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Great Escape Health, Wealth, and the Origins of Inequality
A Nobel Prize-winning economist tells the remarkable story of how the world has grown healthier, wealthier, but also more unequal over the past two and half centuries
The world is a better place than it used to be. People are healthier, wealthier, and live longer. Yet the escapes from destitution by so many has left gaping inequalities between people and nations. In The Great Escape, Nobel Prize-winning economist Angus Deaton--one of the foremost experts on economic development and on poverty--tells the remarkable story of how, beginning 250 years ago, some parts of the world experienced sustained progress, opening up gaps and setting the stage for today's disproportionately unequal world. Deaton takes an in-depth look at the historical and ongoing patterns behind the health and wealth of nations, and addresses what needs to be done to help those left behind.
Deaton describes vast innovations and wrenching setbacks: the successes of antibiotics, pest control, vaccinations, and clean water on the one hand, and disastrous famines and the HIV/AIDS epidemic on the other. He examines the United States, a nation that has prospered but is today experiencing slower growth and increasing inequality. He also considers how economic growth in India and China has improved the lives of more than a billion people. Deaton argues that international aid has been ineffective and even harmful. He suggests alternative efforts--including reforming incentives to drug companies and lifting trade restrictions--that will allow the developing world to bring about its own Great Escape.
Demonstrating how changes in health and living standards have transformed our lives, The Great Escape is a powerful guide to addressing the well-being of all nations.
The world is a better place than it used to be. People are healthier, wealthier, and live longer. Yet the escapes from destitution by so many has left gaping inequalities between people and nations. In The Great Escape, Nobel Prize-winning economist Angus Deaton--one of the foremost experts on economic development and on poverty--tells the remarkable story of how, beginning 250 years ago, some parts of the world experienced sustained progress, opening up gaps and setting the stage for today's disproportionately unequal world. Deaton takes an in-depth look at the historical and ongoing patterns behind the health and wealth of nations, and addresses what needs to be done to help those left behind.
Deaton describes vast innovations and wrenching setbacks: the successes of antibiotics, pest control, vaccinations, and clean water on the one hand, and disastrous famines and the HIV/AIDS epidemic on the other. He examines the United States, a nation that has prospered but is today experiencing slower growth and increasing inequality. He also considers how economic growth in India and China has improved the lives of more than a billion people. Deaton argues that international aid has been ineffective and even harmful. He suggests alternative efforts--including reforming incentives to drug companies and lifting trade restrictions--that will allow the developing world to bring about its own Great Escape.
Demonstrating how changes in health and living standards have transformed our lives, The Great Escape is a powerful guide to addressing the well-being of all nations.
376 pages, Paperback
First published September 22, 2013
About the author
Angus Deaton
42 books168 followersAngus Stewart Deaton is a British and American economist. In 2015, he was awarded the Nobel Memorial Prize in Economic Sciences for his analysis of consumption, poverty, and welfare.
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Displaying 1 - 30 of 196 reviews
October 15, 2022
Feb. 2017 update: I am lowering my rating from 3 stars to 1, because I think that so-called experts just B.S.ing on important matters is too dangerous to be tolerated anymore. Please see comment stream below for more details.
2022 update: If you disagree with this review and want to comment, please try to include something more than insults or nonsense. I say this as a favor to you. It only weakens your case to leave comments that are completely devoid of substance or that contain verifiably false claims.
The Great Escape is a mix of brilliant insights and bizarre nonsense. Millions of children die each year of easily preventable diseases, but Deaton argues that they do not need help. This is an outrageously convenient excuse for those in power. His absurd conclusion comes from getting many facts wrong. The books highlighted below address those individual issues more accurately.
-Nutrition: He tells us Henry VIII was fat but still sick, so feeding people isn't really important. Forgetting about the obesity issue, Deaton is missing the point that adequate vitamin/nutrient intake is important for preventing disease; one can be overweight and still dangerously malnourished.
RX for Survival: Why We Must Rise to the Global Health Challenge
-Sanitation, public health: The sanitarian movement was based on science done by the likes of Florence Nightingale who demonstrated objectively that hygiene saved lives. The actual historical facts tell us that what worked in the past to increase life expectancy was collective action in public health, nutrition, housing, sanitation, etc. Deaton instead emphasizes laboratory science and Germ Theory. These are nice but not very relevant to the historical shift he is trying to explain (because the Epidemiologic Transition happened well before the advent of antibiotics, etc.).
The Great Filth: The War Against Disease in Victorian England
The Role Of Medicine: Dream, Mirage, Or Nemesis?
-New project evaluation: Deaton takes a nihilistic approach to evaluating what works, making the straw man argument that a single study doesn't prove generalizability. So what? We don't have a problem with too much evaluation in poor countries. Even in rich-country medicine, we have a problem with scaling up things that were never proven to work in the first place.
Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients
The Idealist: Jeffrey Sachs and the Quest to End Poverty
-Foreign aid: Deaton's comments on LARGE SCALE AID are nothing new. Rich nations should stop actively hurting poor nations. But he doesn't talk enough about SMALL SCALE AID that does work. There are many NGOs working with villagers in the poorest places on Earth, implementing evidence-based interventions that are improving health and wealth.
Confessions of an Economic Hit Man.
Give a Little: How Your Small Donations Can Transform Our World
.
-Economic development: Deaton says it is too hard to learn from previous examples what poor countries can do for themselves to get out of poverty, because it's all coincidences. Seriously?
Bad Samaritans: The Myth of Free Trade and the Secret History of Capitalism
23 Things They Don't Tell You About Capitalism
2022 update: If you disagree with this review and want to comment, please try to include something more than insults or nonsense. I say this as a favor to you. It only weakens your case to leave comments that are completely devoid of substance or that contain verifiably false claims.
The Great Escape is a mix of brilliant insights and bizarre nonsense. Millions of children die each year of easily preventable diseases, but Deaton argues that they do not need help. This is an outrageously convenient excuse for those in power. His absurd conclusion comes from getting many facts wrong. The books highlighted below address those individual issues more accurately.
-Nutrition: He tells us Henry VIII was fat but still sick, so feeding people isn't really important. Forgetting about the obesity issue, Deaton is missing the point that adequate vitamin/nutrient intake is important for preventing disease; one can be overweight and still dangerously malnourished.
RX for Survival: Why We Must Rise to the Global Health Challenge
-Sanitation, public health: The sanitarian movement was based on science done by the likes of Florence Nightingale who demonstrated objectively that hygiene saved lives. The actual historical facts tell us that what worked in the past to increase life expectancy was collective action in public health, nutrition, housing, sanitation, etc. Deaton instead emphasizes laboratory science and Germ Theory. These are nice but not very relevant to the historical shift he is trying to explain (because the Epidemiologic Transition happened well before the advent of antibiotics, etc.).
The Great Filth: The War Against Disease in Victorian England
The Role Of Medicine: Dream, Mirage, Or Nemesis?
-New project evaluation: Deaton takes a nihilistic approach to evaluating what works, making the straw man argument that a single study doesn't prove generalizability. So what? We don't have a problem with too much evaluation in poor countries. Even in rich-country medicine, we have a problem with scaling up things that were never proven to work in the first place.
Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients
The Idealist: Jeffrey Sachs and the Quest to End Poverty
-Foreign aid: Deaton's comments on LARGE SCALE AID are nothing new. Rich nations should stop actively hurting poor nations. But he doesn't talk enough about SMALL SCALE AID that does work. There are many NGOs working with villagers in the poorest places on Earth, implementing evidence-based interventions that are improving health and wealth.
Confessions of an Economic Hit Man.
Give a Little: How Your Small Donations Can Transform Our World
.
-Economic development: Deaton says it is too hard to learn from previous examples what poor countries can do for themselves to get out of poverty, because it's all coincidences. Seriously?
Bad Samaritans: The Myth of Free Trade and the Secret History of Capitalism
23 Things They Don't Tell You About Capitalism
August 14, 2017
Deaton's tome combines a tad dry presentation with incredibly informative and well-argued contents. Summarizes decades worth of research. Provides some good work on development, growth and wealth creation, with a special focus on public health improvements.
Among its highlights, the book offers a strident critique of foreign aid and technocratic management from an institutional point of view. Deaton acknowledges that aid programmes can do a lot of good, especially if they are given with conditions that prevent corrupt and oppressive governments from stealing the money. Free cash to bad regimes prevents local economic and political development, claims Deaton, and local solutions and narrow health targeting should be favoured instead. "First do no harm" should be our policy concern instead of know-it-all meddling. He claims that "large scale aid does not work because it CANNOT work." Good aims do not automatically lead to good results due to (predictably unpredictable) unintended consequences.
Whether Deaton goes too far in his analysis of foreign aid or not, his sensible analysis, in this and in other issues, is worth reading for all students of economic and political development.
Among its highlights, the book offers a strident critique of foreign aid and technocratic management from an institutional point of view. Deaton acknowledges that aid programmes can do a lot of good, especially if they are given with conditions that prevent corrupt and oppressive governments from stealing the money. Free cash to bad regimes prevents local economic and political development, claims Deaton, and local solutions and narrow health targeting should be favoured instead. "First do no harm" should be our policy concern instead of know-it-all meddling. He claims that "large scale aid does not work because it CANNOT work." Good aims do not automatically lead to good results due to (predictably unpredictable) unintended consequences.
Whether Deaton goes too far in his analysis of foreign aid or not, his sensible analysis, in this and in other issues, is worth reading for all students of economic and political development.
November 21, 2013
By Edward Hadas
It is easy to tell grim stories about the world economy. A billion people still live in desperate poverty. The world’s rich are pulling further away from the poor. Many developed economies are still in a rut, five years after a financial crisis. In “The Great Escape”, Angus Deaton provides a more optimistic, and much more accurate, narrative.
The Princeton economics professor offers a helpful mix of statistics, explanation, analysis and anecdote. He starts with the tale of his own family’s five-generation transition from impoverished Yorkshire agricultural labourer to American hedge fund manager. Expand that example by a factor of a million and you have the economic history of much of Europe, Japan and North America. Magnify by the billion and you get the likely future trajectory for most of the world.
Like most development economists, Deaton is most comfortable with numbers, particularly levels of GDP and GDP growth rates. In places, a more qualitative discussion might have been more persuasive. What is important is not whether a poor country’s GDP is more accurately described as 20 or 40 percent of the U.S. level, but whether the people there are well fed, housed and educated. Yet his graphics and statistical explanations are clear and his technical discussions are accessible.
Deaton dedicates almost half the book to the history of health. The numbers he deploys are illuminating and his digressions on various professional puzzles bolster what amounts to a great story. As he shows, there have been massive improvements in health in rich and most poor countries. The improvement, moreover, shows no sign of stopping.
The author is clearly worried by the increase in global inequality that shows up in GDP calculations. He might have taken more comfort from the spread of the most important products of industrial prosperity - clean water, good food and basic goods. Deaton seems only intermittently aware that inequality in adjusted cash income is quite different from inequality in enjoyment of the fullness of economic life.
“The Great Escape” sometimes seems to try to be gloomy. The historical facts Deaton presents are undoubtedly encouraging. Human ingenuity has solved so many problems that were once considered intractable. No wonder that after admitting the inevitability of “bad things”, Deaton concludes the book with modest but firm optimism: “I expect those setbacks to be overcome in the future, as they have been in the past.”
In many ways, the best chapter of the book is the last. “How to help those left behind” is a thorough and thoughtful condemnation of foreign aid. The basic arguments - that direct aid mostly does not help and often makes bad governments worse - are hardly new, but they are presented succinctly, fairly and clearly. Foreign aid, he says, is largely a salve for the donors’ consciences. There are much more effective ways to help equalise the world economy. For example, Deaton suggests subsidies for the development of drugs against such diseases as malaria, which mostly plague poor people. His agenda also includes a more generous attitude to immigration.
As the title of his book suggests, Deaton sketches out the story of how many people have escaped from poverty and early death. It is a powerful tale. In Deaton’s hands, the all too frequently forgotten accomplishments of the last century are given prominence that is both refreshing and welcome.
It is easy to tell grim stories about the world economy. A billion people still live in desperate poverty. The world’s rich are pulling further away from the poor. Many developed economies are still in a rut, five years after a financial crisis. In “The Great Escape”, Angus Deaton provides a more optimistic, and much more accurate, narrative.
The Princeton economics professor offers a helpful mix of statistics, explanation, analysis and anecdote. He starts with the tale of his own family’s five-generation transition from impoverished Yorkshire agricultural labourer to American hedge fund manager. Expand that example by a factor of a million and you have the economic history of much of Europe, Japan and North America. Magnify by the billion and you get the likely future trajectory for most of the world.
Like most development economists, Deaton is most comfortable with numbers, particularly levels of GDP and GDP growth rates. In places, a more qualitative discussion might have been more persuasive. What is important is not whether a poor country’s GDP is more accurately described as 20 or 40 percent of the U.S. level, but whether the people there are well fed, housed and educated. Yet his graphics and statistical explanations are clear and his technical discussions are accessible.
Deaton dedicates almost half the book to the history of health. The numbers he deploys are illuminating and his digressions on various professional puzzles bolster what amounts to a great story. As he shows, there have been massive improvements in health in rich and most poor countries. The improvement, moreover, shows no sign of stopping.
The author is clearly worried by the increase in global inequality that shows up in GDP calculations. He might have taken more comfort from the spread of the most important products of industrial prosperity - clean water, good food and basic goods. Deaton seems only intermittently aware that inequality in adjusted cash income is quite different from inequality in enjoyment of the fullness of economic life.
“The Great Escape” sometimes seems to try to be gloomy. The historical facts Deaton presents are undoubtedly encouraging. Human ingenuity has solved so many problems that were once considered intractable. No wonder that after admitting the inevitability of “bad things”, Deaton concludes the book with modest but firm optimism: “I expect those setbacks to be overcome in the future, as they have been in the past.”
In many ways, the best chapter of the book is the last. “How to help those left behind” is a thorough and thoughtful condemnation of foreign aid. The basic arguments - that direct aid mostly does not help and often makes bad governments worse - are hardly new, but they are presented succinctly, fairly and clearly. Foreign aid, he says, is largely a salve for the donors’ consciences. There are much more effective ways to help equalise the world economy. For example, Deaton suggests subsidies for the development of drugs against such diseases as malaria, which mostly plague poor people. His agenda also includes a more generous attitude to immigration.
As the title of his book suggests, Deaton sketches out the story of how many people have escaped from poverty and early death. It is a powerful tale. In Deaton’s hands, the all too frequently forgotten accomplishments of the last century are given prominence that is both refreshing and welcome.
March 24, 2018
Deaton has some interesting thoughts on rising inequality, and the dangers it presents to societies. He traces the development of the kinds of economic growth that can contribute to the rich getting richer without everyone else keeping up, and the insidious ways this dynamic perpetuates itself.
On the other hand, Deaton draws some conclusions about the efficacy of evaluating pilot projects (useless and scaling almost never works) and aid to poor countries (useless and no one successful ever got aid) that I think are not well supported.
On the other hand, Deaton draws some conclusions about the efficacy of evaluating pilot projects (useless and scaling almost never works) and aid to poor countries (useless and no one successful ever got aid) that I think are not well supported.
May 31, 2016
Very good read, even though the author jumps between issues. Many points are discussed and underlined with metrics, how to interpret them, and their limits in usefulness. You get a feeling that it is written from an American (USA) audience since so many issues are repeated over and over again.
The books covers the "great escape" from poverty and lack of wellbeing since the onset of the industrial revolution. The progress has obviously not always and not everywhere been as improvements. Wars, pandemics, societal and physical infrastructures, local, national and international policies influence how well improvements are maintained (or not).
The author makes a very convincing case that monetary aid to governments is not the best way to promote the "great escape" of the countries that still lag behind compared with the "best performers". (Nor has it been that in the past).
The language is very approachable even with the tough issues that the books covers. Mostly the author seems to grasp the difference between theory (germ theory of disease) and hypothesis. Which is not common among economists.
Overall I think this book is a great and rewarding read.
The books covers the "great escape" from poverty and lack of wellbeing since the onset of the industrial revolution. The progress has obviously not always and not everywhere been as improvements. Wars, pandemics, societal and physical infrastructures, local, national and international policies influence how well improvements are maintained (or not).
The author makes a very convincing case that monetary aid to governments is not the best way to promote the "great escape" of the countries that still lag behind compared with the "best performers". (Nor has it been that in the past).
The language is very approachable even with the tough issues that the books covers. Mostly the author seems to grasp the difference between theory (germ theory of disease) and hypothesis. Which is not common among economists.
Overall I think this book is a great and rewarding read.
April 6, 2017
Has the human race made progress since the days when all our lives were nasty, brutish, and short?
Some might think this question patently silly, since it would appear to answer itself. But Angus Deaton finds in it a point of entry into his inquiry on “health, wealth, and the origins of inequality,” the subtitle of his ambitious new book. He is in no doubt that humanity has progressed, not steadily but by fits and starts — and continues to do so to this day. “Today,” he writes, “children in sub-Saharan Africa are more likely to survive to age 5 than were English children born in 1918 . . . [and] India today has higher life expectancy than Scotland in 1945.”
In The Great Escape, Deaton, a veteran professor of economics and international affairs at Princeton, explores inequality — between classes and between countries — with a detailed statistical analysis of trends in infant mortality, life expectancy, and income levels over the past 250 years. He concludes that the large-scale inequality that plagues policymakers and reformers alike in the present day is the result of the progress humanity has made since The Great Divergence (between “the West and the rest”) since the advent of the Industrial Revolution. “Economic growth,” Deaton asserts, “has been the engine of international income inequality.”
No argument there: Deaton is far from alone in this belief. Other scholars have written extensively about this topic in recent years. A Farewell to Alms: A Brief Economic History of the World, by Gregory Clark, is just one example.
Late in the 18th Century, the countries of Northern Europe and North America on the one hand and those of Asia, Africa, the Middle East, and Latin America on the other hand were not that far apart as measured by the available indicators of health and income. Deaton cites “one careful study [that] estimates that the average income of all the inhabitants of the world increased between seven and eight times from 1820 to 1992.” However, that average obscures a harsh reality. The ever-quickening rate of change in “the West” since 1760 or so has widened the gap between (and within) countries to an extreme degree. Deaton terms the freedom from destitution and early death that so many of us now enjoy “The Great Escape,” taking his title from the 1963 film of that name about a massive escape of prisoners from a German P.O.W. camp in World War II.
Only now is the gap closing between the rich nations and China and India (by far the world’s two biggest countries, with nearly 40 percent of the planet’s population and half the world’s poor). Deaton doesn’t consider a bright future for all a certainty, not by any means, in view of global climate change and the ever-present threat of killer pandemics. But, assuming the species continues to thrive, there is sufficient data available now to have some confidence that the gross inequality now existing among nations will not persist forever. After all, five sub-Saharan African countries are now growing their economies faster than China’s.
However, that misleading factoid ignores the outsize role that China has played in “the Great Escape” globally. Deaton notes, as have other observers, that “the number [of] people in the world living on less than a (2005) dollar a day fell from about 1.5 billion in 1981 to 805 million in 2008 . . . [This] decline in numbers is driven almost entirely by the Chinese growth miracle; if China is excluded, 785 million people lived on less than a dollar a day in 1981 compared with 708 million in 2008.” (This reality is one of the principal reasons why Paul Polak and I insist in The Business Solution to Poverty that traditional methods to end poverty have largely failed. After all, China’s methods were hardly traditional!)
In the course of exploring the historical record of growing inequality on the world stage, Deaton delves deeply into the role of foreign aid (officially, Overseas Development Assistance, or ODA) and finds it comes up short. ”You cannot develop other countries from the outside with a shopping list for Home Depot, no matter how much you spend,” he writes. With the exception of outside interventions in public health programs — including such breakthroughs as the eradication of smallpox and the near-success with polio — Deaton finds that foreign aid has done more harm than good. He argues that where the conditions for development are present, outside resources are unnecessary. Where they’re absent, ODA entrenches local elites, distorts the local economy, and discourages local initiative. The author insists that “the record of aid shows no evidence of any overall beneficial effect.”
But that’s only part of the story.
In 2012, ODA totaled about $136 billion. Throw in another $30 billion or so from NGOs, and total outside assistance comes to under $200 billion annually. However, net resource transfers from developing countries to rich countries are well in excess of $500 billion annually. (Transfers reached a peak of $881 billion in 2007, fell with the Great Recession, but are rising again.) Quite apart from the fact that an estimated 70 percent of “foreign aid” is actually spent on products and services from donor nations, ODA merely puts a dent in the huge disadvantage that poor countries suffer as a result of lopsided trade policies and prevailing political and commercial imbalances. In any case, just one factor in those resource flows — remittances from overseas residents of poor countries to their families back home — are twice as large as ODA.
The Great Escape is a worthy effort from a senior scholar whose wide-ranging studies have led him to big-picture conclusions. Policymakers and practitioners should be listening carefully.
Some might think this question patently silly, since it would appear to answer itself. But Angus Deaton finds in it a point of entry into his inquiry on “health, wealth, and the origins of inequality,” the subtitle of his ambitious new book. He is in no doubt that humanity has progressed, not steadily but by fits and starts — and continues to do so to this day. “Today,” he writes, “children in sub-Saharan Africa are more likely to survive to age 5 than were English children born in 1918 . . . [and] India today has higher life expectancy than Scotland in 1945.”
In The Great Escape, Deaton, a veteran professor of economics and international affairs at Princeton, explores inequality — between classes and between countries — with a detailed statistical analysis of trends in infant mortality, life expectancy, and income levels over the past 250 years. He concludes that the large-scale inequality that plagues policymakers and reformers alike in the present day is the result of the progress humanity has made since The Great Divergence (between “the West and the rest”) since the advent of the Industrial Revolution. “Economic growth,” Deaton asserts, “has been the engine of international income inequality.”
No argument there: Deaton is far from alone in this belief. Other scholars have written extensively about this topic in recent years. A Farewell to Alms: A Brief Economic History of the World, by Gregory Clark, is just one example.
Late in the 18th Century, the countries of Northern Europe and North America on the one hand and those of Asia, Africa, the Middle East, and Latin America on the other hand were not that far apart as measured by the available indicators of health and income. Deaton cites “one careful study [that] estimates that the average income of all the inhabitants of the world increased between seven and eight times from 1820 to 1992.” However, that average obscures a harsh reality. The ever-quickening rate of change in “the West” since 1760 or so has widened the gap between (and within) countries to an extreme degree. Deaton terms the freedom from destitution and early death that so many of us now enjoy “The Great Escape,” taking his title from the 1963 film of that name about a massive escape of prisoners from a German P.O.W. camp in World War II.
Only now is the gap closing between the rich nations and China and India (by far the world’s two biggest countries, with nearly 40 percent of the planet’s population and half the world’s poor). Deaton doesn’t consider a bright future for all a certainty, not by any means, in view of global climate change and the ever-present threat of killer pandemics. But, assuming the species continues to thrive, there is sufficient data available now to have some confidence that the gross inequality now existing among nations will not persist forever. After all, five sub-Saharan African countries are now growing their economies faster than China’s.
However, that misleading factoid ignores the outsize role that China has played in “the Great Escape” globally. Deaton notes, as have other observers, that “the number [of] people in the world living on less than a (2005) dollar a day fell from about 1.5 billion in 1981 to 805 million in 2008 . . . [This] decline in numbers is driven almost entirely by the Chinese growth miracle; if China is excluded, 785 million people lived on less than a dollar a day in 1981 compared with 708 million in 2008.” (This reality is one of the principal reasons why Paul Polak and I insist in The Business Solution to Poverty that traditional methods to end poverty have largely failed. After all, China’s methods were hardly traditional!)
In the course of exploring the historical record of growing inequality on the world stage, Deaton delves deeply into the role of foreign aid (officially, Overseas Development Assistance, or ODA) and finds it comes up short. ”You cannot develop other countries from the outside with a shopping list for Home Depot, no matter how much you spend,” he writes. With the exception of outside interventions in public health programs — including such breakthroughs as the eradication of smallpox and the near-success with polio — Deaton finds that foreign aid has done more harm than good. He argues that where the conditions for development are present, outside resources are unnecessary. Where they’re absent, ODA entrenches local elites, distorts the local economy, and discourages local initiative. The author insists that “the record of aid shows no evidence of any overall beneficial effect.”
But that’s only part of the story.
In 2012, ODA totaled about $136 billion. Throw in another $30 billion or so from NGOs, and total outside assistance comes to under $200 billion annually. However, net resource transfers from developing countries to rich countries are well in excess of $500 billion annually. (Transfers reached a peak of $881 billion in 2007, fell with the Great Recession, but are rising again.) Quite apart from the fact that an estimated 70 percent of “foreign aid” is actually spent on products and services from donor nations, ODA merely puts a dent in the huge disadvantage that poor countries suffer as a result of lopsided trade policies and prevailing political and commercial imbalances. In any case, just one factor in those resource flows — remittances from overseas residents of poor countries to their families back home — are twice as large as ODA.
The Great Escape is a worthy effort from a senior scholar whose wide-ranging studies have led him to big-picture conclusions. Policymakers and practitioners should be listening carefully.
May 7, 2018
I didn't know when I picked this up how much of a review of my own education and experience it would be, but I'd happily force a high school or uni student with little knowledge to read it as a course requirement. It's a great, comprehensive primer for people interested in global development and public health/administration, as well an antidote to neoliberal economics. It's heavy on the demographics and light on the case studies, which makes for dry reading, but those demographics merely reinforce Deaton's rational, clear-eyed explanations of trends and statistics. I know that he's gotten some flack for the seventh chapter, but he didn't say anything that Dambisa Moyo didn't in Dead Aid, and, on most of it, he's right.
May 28, 2016
Saúde e Longevidade Ainda Não Chegam a Todos
Saúde e Longevidade Já se Podem Comprar
Mas Nem Todos as Conseguem Alcançar!
Nota: Para quem preferir, existe uma edição em português intitulada "A Grande Evasão"
Saúde e Longevidade Já se Podem Comprar
Mas Nem Todos as Conseguem Alcançar!
Nota: Para quem preferir, existe uma edição em português intitulada "A Grande Evasão"
January 13, 2018
There is no more controversial of the social sciences these days than the study of economics. Yes, a social science – the study of human interactions; and though it does contain laws (supply and demand, unintended outcomes) proven and repeatable, it is still after all just about humans. Of course, many people want us to forget that; those who want to use economics to advance their political projects (Marxists and socialists) and their unscrupulous defenders (Paul Krugman, cough… cough…)
Controversial, because economics is always used these days in the defense of violence. Who can take my property, break up my company, force what should be free interactions with those to whom I seek to engage in the trade of goods and services – and why. Of course the most evil man of all time – Karl Marx – was an economist. And a bad one, his children starved to death and committed suicide. That certainly isn’t a recipe for a ‘life more abundant’.
Because THAT is what economics should be about; and that is what Angus Deaton’s thoughtful book “The Great Escape: Health, Wealth and the Origins of Inequality” is about. It is an attempt to understand, as he eloquently states, “…the endless dance between progress and inequality, about how progress creates inequality, and how inequality can sometimes be helpful – showing others the way, or providing incentives for catching up – and sometimes unhelpful – when those who have escaped protect their positions by destroying the escape routes behind them.”
The book delves into two main areas of human existence which are illustrative of humanity’s recent (and dramatic) escape from ‘misery’: the increase in life expectancy and the increase in income (material well-being). The Industrial Revolution, the “Great Divergence”, measuring the progress that has allowed life for the average middle-class American to be better than even that of the Pharaohs of old. It is an optimistic story: yes India and China are emerging so quickly from poverty that it gives reason for hope. It is a sad story: Africa is worse off now than it was when measurements of poverty started.
As a serious economist, Deaton does not offer prescriptive answers – instead merely laying out facts and hypothesizing as to why they are, and what might be required for things to change. Good economists help us see patterns, what helps ‘make things better’ and what ‘makes things worse’ and encourage us to follow small decisions one after another as they lead us to well-being. This is why ideological economists advocating utopias and recipes of how to achieve them are so dangerous; because as Hayek said, “To act on the belief that we possess the knowledge and the power which enable us to shape the processes of society entirely to our liking, knowledge which in fact we do not possess, is likely to make us do much harm.”
I do have a couple of caveats – Deaton rightly highlights the fact that there is no proof that the dramatic increase in the population of the planet has resulted in increased poverty, as Thomas Malthus famously worried, but in fact the opposite has been true. I am not as sanguine as Deaton on this – but I have lived my entire adult life in countries ravaged by poverty; where all the trees have been chopped for firewood and animals eaten to stave off hunger – and I think we’re on the verge of combustion. Perhaps I’m wrong to be pessimistic about “the arriving ordeal”; but I doubt it. My next concern is the use of traditional measurements of poverty, especially in the third world. While $2 a day might be what the World Bank says is destitution, “a life more abundant” requires significantly more. Others have flirted with the idea of a “happiness index” to capture not monetary but quality of life indexes, but these are imperfect as happiness is too subjective an idea. I prefer a “choices based” approach to well-being – because a life more abundant is a result of our ability to choose products, careers, vacations, the number of our children and so on. I don’t know of any economist who has thought of such a scale, more on that later. All that to say is, stating “650 million Chinese escaped extreme poverty” says little about the real improvement in their lives; the threshold seems arbitrary. Same is true for health – while the reduction of infant mortality has increased life expectancy the world over (except for Africa) to about 70 years, it says nothing of the quality of those years – and let’s be honest, compared to Methuselah 70 years is a paltry sum indeed. I also doubt the permanence of our “escape”, given humanity’s penchant for reinventing misery. Deaton recognizes all this, and this is not a criticism except that the title of the book is a little self-congratulatory.
Finally, the end of the book goes into the relatively new field of Foreign Assistance (International Aid). “It is not surprising,” Deaton says, “that, in spite of the direct effects of aid that are often positive, the record of aid shows no evidence of any overall beneficial effect.” This is of course true, and he helpfully and correctly explains the problem with the “tyranny of foreign good intentions”; our foreign assistance is government to government. Never in the history of history has government intervention sparked development. Our own disastrous “New Deal” and “War on Poverty” efforts demonstrate this. And large sums unbalance democracies and cement tyrannies. No, it is best to remember (as Deaton reminds us) that government sets the table; government codes the rules and makes sure everybody is playing fair – but the story of human development is written by the ingenuity of individual people.
Controversial, because economics is always used these days in the defense of violence. Who can take my property, break up my company, force what should be free interactions with those to whom I seek to engage in the trade of goods and services – and why. Of course the most evil man of all time – Karl Marx – was an economist. And a bad one, his children starved to death and committed suicide. That certainly isn’t a recipe for a ‘life more abundant’.
Because THAT is what economics should be about; and that is what Angus Deaton’s thoughtful book “The Great Escape: Health, Wealth and the Origins of Inequality” is about. It is an attempt to understand, as he eloquently states, “…the endless dance between progress and inequality, about how progress creates inequality, and how inequality can sometimes be helpful – showing others the way, or providing incentives for catching up – and sometimes unhelpful – when those who have escaped protect their positions by destroying the escape routes behind them.”
The book delves into two main areas of human existence which are illustrative of humanity’s recent (and dramatic) escape from ‘misery’: the increase in life expectancy and the increase in income (material well-being). The Industrial Revolution, the “Great Divergence”, measuring the progress that has allowed life for the average middle-class American to be better than even that of the Pharaohs of old. It is an optimistic story: yes India and China are emerging so quickly from poverty that it gives reason for hope. It is a sad story: Africa is worse off now than it was when measurements of poverty started.
As a serious economist, Deaton does not offer prescriptive answers – instead merely laying out facts and hypothesizing as to why they are, and what might be required for things to change. Good economists help us see patterns, what helps ‘make things better’ and what ‘makes things worse’ and encourage us to follow small decisions one after another as they lead us to well-being. This is why ideological economists advocating utopias and recipes of how to achieve them are so dangerous; because as Hayek said, “To act on the belief that we possess the knowledge and the power which enable us to shape the processes of society entirely to our liking, knowledge which in fact we do not possess, is likely to make us do much harm.”
I do have a couple of caveats – Deaton rightly highlights the fact that there is no proof that the dramatic increase in the population of the planet has resulted in increased poverty, as Thomas Malthus famously worried, but in fact the opposite has been true. I am not as sanguine as Deaton on this – but I have lived my entire adult life in countries ravaged by poverty; where all the trees have been chopped for firewood and animals eaten to stave off hunger – and I think we’re on the verge of combustion. Perhaps I’m wrong to be pessimistic about “the arriving ordeal”; but I doubt it. My next concern is the use of traditional measurements of poverty, especially in the third world. While $2 a day might be what the World Bank says is destitution, “a life more abundant” requires significantly more. Others have flirted with the idea of a “happiness index” to capture not monetary but quality of life indexes, but these are imperfect as happiness is too subjective an idea. I prefer a “choices based” approach to well-being – because a life more abundant is a result of our ability to choose products, careers, vacations, the number of our children and so on. I don’t know of any economist who has thought of such a scale, more on that later. All that to say is, stating “650 million Chinese escaped extreme poverty” says little about the real improvement in their lives; the threshold seems arbitrary. Same is true for health – while the reduction of infant mortality has increased life expectancy the world over (except for Africa) to about 70 years, it says nothing of the quality of those years – and let’s be honest, compared to Methuselah 70 years is a paltry sum indeed. I also doubt the permanence of our “escape”, given humanity’s penchant for reinventing misery. Deaton recognizes all this, and this is not a criticism except that the title of the book is a little self-congratulatory.
Finally, the end of the book goes into the relatively new field of Foreign Assistance (International Aid). “It is not surprising,” Deaton says, “that, in spite of the direct effects of aid that are often positive, the record of aid shows no evidence of any overall beneficial effect.” This is of course true, and he helpfully and correctly explains the problem with the “tyranny of foreign good intentions”; our foreign assistance is government to government. Never in the history of history has government intervention sparked development. Our own disastrous “New Deal” and “War on Poverty” efforts demonstrate this. And large sums unbalance democracies and cement tyrannies. No, it is best to remember (as Deaton reminds us) that government sets the table; government codes the rules and makes sure everybody is playing fair – but the story of human development is written by the ingenuity of individual people.
January 4, 2024
کتاب «فرار بزرگ» به تبیین و تشریح رابطه بین این موارد می پردازد و حاوی ایده های اصلی دیتون است.دیتون در این کتاب به ارزیابی سلامت، ثروت و ریشه های نابرابری و رفاه در سراسر جهان می پردازد. «فرار بزرگ» داستان فرار مردم از فقر، بیماری ها، مشکلات بهداشتی و رنج به سوی رفاه، سلامت و توسعه و پیشرفت است؛ اما در این فرار کسانی جا مانده اند و بدون گفتن داستان آنها، نمی توان داستان فرار به سوی رفاه و توسعه را بیان کرد.
February 22, 2017
In „Der große Ausbruch. Von Armut und Wohlstand der Nationen“ setzt sich Deaton mit Zusammenhängen zwischen Wirtschaftswachstum, Bevölkerungsentwicklung, Gesundheit, Wohlstand des Einzelnen und des Staates auseinander. Die weit klaffende Schere zwischen Arm und Reich in Nationalstaaten und das Wohlstandsgefälle zwischen armen und reichen Ländern sind ein höchst aktuelles Thema angesichts der globalen Armutsemigration. Deaton ist ein erklärter Gegner von Entwicklungshilfe (insbesondere der Weltbank) und Kritiker einer allgemeinen Krankenversicherung in den USA.
Vom Armutsforscher Amartya Sen hat Deaton sich anregen lassen, „Wohlstand“ ganzheitlich zu betrachten als Zusammenwirken von Lebenserwartung, Gesundheit, Freiheit und subjektiver Zufriedenheit. Die Schwäche von Statistik sieht der Verfasser beim Thema Armut und Wohlstand darin, dass deren Teilaspekte nur einzeln untersucht würden und allein durch den Sprachgebrauch unterschiedlicher Länder Unschärfen entstehen. Die Geschichte des Fortschritts war stets eine Geschichte der Ungleichheit, der Kluft zwischen jenen, die von Veränderungen profitierten und den von der Entwicklung Abgehängten. In diesem Zusammenhang bringt der Autor das treffende Bild von Gewinnern ein, die die Leitern hochziehen. Nachfolgende sollen von einer Entwicklung nicht mehr profitieren können, z. B. indem der Zugang zum Bildungs- und Gesundheitswesen eingeschränkt wird. Ein Schelm, wer darin ein Abbild der USA im Jahr 2017 erkennen wollte. In den USA klaffen heute die Haushaltseinkommen der reichsten 5% der befragten Einwohner und der ärmsten 20% der Befragten Jahr für Jahr weiter auseinander.
Eine hohe Lebenserwartung korreliert nach Deaton nicht mit Zufriedenheit und Wirtschaftswachstum konnte bisher Armut nicht verhindern. Aus Statistiken und in historischen Rückblicken extrahiert Deaton Problemfelder, die die USA und die Weltgemeinschaft dringend in Angriff nehmen müssten. Dazu gehören die für einen rein rechnerisch wohlhabenden Staat ungewöhnlich niedrige Lebenserwartung in den USA, sowie die Schere zwischen erfolgreichen Industriestaaten und Staaten, die ihrer wachsenden Bevölkerung keine menschenwürdigen Arbeitsplätze bieten können. Den direkten Zusammenhang zwischen Teilhabe von Frauen in allen Lebensbereichen und Überlebenschancen ihrer Kinder kennt Deaton, hätte ihn jedoch pointierter formulieren können. Nicht nur für die Organisation einer funktionierenden Infrastruktur wird ein starker Staat mit gut organisierter Verwaltung benötigt, sondern auch für die Umsetzung fortschrittlicher Einstellungen, die Frauen nicht vom Bildungs- und Gesundheitssystem ausschließen. Wenn das Einkommensniveau eines Landes nicht Grund von Kindersterblichkeit ist, warum sterben dann so viele Kinder in armen Ländern? Und welchen Einfluss haben reiche Staaten auf Entwicklungen in armen Ländern, fragt Deaton.
Deaton ist erklärter Gegner von Entwicklungshilfe, die seiner Ansicht nach nicht entwickelt, sondern schadet. Seine Kritkpunkte: das Helfersyndrom der Geberländer, Auftreten der NGOs in Empfängerländern, mangelnde Kontrolle der Wirksamkeit, Ungerechtigkeit, dass kleine Länder pro Kopf mehr Mittel erhalten als große, bevölkerungsreiche Länder, Unterstützung korrupter Regimes, Mittelvergabe nach Eigeninteressen der Geberländer und Lieferung von Waffen in Krisengebiete. Er kann die Zusammenhänge sehr eindrucksvoll erklären, kritisiert die Verhältnisse engagiert und führt vielfältige Quellen zum Thema an. Das Entwicklungshilfe-Kapitel fällt gegenüber der Historie und der Grundlagendarstellung vergleichsweise knapp aus.
Ein zu euphorischer Klappentext kündigt hier ein populäres Sachbuch an (2013 im Original erschienen), das für Leser in Europa bedingt interessant ist. Für mich war etwas enttäuschend, dass das Buch Dead Aid: Warum Entwicklungshilfe nicht funktioniert und was Afrika besser machen kann (engl. 2009) diese Zusammenhänge bereits umfassend dargestellt hat und sich in den vier Jahren bis zu Deatons Buch offenbar keine neuen Erkenntnisse ergaben. Deatons Zahlenmaterial stammt aus dem Zeitraum bis 2010 und ist damit schon recht alt. Deaton neigt zu Weitschweifigkeit und Wiederholungen, bis er auf den Punkt kommt. Die Einzelaspekte der drei großen Kapitel sind zwar für sich interessant, insgesamt fehlt mir im Buch ein roter Faden, der Alles mit Allem zusammenhält.
Zusätzlich zum US-amerikanischen Tunnelblick, der keine Veränderung amerikanischer Verhältnisse zulassen will, zeigt Angus Deaton kaum Fantasie für Entwicklungen in der Zukunft. Probleme des Niedriglohnsektors in den USA verharmlost er, da eine reiche Bevölkerungsschicht doch Arbeitsplätze für Hauspersonal schaffen würde. Wie sich der amerikanische Arbeitsmarkt entwickeln wird, scheint er sich noch nicht vorstellen zu können, wenn durch den Fortschritt in der IT-Technik automatisierte Verfahren und künstliche Intelligenz ganze Berufsfelder im Bereich einfacher Büroarbeiten ersetzen werden. Aussagen eines Ökonomen wie „Amerikaner sind insgesamt reicher als Europäer und können sich diese Dinge (ein kostspieliges Gesundheitssystem) leisten“, hätte ich gern empirisch belegt gesehen. Wer als Leser generell bereit ist, sich mit der Erkennung von Mustern und mit Feinheiten der Statistik auseinanderzusetzen, wird hier jedenfalls lernen, Schlagzeilen und absoluten Behauptungen besser zu misstrauen.
Empfehlen kann ich das Buch Lesern, die Dambisa Moyos Buch noch nicht kennen und die die auf den Status Quo in den USA beharrende Haltung Deatons tolerieren können.
Vom Armutsforscher Amartya Sen hat Deaton sich anregen lassen, „Wohlstand“ ganzheitlich zu betrachten als Zusammenwirken von Lebenserwartung, Gesundheit, Freiheit und subjektiver Zufriedenheit. Die Schwäche von Statistik sieht der Verfasser beim Thema Armut und Wohlstand darin, dass deren Teilaspekte nur einzeln untersucht würden und allein durch den Sprachgebrauch unterschiedlicher Länder Unschärfen entstehen. Die Geschichte des Fortschritts war stets eine Geschichte der Ungleichheit, der Kluft zwischen jenen, die von Veränderungen profitierten und den von der Entwicklung Abgehängten. In diesem Zusammenhang bringt der Autor das treffende Bild von Gewinnern ein, die die Leitern hochziehen. Nachfolgende sollen von einer Entwicklung nicht mehr profitieren können, z. B. indem der Zugang zum Bildungs- und Gesundheitswesen eingeschränkt wird. Ein Schelm, wer darin ein Abbild der USA im Jahr 2017 erkennen wollte. In den USA klaffen heute die Haushaltseinkommen der reichsten 5% der befragten Einwohner und der ärmsten 20% der Befragten Jahr für Jahr weiter auseinander.
Eine hohe Lebenserwartung korreliert nach Deaton nicht mit Zufriedenheit und Wirtschaftswachstum konnte bisher Armut nicht verhindern. Aus Statistiken und in historischen Rückblicken extrahiert Deaton Problemfelder, die die USA und die Weltgemeinschaft dringend in Angriff nehmen müssten. Dazu gehören die für einen rein rechnerisch wohlhabenden Staat ungewöhnlich niedrige Lebenserwartung in den USA, sowie die Schere zwischen erfolgreichen Industriestaaten und Staaten, die ihrer wachsenden Bevölkerung keine menschenwürdigen Arbeitsplätze bieten können. Den direkten Zusammenhang zwischen Teilhabe von Frauen in allen Lebensbereichen und Überlebenschancen ihrer Kinder kennt Deaton, hätte ihn jedoch pointierter formulieren können. Nicht nur für die Organisation einer funktionierenden Infrastruktur wird ein starker Staat mit gut organisierter Verwaltung benötigt, sondern auch für die Umsetzung fortschrittlicher Einstellungen, die Frauen nicht vom Bildungs- und Gesundheitssystem ausschließen. Wenn das Einkommensniveau eines Landes nicht Grund von Kindersterblichkeit ist, warum sterben dann so viele Kinder in armen Ländern? Und welchen Einfluss haben reiche Staaten auf Entwicklungen in armen Ländern, fragt Deaton.
Deaton ist erklärter Gegner von Entwicklungshilfe, die seiner Ansicht nach nicht entwickelt, sondern schadet. Seine Kritkpunkte: das Helfersyndrom der Geberländer, Auftreten der NGOs in Empfängerländern, mangelnde Kontrolle der Wirksamkeit, Ungerechtigkeit, dass kleine Länder pro Kopf mehr Mittel erhalten als große, bevölkerungsreiche Länder, Unterstützung korrupter Regimes, Mittelvergabe nach Eigeninteressen der Geberländer und Lieferung von Waffen in Krisengebiete. Er kann die Zusammenhänge sehr eindrucksvoll erklären, kritisiert die Verhältnisse engagiert und führt vielfältige Quellen zum Thema an. Das Entwicklungshilfe-Kapitel fällt gegenüber der Historie und der Grundlagendarstellung vergleichsweise knapp aus.
Ein zu euphorischer Klappentext kündigt hier ein populäres Sachbuch an (2013 im Original erschienen), das für Leser in Europa bedingt interessant ist. Für mich war etwas enttäuschend, dass das Buch Dead Aid: Warum Entwicklungshilfe nicht funktioniert und was Afrika besser machen kann (engl. 2009) diese Zusammenhänge bereits umfassend dargestellt hat und sich in den vier Jahren bis zu Deatons Buch offenbar keine neuen Erkenntnisse ergaben. Deatons Zahlenmaterial stammt aus dem Zeitraum bis 2010 und ist damit schon recht alt. Deaton neigt zu Weitschweifigkeit und Wiederholungen, bis er auf den Punkt kommt. Die Einzelaspekte der drei großen Kapitel sind zwar für sich interessant, insgesamt fehlt mir im Buch ein roter Faden, der Alles mit Allem zusammenhält.
Zusätzlich zum US-amerikanischen Tunnelblick, der keine Veränderung amerikanischer Verhältnisse zulassen will, zeigt Angus Deaton kaum Fantasie für Entwicklungen in der Zukunft. Probleme des Niedriglohnsektors in den USA verharmlost er, da eine reiche Bevölkerungsschicht doch Arbeitsplätze für Hauspersonal schaffen würde. Wie sich der amerikanische Arbeitsmarkt entwickeln wird, scheint er sich noch nicht vorstellen zu können, wenn durch den Fortschritt in der IT-Technik automatisierte Verfahren und künstliche Intelligenz ganze Berufsfelder im Bereich einfacher Büroarbeiten ersetzen werden. Aussagen eines Ökonomen wie „Amerikaner sind insgesamt reicher als Europäer und können sich diese Dinge (ein kostspieliges Gesundheitssystem) leisten“, hätte ich gern empirisch belegt gesehen. Wer als Leser generell bereit ist, sich mit der Erkennung von Mustern und mit Feinheiten der Statistik auseinanderzusetzen, wird hier jedenfalls lernen, Schlagzeilen und absoluten Behauptungen besser zu misstrauen.
Empfehlen kann ich das Buch Lesern, die Dambisa Moyos Buch noch nicht kennen und die die auf den Status Quo in den USA beharrende Haltung Deatons tolerieren können.
December 3, 2020
Marvelous overview of the pattern of change in health and wealth in the world, with an emphasis on examining how disparities in global differences in health outcomes came about. There is relatively little discussion of the kinds of institutions that enable development, but lots of clear discussion of how measuring well being is complicated by value judgements, politicization of measurement, and sheer difficulty of gathering information.
December 11, 2015
Incredibly readable without sacrificing detail and pleasantly open to admitting ambiguity where applicable. Personally I found part I (on evolution of and relationships among health, growth and income) to be most fascinating. Angus covers a slew of subjects such as epidemiological transition (from infectious diseases to chronic ones), movements along the curve vs shifts of the curve, life expectancy implications of child mortality, feminism and smoking, state capacity (implementing germ theory) vs personal income (nutrition) health improvement attributions, rates of improvements and patterns of difference between first, second and third worlds. I simply couldn’t put the book down till I gulped down the first 4 chapters in one go.
Part II that dealt with wealth and inequality with empathis on US was less compelling most likely because this was probably the 20th treatment of the subject that I’ve read which dampens the novelty. And still a few tidbits, despite not being new, were treated very nicely and intuitively. For example the implications of recent growth in India and China which account for almost 40% of world’s population put a rather ambiguous spin on such questions as to whether economic inequality has been growing. If compared at cross-country level – it has been shrinking in first world, not changing much if looked across all countries and getting worse for 3rd world. But at individual level the picture is rosier (since 40% of world population got a nice bump). Note to self – failure to consider demographics renders much of economic analysis meaningless at best and criminally misleading at worst.
Part III brings us to foreign aid where Deaton is closer to Easterly camp (vs Sachs). Unlike Easterly though Deaton actually offers alternatives to improve the situation. Main thesis (that I happen to subscribe to) is that direct foreign aid to dictators in the third world is not merely unhelpful but is often harmful. For one, attempting to promote economic growth by making the gov’t even less accountable to its people (no need to tax when you can get mostly-strings-free money elsewhere) seems counterproductive to put it mildly; and if you don’t like the theoretical arguments we can look at practice – correlation between amount of aid and growth remain _negative_ even after taking “distress” factors into account.
Easterly's alternative is to do nothing which is emotionally unsatisfying (although technically better than doing harm I suppose), but Deaton’s alternative is to use the money FOR Africa rather than merely spending it IN Africa. Such avenues include but not limited to providing drugs, funding not-necessary-for-first-world-but-helpful-for-third drug therapies, relaxing drug patent restrictions, hiring consultants/lawyers to improve international trade agreements that work to the advantage of the third world rather than against it, changing policies that make globalization work for the 3rd world (perhaps ameliorating negative side effects of trends such as Dani Rodrik’s infamous premature deindustrialization). Deaton’s approaches when it comes to health make a lot of sense to me, I’m somewhat skeptical about some other suggestions – seems like he is trading one set of uncertainties (associated with direct unconditional aid) for another, but I remain optimistic and it is certainly worth a try.
Part II that dealt with wealth and inequality with empathis on US was less compelling most likely because this was probably the 20th treatment of the subject that I’ve read which dampens the novelty. And still a few tidbits, despite not being new, were treated very nicely and intuitively. For example the implications of recent growth in India and China which account for almost 40% of world’s population put a rather ambiguous spin on such questions as to whether economic inequality has been growing. If compared at cross-country level – it has been shrinking in first world, not changing much if looked across all countries and getting worse for 3rd world. But at individual level the picture is rosier (since 40% of world population got a nice bump). Note to self – failure to consider demographics renders much of economic analysis meaningless at best and criminally misleading at worst.
Part III brings us to foreign aid where Deaton is closer to Easterly camp (vs Sachs). Unlike Easterly though Deaton actually offers alternatives to improve the situation. Main thesis (that I happen to subscribe to) is that direct foreign aid to dictators in the third world is not merely unhelpful but is often harmful. For one, attempting to promote economic growth by making the gov’t even less accountable to its people (no need to tax when you can get mostly-strings-free money elsewhere) seems counterproductive to put it mildly; and if you don’t like the theoretical arguments we can look at practice – correlation between amount of aid and growth remain _negative_ even after taking “distress” factors into account.
Easterly's alternative is to do nothing which is emotionally unsatisfying (although technically better than doing harm I suppose), but Deaton’s alternative is to use the money FOR Africa rather than merely spending it IN Africa. Such avenues include but not limited to providing drugs, funding not-necessary-for-first-world-but-helpful-for-third drug therapies, relaxing drug patent restrictions, hiring consultants/lawyers to improve international trade agreements that work to the advantage of the third world rather than against it, changing policies that make globalization work for the 3rd world (perhaps ameliorating negative side effects of trends such as Dani Rodrik’s infamous premature deindustrialization). Deaton’s approaches when it comes to health make a lot of sense to me, I’m somewhat skeptical about some other suggestions – seems like he is trading one set of uncertainties (associated with direct unconditional aid) for another, but I remain optimistic and it is certainly worth a try.
March 25, 2023
Takeaways from reading the book:
What does well-being mean?
Page 24: What does well-being mean? It means 1) material well-being measured by income,
2) physical and psychological well-being measured by health, 3) education, and 4) the possibility to participate in civil society through democracy and rule of law.
Material well-being measured by income:
- Pages 4 and 165: In the last 200 years, there has been relatively strong economic growth in Northwestern Europe and North America and little economic growth in other parts of the world. Economic growth has been the engine of inequality. In the 18th century, most economic inequality was within countries, i.e. between rich, land-owning aristocrats on the one hand and the common people on the other hand. In year 2000, the biggest gaps were between countries.
- Pages 73-76: Human beings have been hunter-gatherers for about 95% of the time we have existed. Equal sharing of resources within groups was a key value of hunter-gatherers. One reason for this was that food could not be stored at that time.
- Page 175: When we measure GDP, we do not include services that a person delivers to care for her / his family. Paradoxically, when the same woman / man delivers services to care for other families, we include it in GDP. Does this mean that GDP is not the best indicator of well-being?
- Pages 180 and 326: In the USA, income inequality has increased, and the number of poor people is rising. In 1959, there were 6.7 million poor people living in the USA. In 2011, 46.2 million Americans were living in poverty. Angus Deaton explains that large concentration in wealth can undermine democracy and growth.
- Page 187: The evolution of income can be looked at from 3 different perspectives: Growth, poverty, and inequality. Growth is about the average and how it changes, poverty is about the bottom, and inequality is about how widely incomes are spread across people.
Physical and psychological well-being measured by health:
- Pages 69, 91 and 112: In Sweden in 1751, it was riskier to be a newborn than an 80 year-old. Today, it is the opposite. Better food and better housing contributed strongly to reducing child mortality. In general, old people die of chronic disease, young people of infectious disease. The fraction of people dying from cancer, stroke, and heart diseases is 3 times as high in high-income countries compared to low-income countries.
- Page 105: Improvements in education may be the single most important cause of better health in lower-income countries today.
- Page 130: Women became smokers later than men and have been slower than men to quit smoking. In the USA, sales of cigarettes was at its highest in the early 1960s at about 11 cigarettes per day for each adult smoker. At that time, 40% of the US population were smoking cigarettes.
- Page 155: Women are giving birth to fewer children. In Africa, the average number of children per woman has declined from 6.6 in 1950 to 4.4 today. In South America, the decline has been from 6 to 2.
What does well-being mean?
Page 24: What does well-being mean? It means 1) material well-being measured by income,
2) physical and psychological well-being measured by health, 3) education, and 4) the possibility to participate in civil society through democracy and rule of law.
Material well-being measured by income:
- Pages 4 and 165: In the last 200 years, there has been relatively strong economic growth in Northwestern Europe and North America and little economic growth in other parts of the world. Economic growth has been the engine of inequality. In the 18th century, most economic inequality was within countries, i.e. between rich, land-owning aristocrats on the one hand and the common people on the other hand. In year 2000, the biggest gaps were between countries.
- Pages 73-76: Human beings have been hunter-gatherers for about 95% of the time we have existed. Equal sharing of resources within groups was a key value of hunter-gatherers. One reason for this was that food could not be stored at that time.
- Page 175: When we measure GDP, we do not include services that a person delivers to care for her / his family. Paradoxically, when the same woman / man delivers services to care for other families, we include it in GDP. Does this mean that GDP is not the best indicator of well-being?
- Pages 180 and 326: In the USA, income inequality has increased, and the number of poor people is rising. In 1959, there were 6.7 million poor people living in the USA. In 2011, 46.2 million Americans were living in poverty. Angus Deaton explains that large concentration in wealth can undermine democracy and growth.
- Page 187: The evolution of income can be looked at from 3 different perspectives: Growth, poverty, and inequality. Growth is about the average and how it changes, poverty is about the bottom, and inequality is about how widely incomes are spread across people.
Physical and psychological well-being measured by health:
- Pages 69, 91 and 112: In Sweden in 1751, it was riskier to be a newborn than an 80 year-old. Today, it is the opposite. Better food and better housing contributed strongly to reducing child mortality. In general, old people die of chronic disease, young people of infectious disease. The fraction of people dying from cancer, stroke, and heart diseases is 3 times as high in high-income countries compared to low-income countries.
- Page 105: Improvements in education may be the single most important cause of better health in lower-income countries today.
- Page 130: Women became smokers later than men and have been slower than men to quit smoking. In the USA, sales of cigarettes was at its highest in the early 1960s at about 11 cigarettes per day for each adult smoker. At that time, 40% of the US population were smoking cigarettes.
- Page 155: Women are giving birth to fewer children. In Africa, the average number of children per woman has declined from 6.6 in 1950 to 4.4 today. In South America, the decline has been from 6 to 2.
November 6, 2015
This wonderful book is by a senior professor of economics at Princeton that links his interests in health economics, developmental studies, development economics, income inequality, and human development. BTW, Deaton just won the Nobel in Economics for 2015. The premise of the book is an old movie about a WWII prison camp escape. The point is to focus on the "great escape" of some societies and groups from the perpetual situation of limited or no economic growth, low life expectancy, and poor health status that had plagued mankind for thousands of years and only started to change in the West after 1800, after which time life expectancies doubled by 2000, along with the rapid economic development that came with the first and second industrial revolutions. There is much going on in this book and much of it is absolutely fascinating. This is related to the line of research that brought Robert Fogel the Nobel price in economics and links diet, health, economics, and national policy. It is mind-blowing stuff and is communicated with a minimal use of equations and models. This is a well written economics book and does not require a lot of technical background.
What I really liked about this was how Deaton links topics that are not typically linked. Are improvements in health care related to economic development? What factors influence life expectancy? How have these factors changed in developed versus developing countries? If a population has a longer median life expectancy, how does that translate into increased economic productivity? Into increased human capital? How can we look at population nutrition status as indicative of economic development or underdevelopment? What are the relationships between health, wealth, and welfare? All of these topics have large bodies of research behind them and the author does an excellent job of outlining the major issues in each area in a clear and useful manner. He is especially good at explaining the complexities of the different terms that are bandied about in policy discussions, for example the various contributing factors influencing income inequality. The author is also superb at using tables and diagrams to convey the richness of these topics.
The later chapters move into topics related to interventions around health, wealth, and income, for example foreign aid versus the development of local investment projects. While I agree with the author's critical perspective on aid, these are less successful ones than are in the first two parts of the book on health and wealth.
What I really liked about this was how Deaton links topics that are not typically linked. Are improvements in health care related to economic development? What factors influence life expectancy? How have these factors changed in developed versus developing countries? If a population has a longer median life expectancy, how does that translate into increased economic productivity? Into increased human capital? How can we look at population nutrition status as indicative of economic development or underdevelopment? What are the relationships between health, wealth, and welfare? All of these topics have large bodies of research behind them and the author does an excellent job of outlining the major issues in each area in a clear and useful manner. He is especially good at explaining the complexities of the different terms that are bandied about in policy discussions, for example the various contributing factors influencing income inequality. The author is also superb at using tables and diagrams to convey the richness of these topics.
The later chapters move into topics related to interventions around health, wealth, and income, for example foreign aid versus the development of local investment projects. While I agree with the author's critical perspective on aid, these are less successful ones than are in the first two parts of the book on health and wealth.
September 9, 2016
The author does a very thorough job describing the effects of economic development on the people who should be affected by such developments. It's very hard to summarize all of the arguments, so I'm only going to pick at a critical one involving the correlation between economic development and inequality.
The author persuasively argues that while the bottom rises during development, so do all the other quantiles. As a result, there is a larger spread between the 1st percentile and the 10th, or between the 10th and the 25th, as development increases. Since prices move up with demand, they will reflect the purchasing power of the middle 50% and thus leave the bottom 25% behind. This is actually correct: variance does correlate with mean. Deaton also persuasively argues that this may not be a problem if we pivot from equality standards to living standards. Essentially, does it matter if the bottom is further away if they have more stuff? Does the poor have more than they did 100 years ago?
They do, but Deaton says that growth for the poor should be much faster than now. The poor still suffer from malnourishment, lack of sanitation and improper housing among other ailments. Deaton also spends a lot of time describing the geographical (or really socioeconomic) barriers that prevent Africa from rising as quickly as it should given how quickly southeast Asia and Eastern Europe have advanced.
I'm not giving this book a fifth star because Deaton's presentation of the argument as a hard-data argument is missing easy-to-use hard data. I found the graphs to be unhelpful. In one example, Deaton is describing the negative correlation between growth & aid (generally due to aid being deployed in declining countries) but used 2 bar charts instead of a chart with two lines. This lack of proper presentation caused a lot of hurdles and re-scanning of Deaton's text for me. His storytelling is properly scientific but sometimes his data-driven arguments get lost.
It's still a book worth reading and Deaton provides solutions to many of the foreign aid issues that must be addressed. Like Deaton says, you have to entertain at some point the notion that no aid is better than aid if you want to start tackling the many issues plaguing foreign aid.
The author persuasively argues that while the bottom rises during development, so do all the other quantiles. As a result, there is a larger spread between the 1st percentile and the 10th, or between the 10th and the 25th, as development increases. Since prices move up with demand, they will reflect the purchasing power of the middle 50% and thus leave the bottom 25% behind. This is actually correct: variance does correlate with mean. Deaton also persuasively argues that this may not be a problem if we pivot from equality standards to living standards. Essentially, does it matter if the bottom is further away if they have more stuff? Does the poor have more than they did 100 years ago?
They do, but Deaton says that growth for the poor should be much faster than now. The poor still suffer from malnourishment, lack of sanitation and improper housing among other ailments. Deaton also spends a lot of time describing the geographical (or really socioeconomic) barriers that prevent Africa from rising as quickly as it should given how quickly southeast Asia and Eastern Europe have advanced.
I'm not giving this book a fifth star because Deaton's presentation of the argument as a hard-data argument is missing easy-to-use hard data. I found the graphs to be unhelpful. In one example, Deaton is describing the negative correlation between growth & aid (generally due to aid being deployed in declining countries) but used 2 bar charts instead of a chart with two lines. This lack of proper presentation caused a lot of hurdles and re-scanning of Deaton's text for me. His storytelling is properly scientific but sometimes his data-driven arguments get lost.
It's still a book worth reading and Deaton provides solutions to many of the foreign aid issues that must be addressed. Like Deaton says, you have to entertain at some point the notion that no aid is better than aid if you want to start tackling the many issues plaguing foreign aid.
November 19, 2016
This book was a challenge to read; it was not exactly a page turner. It took some effort to get through the portions with copious amounts of numbers and chart analysis.
I did read it for a reason and it did provide me what I was looking for. I find myself becoming suspect of the growing inequality in this country. The rich keep getting richer and it seems like the middle class just keeps getting squeezed. I find my paycheck inching up while my living expenses seem to be going up faster. My fear is that the growing inequality will grind the economy to a halt. Without a middle class financially secure enough to spend money, there will be no fuel to power the economic engine of this country. I propose the question of who would be more efficient cycling money through the economy - a corporate CEO who receives a $1,000,000 bonus or 2000 middle class families who receive a $500 bonus?
Here is my argument and here is what I learned from the book. There is nothing wrong with people making money or even making TONS of money. If you make more money because you worked harder, worked smarter, or were more creative than that is fantastic as you deserve it. The problem is when rich people use their wealth to undermine democracy and growth. One perfect example of this is the lobbying industry (think your congressman listens to you the voter or the lobbyist with the six figure check?). In the United States, we have not seen the current extremes of income and wealth for more than a hundred years. Such inequality encourages the rich to block the same routes to wealth that they themselves traveled. Economic growth in this country in each recent decade has been lower than the previous one. This books shows numbers that indicate this slowdown in growth has been accompanied by expansions of inequality. That is exactly what I was looking for in this book.
I did read it for a reason and it did provide me what I was looking for. I find myself becoming suspect of the growing inequality in this country. The rich keep getting richer and it seems like the middle class just keeps getting squeezed. I find my paycheck inching up while my living expenses seem to be going up faster. My fear is that the growing inequality will grind the economy to a halt. Without a middle class financially secure enough to spend money, there will be no fuel to power the economic engine of this country. I propose the question of who would be more efficient cycling money through the economy - a corporate CEO who receives a $1,000,000 bonus or 2000 middle class families who receive a $500 bonus?
Here is my argument and here is what I learned from the book. There is nothing wrong with people making money or even making TONS of money. If you make more money because you worked harder, worked smarter, or were more creative than that is fantastic as you deserve it. The problem is when rich people use their wealth to undermine democracy and growth. One perfect example of this is the lobbying industry (think your congressman listens to you the voter or the lobbyist with the six figure check?). In the United States, we have not seen the current extremes of income and wealth for more than a hundred years. Such inequality encourages the rich to block the same routes to wealth that they themselves traveled. Economic growth in this country in each recent decade has been lower than the previous one. This books shows numbers that indicate this slowdown in growth has been accompanied by expansions of inequality. That is exactly what I was looking for in this book.
February 24, 2016
Angus Deaton is a big name in Economic Science, he got Nobel Prize in 2015 "for his analysis of consumption, poverty, and welfare". His "The analysis of household surveys" was my table book for decade.
In his recent "The Great Escape" he take a look on Inequality, focusing on health an wealth and paying more attention to USA and other rich countries. Looking on intersecting and mutually reinforcing inequalities is a central thing in a book, allowing us to understand why the Great Escape from misery and death did not come true for everybody, despite multitude of great things science provides to humanity. In the last part, Help, he took skeptical (or realistic) stance towards Aid. He points out the many well documented illnesses of the foreign aid--it typically reflect donor's priority, often times it doesn't take into account local needs, etc. He also underscore an important observation--other mechanisms (like removal of trade barriers, or removing obstacles for migration and organizing it in civilized way) could make much more for improving living standards. I would suggest to read this chapter together with two other books. "Kicking Away the Ladder: Development Strategy in Historical Perspective" by Ha-Joon Chang document a bunch of things now developed countries did to make Great Escape of others impossible or very hard. On the other hand "The White Man's Burden: Why the West's Efforts to Aid the Rest Have Done So Much Ill and So" by William Easterly provides bitter skeptical (maybe overskeptical) review of things did not work in the foreign aid.
In his recent "The Great Escape" he take a look on Inequality, focusing on health an wealth and paying more attention to USA and other rich countries. Looking on intersecting and mutually reinforcing inequalities is a central thing in a book, allowing us to understand why the Great Escape from misery and death did not come true for everybody, despite multitude of great things science provides to humanity. In the last part, Help, he took skeptical (or realistic) stance towards Aid. He points out the many well documented illnesses of the foreign aid--it typically reflect donor's priority, often times it doesn't take into account local needs, etc. He also underscore an important observation--other mechanisms (like removal of trade barriers, or removing obstacles for migration and organizing it in civilized way) could make much more for improving living standards. I would suggest to read this chapter together with two other books. "Kicking Away the Ladder: Development Strategy in Historical Perspective" by Ha-Joon Chang document a bunch of things now developed countries did to make Great Escape of others impossible or very hard. On the other hand "The White Man's Burden: Why the West's Efforts to Aid the Rest Have Done So Much Ill and So" by William Easterly provides bitter skeptical (maybe overskeptical) review of things did not work in the foreign aid.
November 1, 2015
The Great Escape (2013) by Angus Deaton describes how parts of the world escaped poverty and short sick lives and how the rest of the world is doing so or could do so. Deaton is a Nobel Prize winning economist whose work concerned how poor people behave and what would improve their lives.
The book first looks at how the overall wellbeing of the world has changed, then at health, then at money and wealth and then at what can has been tried and what can be done.
The overall picture of human wealth, health and prosperity and how it has changed over the past 200 years is incredible. Deaton describes just how remarkable it has been with vivid descriptions and graphs of the changes.
The section health shows just how much child mortality has altered the picture and how public health has had a considerable impact on human life.
In the chapter on money Deaton goes through how consumption has changed and how different parts of the world have different poverty lines.
Finally Deaton looks at development aid and points out how it has failed to do what it set out to.
It's a really interesting book written by a top economist who has studied in detail what he writes about. He's produced a very readable account of how much of the world has escaped poverty. The chapters on Health and Development aid are particularly good.
The book first looks at how the overall wellbeing of the world has changed, then at health, then at money and wealth and then at what can has been tried and what can be done.
The overall picture of human wealth, health and prosperity and how it has changed over the past 200 years is incredible. Deaton describes just how remarkable it has been with vivid descriptions and graphs of the changes.
The section health shows just how much child mortality has altered the picture and how public health has had a considerable impact on human life.
In the chapter on money Deaton goes through how consumption has changed and how different parts of the world have different poverty lines.
Finally Deaton looks at development aid and points out how it has failed to do what it set out to.
It's a really interesting book written by a top economist who has studied in detail what he writes about. He's produced a very readable account of how much of the world has escaped poverty. The chapters on Health and Development aid are particularly good.
December 9, 2013
The first comment to make about this fine book is that it is beautifully written. The tone and texture of the prose renders it not only open to the diverse disciplinary backgrounds of readers, but also evocative and engaging.
Deaton's great work is the alignment of often disparate topics: economic 'progress,' health, wellbeing and inequality. There is an evenness of argument that is incredibly welcome after the ideologues - particularly in the United States - have offered a critique of any scheme with the word 'public' in front of it.
For those interested in understanding the context and patterns around the Global Financial Crisis, for those interested in understanding globalization in its many meanings, for those interested in thinking about the nature of 'wellbeing' around the world - this is an outstanding book.
Deaton's great work is the alignment of often disparate topics: economic 'progress,' health, wellbeing and inequality. There is an evenness of argument that is incredibly welcome after the ideologues - particularly in the United States - have offered a critique of any scheme with the word 'public' in front of it.
For those interested in understanding the context and patterns around the Global Financial Crisis, for those interested in understanding globalization in its many meanings, for those interested in thinking about the nature of 'wellbeing' around the world - this is an outstanding book.
May 22, 2016
I took almost a month to read this book. It's filled with graphs and diagrams that are difficult to understand, and explanations that takes repeated reads to comprehend. I only gave it three stars from an objective view, as I thought it might be really informative to people who are familiar with diagrams and prefer them, and also to have a bulk of information served to them, and mind you, not really in English, if you know what I mean.
I felt utterly displeased at the end of the book as well, Deaton's views and argument were pretty unorthodox, and I have to say, even after all the information, graphs, statistics, facts (according to him), I'm not convinced. So to me, really, this is a 2-star book. Saved by some ideas that made sense in chapter six. But that's about all.
I felt utterly displeased at the end of the book as well, Deaton's views and argument were pretty unorthodox, and I have to say, even after all the information, graphs, statistics, facts (according to him), I'm not convinced. So to me, really, this is a 2-star book. Saved by some ideas that made sense in chapter six. But that's about all.
January 12, 2017
Interesting stuff. Discussion of health and its causes (including the surprisingly limited role of medical treatment, drugs, etc. relative to public sanitation type infrastructure) was fascinating. Deaton also makes an interesting argument opposing almost all development aid, as it makes target countries responsive to donors rather than their citizens. Book is well-written/argued and addresses uncertainties in its data well. I don't much care about inequality so I was indifferent to that discussion. (I care about poverty and want it to go away, and as a shareholder I care about whether executive compensation is justified, but I don't think either the government or private individuals can do much good by worrying about the ratio of those two things.)
June 20, 2017
This is a very good book. It’s about the incredible escapes from death and poverty that have been made over time, and especially in the 20th century. The chapter on aid was interesting - Deaton is skeptical of the benefit of most forms of foreign aid. He says that the problems are primarily political and institutional, not financial - and aid can actually exacerbate these problems. It’d be interesting to read rebuttals from figures like Peter Singer.
It’s als a very hopeful read. It makes you realize that now is absolutely the best time in history to be alive, and we have every reason to believe that conditions will continue to improve for future generations.
It’s als a very hopeful read. It makes you realize that now is absolutely the best time in history to be alive, and we have every reason to believe that conditions will continue to improve for future generations.
April 19, 2019
I appreciate Deaton’s sober and thorough look at inequality, poverty, and the sometimes-harmful effects of philanthropy. He writes, “We now think of colonialism as bad, harming others to benefit ourselves, and aid as good, hurting us (albeit very mildly) to help others. But that view is too simple, too ignorant of history, and too self-congratulatory...we need to be sure that we’re not doing harm. If we are, we are doing it for us, not for them.”*
Despite all this, the book is not as depressing as one might assume. There is hope, as long as we consider the effects of our efforts.
*transcribed from the audio; apologies for errors
Despite all this, the book is not as depressing as one might assume. There is hope, as long as we consider the effects of our efforts.
*transcribed from the audio; apologies for errors
October 27, 2018
The author is well informed and careful with his words as he describes the progress in health, wellbeing and the reduction of poverty over time. There is balance and wisdom, but, in comparison with other erudite authors on development and fairness his writing is wordy and repetitive. It is not a hard read because of its concepts, it is a hard read because of its ifs and buts and whys and wherefores. This is the style of an emeritus professor of course, but the editors could have helped the lay reader. There is much of importance here, but he needed help in communicating it.
February 25, 2022
Quite informative, and with some conclusions that are quite contrary to my, rather instinctive than scientific, beliefs, e.g. that bigger countries are better positioned to make progress as they have more resources and a larger pool of talented and educated people (I rather thought that smaller countries were easier to manage, and if mismanaged didn't make such an impact on the world); or that direct foreign aid to poor countries does more harm than good, which rather makes sense come to think of it.
July 28, 2017
Personally, I felt that the book was unnecessarily lengthy at times with loads of words and little statistical evidence presented in graphs or tables. Chapters 2 to 6 are mainly descriptive on health and wealth with the last chapter being the actually interesting bit of the book, i.e. the author's own ideas and arguments on what to change and what has failed. If you are only interested in the main message/ the author's main ideas, read the last chapter first.
February 18, 2016
Angus Deaton's "The Great Escape" was a great refresher since finishing up grad school and no longer living in academia. I like his focus on the US for a couple of chapters and enjoyed his dissection of foreign aid. I wish that section was a bit longer and developed more, but overall a great read on global inequality.
December 15, 2016
Ugh. Mainstream economics is like junk food. You know it makes you feel sick but every now and then you eat it anyway.
Supply-demand bullshit plus a bit of paraphrasing Amartya Sen, so more or less the modern day World Bank. Nobel Prize my ass. Certainly not for this thoroughly uninspiring book.
Supply-demand bullshit plus a bit of paraphrasing Amartya Sen, so more or less the modern day World Bank. Nobel Prize my ass. Certainly not for this thoroughly uninspiring book.
October 30, 2013
the discussions on well being are the highlight and something that often gets missed in our pundit age of digital information.
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