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We examined the relation between infant mortality rates, gross national product, and income distribution. Our findings support the hypothesis that average measures of population health are influenced by the distribution of income within societies.
Between 1947 and 1987 expenditures for health care in the United States grew 2.5 percent per annum faster than expenditures for other goods and services. The health sector's share of the gross national product rose from well under 5 percent in the late 1940s to more than 11 percent in the late 1980s. The expenditures gap has two components: health care prices rose 1.6 percent per annum more rapidly than other prices, while the quantity of health care grew 0.9 percent per annum faster than other quantities. Many factors, including wages, productivity, technology, and insurance contributed to these trends. No single explanation suffices, and no simple solution is apparent.
BACKGROUND: Increasing prevalence and worldwide variation in asthma and other atopic diseases suggest the influence of environmental factors, at least one possibly related to socioeconomic wellbeing. This paper examines the relationship of symptoms of asthma, rhinitis and eczema with gross national product per capita (GNP per capita). METHODS: The prevalences of atopic symptoms in 6-7- and 13-14-year-old children were assessed in 91 centres (from 38 countries) and 155 centres (from 56 countries), respectively, in the International Study of Asthma and Allergy in Childhood (ISAAC). These symptoms were related to 1993 GNP per capita for each country as reported by the World Bank. The relationships between symptoms of atopic diseases and infant mortality, the human development index and 1982 GNP per capita were also considered. RESULTS: The countries in the lowest quartile of GNP per capita have the lowest median positive responses to all the questions on symptoms of asthma, rhinitis and eczema. There was a statistically significant positive association between wheeze in the last 12 months and GNP per capita in the 13-14-year age group, but not in the 6-7-year age group. There was also a positive association between GNP per capita and eczema in both age groups. CONCLUSIONS: The positive associations between GNP per capita and atopic symptoms being of only moderate strength suggests that the environmental factors are not just related to the wealth of the country.
The summarized odds ratios of epidemiologic studies on the relationship between exposure to environmental tobacco smoke (ETS) and lung cancer by country were recalculated, using the odds ratio values in a 1992 report entitled, "Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders" by the US Environmental Protection Agency. The relationship between the summarized odds ratio and per capita gross national product (GNP) in 1964 was studied by the country. The graphic relationship between the summarized odds ratio (ordinate) and GNP (abscissa) showed an upward convex curve. The summarized odds ratios of a developing country (China) and developed countries (USA, Western Europe) in 1964 indicated a very weak association, while those of other countries (Greece, Hong Kong, and Japan) were slightly greater than unity (1.0). This means that ETS in the developing and developed countries in 1964 hardly affected lung cancer, whereas that in the other areas affected lung cancer somewhat. Socioeconomic status in developed countries is far better than that in developing countries, and factors related to socioeconomic status may affect the summarized odds ratio. It is recognized that cancer is diagnosed clinically some years after cancer risk factors appear. If the socioeconomic status involves some risk factors which affect lung cancer, the relationship between the summarized odds ratio and the GNP may be significant. Therefore, we can forecast that the summarized odds ratio of Japan will decrease to close to unity and that that of China will increase in the future because of economic growth, making it possible for the Chinese Government to adopt a policy to reduce the influence of ETS on health.
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The number of veterinarians in relation to livestock units, human population, milk and meat production and gross national product for 93 countries is presented. The structure of veterinary manpower is discussed and information on veterinary involvement with companion animals and public health is given. For 23 countries representing all the continents, the number of livestock units, human population and gross national product per veterinary school are presented.
A population health status index designated as the gross national health product (GNHP) is proposed as a general measure of the health of nations or population groups. The GNHP integrates mortality and disability data into a single number in units of disability-free life years lived per 100,000 population. It is based primarily on mortality ratios and life expectancies of component age groups of the population, modified by their respective disability experiences. A computational example with data currently available on U.S. geographic regions from publications of the National Center for Health Statistics shows that the GNHP was highest in the West, indicating the highest number of disability-free years lived. Because of simplicity in its computation and interpretation, the GNHP can be used by health systems agencies (HSAs) in monitoring their performance or in conducting comparative studies.
This paper presents estimates of how much road accidents cost the national economy, stated as a percentage of the gross national product (GNP). Official estimates of road accident costs from 1990 or later were compiled from easily accessible sources for twelve countries. Estimates of the gross national product were taken from OECD publications. On the average, the total costs of road accidents, including an economic valuation of lost quality of life, were estimated to about 2.5% of the gross national product. Excluding the valuation of lost quality of life, road accident costs on the average amounted to 1.3% of the gross national product. When valuation of lost quality of life is included, costs ranged from 0.5 to 5.7% of GNP. When valuation of lost quality of life is disregarded, costs ranged from 0.3 to 2.8% of GNP.
BACKGROUND: There has been little direct exploration of the relationships between dietary factors and human leukemia; however, a number of literature reports from animal studies and correlation analyses between countries suggest that diet can influence leukemia risk. METHODS: Statistical analyses of international food supply data and leukemia incidence data were performed to define better the diet-human leukemia relationship. Incidence data for lymphoid, myeloid, and total leukemia (all leukemia subtypes combined) from 24 countries with reliable cancer registry data were regressed with estimates of per capita disappearance of macronutrients and alcohol, as well as gross national product and average height. RESULTS: Simple correlation analyses showed that the dietary variables were associated with leukemia in a gender- and site-specific fashion. Males consistently had higher correlations than females. The strongest correlations were found between total calorie intake and both lymphoid and total leukemia incidence, especially among males. Myeloid leukemia in either gender was most strongly associated with gross national product. To control for potential confounding, multiple regression analyses were performed, with all regression models adjusted for gross national product, height, and dietary covariates. Total calorie supply was the only significant explanatory variable for the international variation in lymphoid and total leukemia in these analyses. The calorie-leukemia association was stronger among males than among females. No significant association was observed between myeloid leukemia and any of the dietary variables studied, after adjusting for height and gross national product. CONCLUSION: The findings from this rigorous analysis of international data strengthen and expand the hypothesis based on previous simple correlation analyses and animal experiments that an underlying biological relationship exists between diet, particularly energy intake, and international variations in the incidence of certain types of human leukemia. Possible mechanisms for the calorie-leukemia associations are discussed.
This article is concerned with the influence of age and research support on the frequency of technical innovation and economic growth. Based on the observations of Mumford and Gustafson, the authors argue that major contributions are derived from the creation of new understandings brought about by the integration and reorganization of existing understandings [1]. It is also argued that the creation of new understandings is most likely to occur in the earlier phases of people's careers when capable individuals are placed in an environment that will support innovative efforts. To examine these hypotheses and their broader economic implications, data were obtained from government sources describing the percentage of the population between the ages of twenty-five and forty-four, and between the ages of forty-five and sixty-four, as well as the percentage of the gross national product devoted to research and development efforts, the percentage of individual patents awarded, and deviations from long-term trends in the gross national product. These data were then analyzed in a time series analysis covering the period from 1929 to 1984. The results indicated that research support and age influenced the number of patents awarded which, in turn, influenced deviations in the gross national product. On the basis of these observations and the underlying theory, the authors conclude that substantially greater attention should be given to the development and maintenance of creative potential.
Although growing more slowly than in recent years, spending for health continued to account for an increasing share of the Nation's gross national product. In 1983, spending for health amounted to 10.8 percent of the gross national product, or $1,459 per person. Public programs financed 40 percent of all personal health care spending. Medicare and Medicaid expended $91 billion in benefits, 29 percent of all spending for personal health. New estimates of spending in calendar year 1983, along with revised measures of the benefits paid by private health insurers, are presented here.
Health expenditure growth is projected to moderate considerably during 1983-90, reaching $660 billion in 1990 and consuming over 11 percent of the gross national product. During 1973-83, spending for health care more than tripled, increasing from $103 billion to $355 billion and moving from 7.8 percent to 10.8 percent of the gross national product. Government spending for health care is projected to reach $284 billion by 1990, with the Federal Government paying 73 percent. The Medicare Prospective Payment System, private sector initiatives, and State and local government actions are providing incentives to substantially increase competition and cost effectiveness in health care provision.
Examination of data from 141 countries showed that infant mortality rates for 1979 were positively correlated with the proportion of gross national product devoted to military spending (r = 0.23, p less than 0.01) and negatively correlated with indicators of economic development, health resources, and social spending. In a multivariate analysis controlling for per caput gross national product, arms spending remained a significant positive predictor of infant mortality rate (p less than 0.0001), while the proportion of the population with access to clean water, the number of teachers per head, and caloric consumption per head were negative predictors. The multivariate model accounted for much of the observed variance in infant mortality rate (R2 = 0.78, p less than 0.0001), and showed good fit to similar data for the year 1972 (R2 = 0.80, p less than 0.0001). The model was also predictive of infant mortality rates in subgroup analysis of underdeveloped, middle developed, and developed nations. Analysis of time trends confirmed that an increase in military spending presages a poor record of improvement in infant mortality rate. These findings support the hypothesis that arms spending is causally related to infant mortality.