Demographic Responses to Economic Adjustment in Latin America

By G. Tapinos; A. Mason et al. | Go to book overview

Not all recent research supports the thesis that mortality has been adversely affected by economic crisis. Behrman and Deolalikar ( 1989) review results of their study of Jamaica in which they analyse 1984-5 health inputs and outcomes coincident with the implementation of a structural adjustment programme. Using a quadratic equation to represent secular trends, they find little evidence to support the view that health characteristics have departed from their long-term path, despite conclusions to the contrary by Boyd ( 1988). Hill and Pebley ( 1988) examine quinquennial data on the proportion of children dying before age five and, Ghana aside, find no evidence of a slowdown and for the countries for which data are available, evidence of an accelerated decline. Only in the case of Asia is there evidence of a slowdown in the rate of mortality decline on a regional basis.

Where does this leave us? First, research on the determinants of mortality suggests that many of the economic problems that developing countries have encountered during the 1980s should adversely affect mortality. However, this research does not adequately address timing issues and the extent to which mortality change might lag changes in income, nutrition, or education. The available evidence does suggest that long-term social and economic development is more important than short-term fluctuations. Second, the link between the economic situation and mortality conditions is not set in concrete. At the household level, a variety of actions can be taken to ameliorate the adverse impact of economic contraction on mortality. At the macro level, governments, assisted by international donors, have achieved impressive gains in mortality even at fairly low material standards of living. However, reductions in government expenditures in many countries has reduced the public health care resources and impaired the ability of the system to deal with any emerging health problems. Third, the likely impact of adjustment policies, per se, depends on the success of those policies. If short-term increases in unemployment and reductions in income growth yield more rapid and broadly based economic development, mortality conditions may be improved by adjustment policies. Fourth, data are inadequate to judge whether the economic crisis or adjustment policies have adversely affected mortality, in general. Many countries have continued to achieve substantial improvement in mortality; a few have experienced slowdowns or even mortality reversals; for many countries, we do not know.


Concluding Remarks

Reviewing recent research on fertility and mortality and the impact of structural adjustment and economic crisis leads to two important conclusions. The first is that the information available to track mortality and fertility has many limitations. The problem is particularly troubling because the data inadequacy is greatest in the poorest countries--the very countries where economic crisis surely had its greatest impact.

The second important conclusion is that people in many developing countries have a remarkable ability to minimize the impact of severe economic crisis. Many

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