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lecture2_1_05_11_large - LECTURE 2 Historical Health...

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LECTURE 2: Historical Health Improvement
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Why study historical health improvement?
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Why study historical health improvement? •With the exception of HIV/AIDS, the epidemiological profile of poor countries today closely resembles that of today’s wealthy countries 100 years ago •Lessons from history for health improvement in poor countries today? •Question of generalizeability – but similar questions about generalizeability across poor countries today (does Thailand’s success in stemming the spread of HIV hold lessons for Sub-Saharan Africa?) •Biggest debate on historical health improvement is about the relative importance of economic growth vs. technological progress in health (ie, reductions in the relative price of health) •‘Modern’ medicine hits the scene late (1930s or so) •***Considerable debate about this until the 1980s – the old view was to focus on overall economic development rather than health specifically (UNICEF and GOBI, for example)
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Changes in wealth vs. changes in the relative price of health AOG Health AOG Health
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Changes in wealth vs. changes in the relative price of health AOG Health AOG Health What specific technological progress in health are we talking about?
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Bacteriology: *Note: we’ll come to nutrition…
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*Note: very important ‘soft’ technologies not listed (like basic hygiene) as well as key innovations that preceded bacteriology (emphasis on clean water and good sanitation)
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Bacteriology ‘Modern’ Medicine
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Bacteriology ‘Modern’ Medicine
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BTW, how do we even know about historical mortality?
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BTW, how do we even know about historical mortality? •Parish records: church records first required to be kept in England in 1538; record baptisms, burials, and marriages in tens of thousands of catchment areas around local churches documented every month •Similar studies conducted in Africa today •Wrigley and Schofield (1989) – 404 aggregate UK parishes, accounting for about 4% of the British population; geographic distribution roughly proportionate to population •Inaccuracies? Surely. What’s the alternative? •No information about cause of death
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lecture2_1_05_11_large - LECTURE 2 Historical Health...

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