Special report: Business books quarterly

Economic inequalityIn sickness and in health

Measuring fairness

The Great Escape: Health, Wealth, and the Origins of Inequality. By Angus Deaton. Princeton University Press; 360 pages; $29.95 and £19.95. Buy from Amazon.com, Amazon.co.uk


Pessimistic commentators will point out that income gaps between countries have failed to narrow over the past 50 years. This overall lack of convergence is surprising since in principle the more backward an economy the greater its scope for rapid catch-up growth. Some countries, such as Malaysia and Thailand, have realised that potential. But others, especially African states like Congo and Niger, have actually become poorer.

But focusing on gaps between states, many of which are small, neglects the fact that the two countries with the biggest populations, China and India, have been growing rapidly for decades. China’s economic miracle has been pivotal in bringing down global poverty from around 1.5 billion in the early 1980s to 800m. Even though China itself is becoming more unequal (as are advanced countries like America), the fast growth of such a big, poor country should be enough to bring down global inequality.

That appraisal rests on what has been happening to incomes or GDP per person, assuming that actual growth in China and India has been as fast as officially stated. One particular strength of Mr Deaton’s approach is that he does not confine his investigation to material living standards. Not only are people becoming more prosperous but also they are living longer and are taller and stronger. When improvements in health are taken into account, even more inroads are being made into global inequality. The gap between life expectancy in advanced countries and the developing world has shrunk since the second world war.


The starkest evidence of the inequality arising from uneven progress is the plight of the billion or so people stuck in developing countries who still live in abject poverty and have low life expectancy. Should the more fortunate, enjoying longer and more affluent lives, give more money to help them? No, argues Mr Deaton in the most controversial part of his book. He takes aim at global aid, arguing that with the exception of some health programmes it generally does more harm than good (a critique made long ago by Peter Bauer of the London School of Economics).


“The Great Escape” covers a lot of ground and there will be points that other scholars may dispute, such as what caused life expectancy to rise in countries like Britain before the medical advances of the post-war period. But the theme requires a big canvas and bold brushwork, and Mr Deaton capably offers both.

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