Out of Sync? Demographic and Other Social Science Research on Health Conditions in Developing Countries
Behrman, Jere R., Behrman, Julia A., Perez, Nykia M., Demographic Research
In this paper, we present a framework for considering whether the marginal social benefits of demographic and social science research on various health conditions in developing countries are likely to be relatively high. Based on this framework, we argue that the relative current and future predicted prevalence of burdens of different health/disease conditions, as measured by disability-adjusted life years (DALYs), provide a fairly accurate reflection of some important factors related to the relative marginal social benefits of demographic and social science research on different health conditions. World Health Organization (WHO) DALYs projections for 2005-30 are compared with (a) demographic and other social science studies on health in developing countries during 1990-2005, and (b) presentations made at the Population Association of America annual meetings during the same time period. These comparisons suggest that recent demographic and social science research on health in developing countries has focused too much on HIV/AIDS, and too little on non-communicable diseases.
Health is of considerable interest to researchers, both because of its intrinsic value, and because improved health contributes directly to people's welfare. Improved health may also prove to be of instrumental importance if better health saves resources that otherwise would have been used to deal with morbidity, and if better health increases productivity. Recent estimates have suggested that the benefit/cost ratios for a number of investments in better health and nutrition in developing countries have been overwhelmingly positive, and indeed rank very highly among a wide range of alternative investments in the developing world (e.g., Lomborg 2004, Copenhagen Consensus 2008). Further, health may be closely associated with a range of demographic concerns. For reasons such as these, health in developing countries has long been of interest to demographic and other social science researchers.
But health in developing countries is a very broad topic, and the available resources, both in terms of funding and of researchers' time, for demographic and other social science research (hereafter, "social science research") on health in developing countries are limited. Therefore, the question of how well are these resources allocated is important.
We address some important dimensions of this question in this paper. In Section 2, we provide a framework for thinking about what the socially optimal distribution of social science research resources among health conditions in developing countries is. In Section 3, we describe the distribution of recent social science research on health in developing countries in terms of the three aggregate disease/health conditions categories used by the Global Burden of Disease/World Health Organization (GBD/WHO): (1) communicable, maternal, perinatal, and nutritional conditions (CMPNC); with disaggregation to separate out HIV/AIDS, (2) non-communicable diseases (NCD), and (3) injuries. In Section 4, we describe the projected levels and changes in health/disease categories in the developing world. In Section 5, we describe how these/health/disease categories relate to social science research on health in developing countries.
Before turning to the analysis, we clarify that our emphasis in this paper on the use of resources for research in demography and other social sciences on various health conditions in developing countries is distinct from two related literatures. (1) A separate question, and one that has been examined previously, is that of the appropriate allocation of resources for prevention and care among various health conditions in developing countries (e.g., Shiffman, Beer and Wu 2002; Suhrcke et al. 2005; England 2007; Halperin 2008; Bongaarts and Over 2010a, b; Barry and Townsend 2010; Nattrass and Gonsalves 2010; Asiimwe et al. 2010; Holmes et al. 2010; Reddi and Leeper 2010). …