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Social and economic development and change in four Guatemalan villages: demographics, schooling, occupation, and assets.

This article uses census data and village histories to examine changes over the last 35 years in the four villages where the Institute of Nutrition of Central America and Panama (INCAP) Longitudinal Study (1969-77) was conducted and offers a rare picture of development and change in rural localities over a long period of time. In addition, by characterizing the environment in which the subjects of this study were raised, we provide context for and inputs into quantitative analyses of data collected at various points in time on these subjects. The villages have undergone massive demographic, social, and economic change. Initial differences have conditioned many of these changes, especially differences associated with agricultural potential and location. Originally these villages were rather isolated, but road and transportation access has improved substantially. The populations in the villages have more than doubled and also have aged. While marriage patterns have held steady, religious practice has changed a great deal. After many years of steady out-migration, three of the four villages are more recently experiencing net in-migration, a pattern associated with ease of access. Schooling access and outcomes also have improved, with average grades of schooling nearly tripling and literacy doubling to levels currently above national averages. Although agriculture remains an important component of individual livelihood strategies, non-agricultural sources of employment have become more important. Much of this change is associated with declining agricultural markets and increased access to non-agricultural jobs near the villages and in the capital. Accompanying these changes has been an improvement in living standards as measured by a number of indicators of household living conditions and consumer durable goods.

Adolescent↗

The Sachs report: investing in health for economic development--or increasing the size of the crumbs from the rich man's table? Part II.

The Commission on Macroeconomics and Health report (Sachs report of 2001) has been heralded as inspiring and groundbreaking and is being adopted as the blueprint for global health policymaking. This article argues that the report is deeply conservative and unoriginal. It encourages medico-technical solutions to public health problems; it ignores macroeconomic determinants and other root causes of both poor health and poverty; it reverses public health logic and history; it is based on a set of flawed assumptions; it reflects one particular economic perspective to the exclusion of all others; and it recommends greater amounts of charity while preserving the status quo of a deeply unjust and irrational international economic order. Wishful thinking and ideology are presented as established facts to legitimize globalization, and health is conceived primarily as an input to productivity rather than as a human right. The benefits that would result from simple, macroeconomic measures directed toward social justice and the meeting of basic needs are incomparably greater than those that would result from following CMH recommendations in terms of sustainable improvements in both health and economic well-being. The ultimate source of poor health status and miserable living conditions is the extreme concentration of power, nationally and internationally, in the hands of the few.

Economics↗

National road casualties and economic development.

OBJECTIVE: This paper explores why traffic fatalities increase with GDP per capita in lower income countries and decrease with GDP per capita in wealthy countries. METHODS: Data from 41 countries for the period 1992-1996 were obtained on road transport crashes, injuries, and fatalities as well as numbers of vehicles, kilometers of roadway, oil consumption, population, and GDP. Fixed effects regression was used to control for unobservable heterogeneity among countries. RESULTS: A 10% increase in GDP in a lower income country (GDP/Capita <1600) is expected to raise the number of crashes by 7.9%, the number of traffic injuries by 4.7%, and the number of deaths by 3.1% through a mechanism that is independent of population size, vehicle counts, oil use, and roadway availability. Increases in GDP in richer countries appear to reduce the number of traffic deaths, but do not reduce the number of crashes or injuries, all else equal. Greater petrol use and alcohol use are related to more traffic fatalities in rich countries, all else equal. CONCLUSION: In lower income countries a rise in traffic-related crashes, injuries, and deaths accompanies economic growth. At a threshold of around 1,500 dollars-8,000 dollars per capita economic growth no longer leads to additional traffic deaths, although crashes and traffic injuries continue to increase with growth. The negative association between GDP and traffic deaths in rich countries may be mediated by lower injury severity and post-injury ambulance transport and medical care.

Accidents, Traffic↗

Mortality from congenital abnormality in Malaysia 1991-1997: the effect of economic development on death due to congenital heart disease.

An analysis was done of available data from the Department of Statistics Malaysia, on the type of congenital abnormality contributing to death, to determine whether progress in health care over recent years was associated with any decline in mortality from congenital abnormality. A significant decline in death due to congenital abnormality was observed between 1991 and 1996. This was attributable to a decline in deaths due to congenital heart disease occurring because of improvements in cardiac surgical services for infants. In 1997 death due to congenital heart disease increased significantly. This could be attributed to improvements in the diagnosis of congenital heart disease in the neonate.

Congenital Abnormalities↗

Health patterns in New Zealand: class, ethnicity and the impact of economic development.

In the broad sweep the experience of New Zealand in health trends and patterns is similar to that of other advanced industrial societies, yet there are some important differences that draw on the country's colonial past and, more particularly, on its location in the South Pacific. Of special note is the historical experience of the indigenous Polynesian minority--the Maori--in their passage through the demographic transition to their current position in the modern urban environment. It is this dual phase of development--industrialisation for the European majority, 'westernisation' for the Polynesians--that provides the special interest of the New Zealand setting, particularly in the analysis of class and ethnicity in the shaping of health patterns.

Adolescent↗