digestive diseases, congenital, perinatal, and “ill-defined” conditions, mostly concentrated before age 20 and between ages 20 and 50, is responsible for most of the reduction in life expectancy inequality. At the same time, the recent effect of AIDS, together with reductions in mortality after age 50--due to nervous system, senses organs, heart and circulatory diseases--contributed to increase health inequality across countries.
人均国内生产总值通常被用来代表生活在不同国家的个人的生活质量。然而，福利也受到生命数量的影响，这由寿命来表示。本文将寿命纳入对跨国不平等演变的综合评估中，并表明其具有重要的数量意义。与纳入寿命增长后不平等程度降低形成鲜明对比的是，之前的研究记录到，直到 20 世纪 90 年代，跨国不平等程度并没有降低。纵观整个第二次世界大战后时期，健康有助于显著减少各国之间的福利不平等。本文推导了寿命边际内变化的估值公式，并计算了 1960 年至 2000 年期间 96 个国家健康收益的“全”增长率。纳入寿命增长会改变传统结果；收入较低的国家的增长速度往往快于收入较高的国家。我们估计，在 1960 年，最贫穷的 50%的国家的“全收入”平均每年增长 4.1%，其中 1.7 个百分点归因于健康，而最富裕的 50%的国家的增长率为 2.6%，其中只有 0.4 个百分点归因于健康。此外，我们将预期寿命的变化分解为 13 类主要死因和 3 个年龄组的变化。我们表明，传染病、呼吸道和消化系统疾病、先天性、围产期和“不明原因”疾病的死亡率主要集中在 20 岁之前和 20 至 50 岁之间，这是预期寿命不平等程度降低的主要原因。与此同时，艾滋病的近期影响以及 50 岁以后死亡率的降低——由于神经系统、感官器官、心脏和循环系统疾病——导致各国之间的健康不平等程度增加。
