Health, population and development

Health status and trends in LDC's are reviewed using life expectancy as the principal measure. There are substantial regional differences in health status. East Asia and the Americas have about 20 more years of life expectancy than Tropical Africa and 10 years more than Northern Africa and Southern Asia.

Improvements in life expectancy in the last 20 years have averaged over 10 years in less developed countries. The absolute gains, however, have diminished during this period. Changes in mortality show substantial declines in all age classes.

In developing countries the bulk of deaths are among children under five years. Reductions in mortality in this age group have been relatively slow, though the causes seem largely preventable at low cost. Diarrheas, malnutrition, measles, lower respiratory infections, tetanus and malaria dominate as causes. Tetanus and malaria significance varies with location. Deaths in children less than one month old account for 35–60 percent of infant mortality and are largely associated with low birth weight and tetanus. The sequalae of poverty lie at the base of much of child mortality, but the consequences of poverty for those who survive malnutrition, diarrheas and infection are probably more important.

Analysis of correlates of life expectancy in LDCs indicates that life expectancy is most strongly associated with literacy. Water and sanitation play a significant but much smaller role as explanatory variables, with GNP per capita adding little more.

Finally, an approach to health sector resource allocation is presented based on projecting mortality, disability, and costs of alternative policies and levels of expenditure.