According to experts, economic growth theoretically leads to better health among the population. Not everyone benefits in the same way, however, and industrial production is frequently also linked to environmental damage.

“Policies are merely the degree of freedom permitted by the economy,” the German political satirist, actor and author Dieter Hildebrandt (1927–2013) once said. The extent to which this applies is dependent on the creative drive and courage of the decision-makers. However, it is indisputable that our modern, highly specialised economy that is based on the division of labour shapes all our lives to a large extent. We all need goods, services and work for our families and ourselves. But what effect does this have on our health?

Text: Dietmar Schobel

“Economic growth has a fundamentally positive influence on the health of the population. I know of no country where the two are not connected. However, this connection is more pronounced in developing countries than in the rich states,” says Mark Pearson, Deputy Director of Employment, Labour and Social Affairs of the Organisation for Economic Co-operation and Development (OECD), to which 36 Member States worldwide belong.

Economic growth has a fundamentally positive influence on the health of the population.

MARK PEARSON, DEPUTY DIRECTOR OF EMPLOYMENT, LABOUR AND SOCIAL AFFAIRS OF THE OECD

Better health due to economic growth

“Numerous studies have evidenced that people who are employed and earn more are in the main healthier than those who do not,” comments Hans Kluge, Director of the Division of Health Systems and Public Health at the World Health Organization Regional Office for Europe, who has observed favourable effects of economic growth at an individual level. It is not quite as clear on a macro-economic level, however. For instance, states with a higher gross domestic product are capable of investing more in the social network and healthcare in principle. “But we know that even in richer countries, the amount spent on public health is far lower than it ought to be,” remarks Hans Kluge.

In a current OECD working paper on the topic of “Inclusive growth and health”, it is established that not all groups of the population benefit in the same way from the nations’ current growth in economic power and health.  “Despite overall gains in the health of the population, large inequalities in health still persist in most OECD countries. These health inequalities seem to have been persistent over time, and are particularly large in Central and Eastern Europe,” write the authors Chris James, Marion Devaux and Franco Sassi.

We know that even in richer countries, the amount spent on public health is far lower than it ought to be

HANS KLUGE, DIRECTOR OF THE DIVISION OF HEALTH SYSTEMS AND PUBLIC HEALTH AT THE WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR EUROPE

Reduce side effects

A further important aspect is that the way in which working conditions are designed, and pollution of the air, water and soil due to the production and consumption of goods, can have a negative effect on health either directly or indirectly. “However, this does not mean that it is a reason to restrict economic growth. Instead, we should reduce undesirable side effects as best possible,” states Marc Pearson: “The awareness that this is absolutely necessary already exists, especially in many emerging and developing countries.”

The same is true for the importance of the health system overall, says the OECD representative. “I do not believe that there are many finance ministers around the world who only see the health sector as a cost factor. Nowadays, it is mainly clear that the health of the population has value in itself and is a prerequisite for prosperous economies,” says Marc Pearson: “Slowly but surely, over the past decades the attitude of decision-makers around the world with respect to this issue has been changing.”

DATA & FACTS

The gains in life expectancy that were achieved in recent years can be traced back both to factors within the health system and also those outside the health system, according to the OECD working paper “Inclusive growth and health”. For instance, a 10 per cent increase in health spending is associated with a gain of 3.5 months of life expectancy from 1995 to 2015, on average across 35 OECD countries. The same rate of improvement in healthier lifestyles is associated with a gain of 2.6 months of life expectancy (fewer smokers with 1.6 months, and decreased alcohol use with 1.0 month). Wider social determinants also matter. A 10 per cent increase in income is associated with a gain of 2.2 months of life expectancy, and a 10 per cent increase in education with 3.2 months.

Source: Chris James, Marion Devaux and Franco Sassi: Inclusive Growth and Health, OECD Health Working Paper No. 103, 15 December 2017