Asher Rosinger and Ricardo Godoy
Weight and height are critical indicators of short- and long-term human nutrition and health. This chapter reviews secular trends of weight, height, and body mass index (BMI) from studies that relied on primary data of living adults in small-scale, native populations in rural areas of developing nations. Most studies reviewed found trends of increases in weight and BMI over an average study period of 20 years. Women gained an average of 8.8 kg and 3.1 kg/m2, and men gained an average of 5.1 kg and 2.1 kg/m2 over this time span. Additionally, 10 of 13 native populations reviewed had a recent overweight and obesity prevalence of at least 10 percentage points lower than the national averages for men and women combined. In contrast to weight, 12 out of 21 studies found no change (n = 8) or a decline (n = 4) in secular trends of height.
Richard H. Steckel
Beginning with Bismarck’s Germany in the late 19th century, nations gave increasing attention to measures of well-being while traveling the path to welfare states of the 20th century. Following the ascent of the germ theory of disease, governments could play a large and cost-effective role in serving public health and national competitiveness. The Great Depression energized the creation of a second important policy tool, national income accounts. This chapter discusses the evolution and application of biological measures of well-being, with comparisons to per capita gross domestic product from vital registration and life tables to morbidity and to anthropometric measures such as stature, weight, and skeletal remains. Recently, surveys of happiness have entered scholarly debate.
This chapter provides an overview of research primarily within the discipline of economics that empirically examines how biomarkers influences specific health and socioeconomic outcomes. Since the role that biomarkers are hypothesized to play in the estimating equation differs across studies, a distinction is first made between two separate categories of biomarkers: biological time-varying measures such as hormones and biological time-invariant measures including DNA. Recent research in these two categories is then reviewed, focusing on studies that can present the most credible evidence of the role of specific biomarkers. Last, an emerging literature that focuses on the interactions between time-varying environmental conditions and time-invariant genetic factors is discussed. The chapter concludes by highlights three promising areas for future research and suggesting researchers should shift their attention away from investigating specific candidate genes to polygenic risk scores, as well as focus on genetic interactions with more aggregated rather than specific environmental influences.
W. Peter Ward
Birth weight is a biometric measure of well-being widely used as an infant health indicator. It also offers insights into maternal and population health more generally. The most common measures of weight at birth are the mean and the proportion of low birth weight (LBW; less than 2,500 g) infants. LBW neonates experience higher risk of infant morbidity and mortality. Globally, LBW rates average 15%. Wealthy Western societies generally experience the highest mean weights whereas the lowest are found in some of the globe’s poorest nations. Factors affecting newborn weight fall into five categories: genetic, environmental, gestational, socioeconomic, and nutritional. Studies of birth weight concerned with change over time reveal important regional and temporal differences, notably during times of social and economic crisis. Numerous studies have identified relationships between low birth weight and a range of health problems in later life, including hypertension, coronary heart disease and non-insulin-dependent diabetes.
The Causes and Consequences of Increased Female Education and Labor Force Participation in Developing Countries
Rachel Heath and Seema Jayachandran
Two important recent trends in most developing countries are the rise in female labor force participation and the closing of gender gaps in school enrollment. This article begins by exploring the causes of the increases in female education, which include greater job availability and policy interventions that have promoted girls’ education. The article then explores the causes of increased female employment, which include a sectoral shift from “brawn-based” industries to services, as well as policies that have increased girls’ education. The article also discusses the effects of these increases in female education and labor supply, particularly for the well-being of women.
Anthropometric measures in childhood predict the risk of metabolic diseases decades later. Low birthweight and short stature are associated with higher incidence of cardiovascular diseases and type 2 diabetes in adulthood, supporting a hypothesis that early malnutrition has long-lasting adverse effects on metabolism. However, in industrialized countries, overnutrition has replaced undernutrition as a major childhood risk factor of metabolic diseases. Subsequently, body mass index is currently the most important childhood anthropometric indicator predicting the risk of adult metabolic diseases. One unit increase of body mass index at 13 years of age was found to increase the risk of coronary heart disease by 20%. Rapid growth in height in infancy, mid-childhood, and at the start of puberty is also associated with higher risk of coronary heart disease. Physical development over childhood is closely related to nutrition and other environmental factors; these associations indicate the importance of childhood environment for healthy adulthood.
Prashant Bharadwaj and Tom Vogl
This chapter reviews the literature on the effects of aggregate crises on human biological outcomes. The crises considered are acute, severe, and unexpected negative events occurring at the population level: recessions, famines, epidemics, natural and environmental disasters, and wars. A review of the literature suggests that the effects of aggregate crises on human biology are pervasive and long-lasting. More broadly, however, the literature highlights the lasting effects that social, economic, political, environmental, and pathological crises have on the human body. Children, who are never complicit in creating crises, carry the burden of exposure for the rest of their lives. Although advances in methodology and data availability have allowed researchers to uncover these nuanced but powerful effects, much work remains in improving crisis response, especially in poor countries. Such improvements would have beneficial effects long after the acute period of a crisis subsides, on outcomes far beyond its most obvious sequelae.
This article assesses the impact of changing demography on inequality and poverty. Section 2 considers how household living arrangements affect personal economic well-being and its distribution across the population. Section 3 looks at recent evidence on the inequality effects of demographic trends. These trends include the rise of cross-border migration, population ageing, delays in first marriage and first births, increases in the rate of divorce, rising female employment rates, and changes in the correlation of husbands' and wives' earnings. The article concludes with a brief discussion of unresolved issues in assessing the impact of demography on trends in inequality.
Susan L. Averett and Yang Wang
In this chapter, the authors explore the double burden of malnutrition. Although undernutrition remains a pressing issue in developing countries, for many developing nations obesity rates are rising, and obesity is emerging as a significant driver of adverse health outcomes displacing more traditional concerns of malnutrition and infectious disease. For the first time in human history, the number of overweight people rivals the number of underweight people. The chapter begins by defining and documenting the problem, then examines factors leading to its rise. The authors conclude the chapter with a discussion of potential policy responses, along with an economic rationale for such intervention.
This article focuses on education acquisition and inequality, the impact of education on economic and social outcomes and on how changes in education, together with the pattern of demand for skills, affect earnings and income distributions. Section 2 considers research that looks at connections between education acquisition and inequality at different stages of the life cycle. Section 3 discusses the economic impact of education. Section 4 considers how changes in education have altered the distribution of wages and employment and affected labour market inequality. This has become a very large research area, with evidence from many settings showing that education matters more for labour market outcomes than it did in the past. Section 5 offers some conclusions about research in this area, briefly linking it to contemporary discussions about education policy.
Sven E. Wilson
Obesity deserves attention by economists because it has moved to the forefront of public health concerns worldwide and because it is a health condition that defies the general economic pattern that economic prosperity is associated with better health. The economic theory of household behavior and accompanying empirical evidence both suggest that married couples are able to reap the rewards of more efficient investment in health. Obesity, however, is an important exception, with both men and women tending to gain weight following marriage. Wealthier societies should also be able to invest more effectively in child health, but the epidemic of childhood obesity in rich countries counters this trend. This essay argues that the paradoxical economics of obesity must be studied within the primary context where obesity-related decisions are made: the family. Thus, the case of obesity reveals the benefits of and challenges to obtaining a better understanding of familial health capital.
Claus C. Pörtner
Fertility in most developing countries has declined substantially and is in many places now close to replacement level. Despite the large reductions, there are still important outstanding questions when it comes to fertility in developing countries. This chapter examines four of those questions. First, why has Sub-Saharan Africa not seen reductions in fertility as large as other developing countries? Second, what factors determine the timing of fertility, especially for first births, and how is timing related to schooling and labor market outcomes? Third, what is the role of bargaining power when determining fertility? Finally, how do sex preferences affect fertility outcomes? In addition, I discuss the literature on the effectiveness of population policies on both fertility and outcomes such as health and schooling.
Katrin Kromeyer-Hauschild, Anja Moss, and Martin Wabitsch
This chapter reviews the current prevalence of overweight and obesity and trends over time in body mass index (BMI) and in the distribution of BMI worldwide. During the past three decades, a consistent increase in the prevalence of overweight and obesity in children and adults has been documented worldwide, with substantial differences between countries and regions. Evidence shows that the BMI increase began among those born early in the 20th century, with considerable variation over time. Simultaneously, the distribution of BMI has shifted in a skewed fashion, with marked changes in the upper BMI range indicating that the heaviest people have become even heavier whereas lean people have shown only small changes. Rates of the prevalence of underweight children are falling in developing countries with parallel increases in the rates of overweight children as a result of globalization. Underweight, overweight, and obesity still represent a significant health issue.
Nicholas J. Meinzer and Joerg Baten
This chapter traces global trends in physical stature from the Neolithic Agricultural Revolution to modern times. Major cycles in nutritional status and the biological standard of living can be documented across the course of human history as the amount and quality of nutrition changed. In addition, inequality of living standards increased in the more stratified societies that came into being after the Agricultural Revolution. A second major transformation of living standards began with the Industrial Revolution, putting strain on the biological living standards of many populations, especially when accompanied by population growth, market integration, and rising inequality. A rapid increase in physical stature began in Europe only after the 1870s, about a century after the beginning of modern economic growth. Global studies on height inequality indicate a long-run decline of inequality during the late 19th and early 20th century in Europe. Inequality trends are related to important societal-level outcomes.
Growth and Maturation of Children and Adolescents: Variability Due to Genetic and Environmental Factors
Alan D. Rogol
Normal growth of a child or adolescent likely indicates his or her good general health and well-being. However, there is great variability in the heights and weights that are within the range of normal. Abnormally slow growth may indicate a pathological process or disruption of the environment. Height is a genetically determined parameter, but, at least in the human, it is affected by the interactions of hundreds of genes. In otherwise well children, perhaps 80% of the variance is inherited. Pubertal maturation follows a “fixed” sequence in boys and girls, but its timing and tempo are both determined by the interactions of multiple genes. Environmental effects may play a role in the early initiation of puberty in the obese and the delayed initiation in those with caloric deprivation. Subjects with pathologic growth trajectories deserve medical evaluation because those processes may be abrogated with proper treatment.
Early-life growth faltering is widespread: approximately170 million children under 5 years old are stunted. Growth faltering in the first thousand days (FTD) after conception is associated negatively with educational, labor market, marriage market, adult health, and intergenerational outcomes. This chapter looks at pertinent questions: is FTD growth faltering immutable, or is catch-up growth possible? Do associations with important subsequent outcomes hold only for FTD nutritional status, or are there also associations of later nutritional status with such outcomes? Do associations between FTD nutritional status and life cycle outcomes imply causality? These questions and the assumptions underlying current analyses lead to a more nuanced understanding of FTD growth faltering suggesting that it is not immutable and that there are significant associations between nutritional status beyond 2 years with important outcomes such as cognitive status. Important underresearched issues remain, including persuasively identifying the causal effects of both FTD and subsequent nutritional status.
Andrew Leigh, Christopher Jencks, and Timothy M. Smeeding
This article deals with the relationship between economic inequality and health. It first reviews the most common hypotheses about how inequality might affect health and vice versa. It then turns to an assessment of the empirical evidence for a link between health and inequality. It emphasizes that the cross-sectional relationship between inequality and health is quite likely to provide biased estimates so use of panel data and appropriate techniques represents a significant advance in the literature to date. The evidence for a relationship between inequality and health (in either direction) is found to be weak, and the field is characterized as one with too many theories for the number of available data points at this time.
Darius N. Lakdawalla and Julian Reif
The rise in obesity has generated enormous concern among policy makers and the general public. Economists have focused on explaining the causes of this rise, along with the attendant implications for public policy. This chapter summarizes the economic literature on the theory of weight determination, including the optimal determination of food intake and exercise, and the influence of prices and peer effects. In addition, the chapter reviews the empirical literature that tests a range of explanations for the rise in obesity, such as declining food prices, increasing price of exercise, rising income, peer effects, and the decline in cigarette consumption.
This chapter discusses the relationship between height and wages under a theoretical and empirical perspective. Many channels explain why height and wage are positively correlated. A major strand is based on unobserved cognitive and physical abilities that are connected with height and that influence wages. Further indirect links are possible via schooling, health, and risk aversion. Finally, discrimination and satisfaction are possible potential causes that a statistical association is well-founded. Most empirical investigations only analyze a direct linear relationship and find a positive height premium roughly between less than 1% and 10% due to an increase of 10 cm in height. The applied methods can partially explain the differences. Measurement errors, unobserved heterogeneity, endogeneity, and nonlinearities are methodological problems that should be considered. Moreover, the height premium varies with the specification. The incorporation of nutrition, health, education, leadership, physical capacity, age, weight, and, especially, gender influence estimation results.
Michael W. Kaganovich
The combination of high achievement in all measures of educational attainment with laggard levels of labor productivity is a peculiar legacy of post-Soviet Russia that has given the impetus for reform of its higher education system. The chapter analyzes the development of a mixed (two-track) system of higher education admission and financing in Russia whose unique feature is an extreme form of merit-based price discrimination and examines the implications of this system for the distribution and sustainability of educational attainment in Russia. International comparisons to alternative systems of higher education provision are discussed from the standpoints of accessibility and efficiency.