Comparative Life Expectancy in Africa

Abstract

August 2001 Health outcomes are positively correlated with income, but the link is far from uniform. The key variables associated with good health outcomes (controlling for health expenditures) are access rates - to health services, to clean water and sanitation, and to education, particularly for women.

For health outcomes, is poverty destiny? McCarthy and Wolf explore this question for life expectancy in Africa, where health outcomes are positively correlated with income, but where the link is far from uniform. The key variables associated with good health outcomes (controlling for health expenditures) are access rates - to health services, to clean water and sanitation, and to education, particularly for women.

Health expenditure, either as percentage of GNP or per capita, is not a good predictor of health outcomes (endogeneity aside). The tenuous link among health expenditures, health service outputs, and health outcomes suggests marked differences in the mapping from spending to services and from services to outcomes. While few conclusions can be drawn on the aggregate level, the patterns raise questions about what share of public expenditure should be devoted to preventive as opposed to curative measures, and the relative importance of sanitation infrastructure versus traditional health care.

This paper - a product of Public Service Delivery, Development Research Group - is part of a larger effort in the group to study the health-environment-economy nexus. The study was funded by the Bank's Research Support Budget under the research project "Health, Environment, and the Economy" (RPO 683-73). The authors may be contacted at [e-mail] or [e-mail].