It's almost axiomatic that people in rich countries usually enjoy better health and live longer than those in poor countries. North Americas average per capita income is nearly $20,000, for example, and its life expectancy is 75 years, while per capita income in Africa is $600, and life expectancy is 52 years.
With so many developing countries mired in relative poverty, however, its the exceptions to this rule that matter most for improving world health. So argue physicians W. Henry Mosley and Peter Cowley of Johns Hopkins University in a recent report, The Challenge for World Health, published by the Population Reference Bureau. The two researchers note that a number of poor nations have life expectancies almost as long as wealthy countries do.
In China and Sri Lanka, for example, per capita figures for gross national product are just $330 and $420, respectively. Yet the life expectancies in 1990 were 70 and 71 years. Similarly, Jamaica, Chile, Costa Rica, and Malaysia all have per capita gnps of under $2,000 and life expectancies of at least 70 years.
What accounts for this performance? Mosley and Cowley note that the poor nations with high longevity share two key characteristics: high literacy levels among women as well as men, and low fertility rates. While family planning may help in some instances, the researchers observe that educated women tend to have fewer children because their roles in society are not restricted to childbearing and child-rearing.
Good health, concludes the study, can be achieved at relatively low cost. But it requires strong political and social commitment, especially to improve womens education and to ensure equal access to health care.