By Guest Blogger Dan Traficonte
In this second blog post covering my visit to the Consortium of Universities for Global Health Conference, I highlight some fascinating new research on the relationship between global poverty and population health.
Dr. Joseph Dieleman from the Institute for Health Metrics and Evaluation at the University of Washington presented his research on national poverty rates of 129 countries and their effect on mortality. Typically in the global health literature, a country’s wealth serves as a predictor of population health outcomes—that is, wealth means health. However, the relationship between poverty and health outcomes has not been systematically evaluated in cross-country studies because of insufficient data. Dr. Dieleman sought to address this relationship and show how poverty can explain variation in health using 22 complete poverty and health data series.
Building on the World Bank’s International Comparison Program dataset of 800+ household surveys, Dr. Dieleman used covariates and intertemporal trends to generate a complete data series for 129 countries for 1990-2013. To predict national poverty rates at 51 different income thresholds, 20 variants of three models were supported by out-of-sample validation to choose the best model. Finally, Dr. Dieleman incorporated health data into his model using fixed-effects linear regression techniques to test how national poverty rates are associated with changes in adult and child mortality.
Statistical jargon aside, Dr. Dieleman found that the number of people living on one dollar per day is decreasing in most parts of the world, although in some parts of Africa this extreme poverty indicator is increasing. When poverty is defined as living on five dollars per day, however, the number of people living in poverty is increasing in 88 countries worldwide. What relationship do these results have with health data? Dr. Dieleman’s troubling findings indicate that escaping extreme poverty—escaping life on one dollar per day—is not sufficient to produce great improvements in health. When escaping poverty is redefined at a larger income threshold—five dollars per day, for example—health improvements are more substantial and predictable.
Dr. Dieleman’s findings have major implications for global health and development policy. Eradicating extreme poverty may not be enough to improve the health outcomes of the global poor—if Dieleman’s findings are indicative of a larger trend, more substantial improvements in income may be necessary.
Dan Traficonte is a 1L at Harvard Law School interested in the intersection of global health and international development.
