Human Disease: Effects of Economic Development

Abstract

Since palaeolithic times economic development has had mixed effects on the burden of human disease and injury. Pre‐modern agrarian populations with universal early marriage probably experienced the least favourable levels of health and survival, in many cases worse than their hunter‐gatherer ancestors. Over recent centuries, favourable effects of economic development on health have been ascendant. Child and adult survival have improved markedly in recent decades in most developing countries. However, many important health problems arising from economic development remain unsolved, including tobacco addiction, physical inactivity and obesity, to environmental contamination and disruption (including, now, systemic environmental changes such as climate change). The improvement in global food security has also stalled. Unless corrected, these interacting issues may undermine global public health. Key Concepts: Economic development has mixed but generally positive health effects, especially in recent centuries. Economic development involves several transitions – agricultural, technological, industrial, demographic, nutritional, epidemiological and sustainability. Knowledge is central to the epidemiological and demographic transitions. These transitions are causally intertwined in complex ways. Development can lead to transitional ‘overshoot’, for example from high to low fertility, from under to over caloric intake and from under to overconsumption of environmental resources. Global population health is threatened by declining environmental health determinants, which risks a consequential decline in social health determinants. Dominant measures of economic development omit negative externalities (adverse effects which impinge on public goods, other people, or future generations), thus providing excessively optimistic progress indicators. There is an urgent need for a ‘sustainability transition’, entailing a shift to renewable energy, ecological conservation and enhanced equity. This could be assisted by new metrics of economic growth and human well‐being. There is a possibility that paths of economic development will continue to diverge, leading to an ‘enclave’ world with sections of the human population being ‘left behind’ whilst progress continues elsewhere.