As I noted last week, I am committed to helping to create a healthy future for all. But I am greatly concerned that we are not on the right path to do that.
When I look back over the length of my career, it is clear that in many ways we have created a healthier future.
One important indicator is life expectancy. According to Our World in Data, in 1970, when I was still in medical school, life expectancy at birth was 56.3 years globally and 72.6 years in sa国际传媒.
Just over 50 years later, in 2023, it was 73.2 years globally, a gain of almost 17 years, while it was 10 years longer, at 82.6 years, in sa国际传媒.
While some of that gain is due to better health care — especially, globally, improved maternal and child health — most is due to other factors: improved sanitation, clean drinking water, adequate, safe and healthy food, improved education, better housing and so on. Together, these factors constitute the social determinants of health.
These gains largely result from economic development. World Bank data, cited by Our World in Data, shows the world GDP (in constant 2017 dollars) grew from $26.23 trillion in 1970 to $139.26 trillion in 2022, a 5.3-fold increase.
So even though the world’s population roughly doubled over that period, from four billion in 1974 to eight billion in 2023, global average GDP per person nonetheless grew, from $7,100 in 1970 to $17,527 in 2022, an increase of almost 2.5 times.
But while this meant that many people, communities and nations could afford the better food, housing and education they needed, it has also resulted in a great increase in demand for those and other products.
As a result, economic development has been an uneven two-edged sword — we have reaped the benefits, but we have sown a set of costs for future generations.
Or as the Rockefeller-Lancet Commission on Planetary Health put it, we have “mortgaged the health of future generations to realise economic and development gains in the present.”
One of those costs has been high levels of inequality, both between and within countries. The latest data from the World Inequality Lab shows that in 2023, the bottom half of the world’s population got less than 10 per cent of global income, while the richest 10 per cent captured more than half.
In regional terms, the average income in North America is 15 times greater than in Sub-Saharan Africa,
In sa国际传媒, the World Inequality Lab reports, the top 10 per cent earned 36 per cent of national income in 2023.
While better than the global average, that level of inequality is “far higher than during the 1970s and even into the mid-1980s.”
In 1985, for example, the top 10 per cent of earners earned 29 per cent of national income. So there has been a marked concentration of income — and thus of wealth and power — in the past 40 years or so.
Another important consequence of both population and economic growth and the resultant increase in demand is what the UN calls a triple planetary crisis of climate change, biodiversity loss and pollution.
That is, in turn, part of a wider crisis in which, leading Earth systems scientists tell us, we have crossed planetary boundaries for six of nine key Earth systems (including the three in the triple crisis) and are approaching two of the remaining three.
Moreover, the world’s Ecological Footprint, which was equivalent to one Earth’s worth of annual bio-productive capacity in 1972, had risen to an un sustainable demand for 1.7 Earths’ worth by 2022.
So while economic development and growth have been a great benefit in many ways, that is no longer the case except in low-income countries, where many people still live in poverty, with their basic needs unmet.
Indeed, what now stands in the way of a healthy future for all is continued old-school economic development in high and middle-income countries, and the distorted societal values that underlie this unhealthy neoliberal economic system.
That, and the creation of a positive alternative society and economy, is my focus for the next couple of weeks, and in the monthly columns that I will be writing, starting in the new year.
Dr. Trevor Hancock is a retired professor and senior scholar at the University of Victoria’s School of Public Health and Social Policy.
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