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The Great Escape

The Great Escape: Health, Wealth, and the Origins of Inequality

Copyright Date: 2013
Pages: 392
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  • Book Info
    The Great Escape
    Book Description:

    The world is a better place than it used to be. People are wealthier and healthier, and live longer lives. Yet the escapes from destitution by so many have left gaping inequalities between people and between nations. In The Great Escape, Angus Deaton--one of the foremost experts on economic development and on poverty--tells the remarkable story of how, starting 250 years ago, some parts of the world began to experience sustained progress, opening up gaps and setting the stage for today's hugely unequal world. Deaton takes an in-depth look at the historical and ongoing patterns behind the health and wealth of nations, and he addresses what needs to be done to help those left behind.

    Deaton describes vast innovations and wrenching setbacks: the successes of antibiotics, pest control, vaccinations, and clean water on the one hand, and disastrous famines and the HIV/AIDS epidemic on the other. He examines the United States, a nation that has prospered but is today experiencing slower growth and increasing inequality. He also considers how economic growth in India and China has improved the lives of more than a billion people. Deaton argues that international aid has been ineffective and even harmful. He suggests alternative efforts--including reforming incentives to drug companies and lifting trade restrictions--that will allow the developing world to bring about its own Great Escape.

    Demonstrating how changes in health and living standards have transformed our lives, The Great Escape is a powerful guide to addressing the well-being of all nations.

    eISBN: 978-1-4008-4796-9
    Subjects: Economics, Business, Law, Political Science, History

Table of Contents

  1. INTRODUCTION: What This Book Is About
    (pp. 1-22)

    LIFE IS BETTER NOW than at almost any time in history. More people are richer and fewer people live in dire poverty. Lives are longer and parents no longer routinely watch a quarter of their children die. Yet millions still experience the horrors of destitution and of premature death. The world is hugely unequal.

    Inequality is often a consequence of progress. Not everyone gets rich at the same time, and not everyone gets immediate access to the latest life-saving measures, whether access to clean water, to vaccines, or to new drugs for preventing heart disease. Inequalities in turn affect progress....

  2. ONE The Wellbeing of the World
    (pp. 23-56)

    THE GREATEST ESCAPE in human history is the escape from poverty and death. For thousands of years, those who were lucky enough to escape death in childhood faced years of grinding poverty. Building on the Enlightenment, the Industrial Revolution, and the germ theory of disease, living standards have increased by many times, life spans have more than doubled, and people live fuller and better lives than ever before. The process is still going on. My father lived twice as long as either of my grandfathers; his real income as a civil engineer was many times the income of his father,...


    • TWO From Prehistory to 1945
      (pp. 59-100)

      THE WORLD IS A HEALTHIER PLACE now than at almost any time in the past. People live longer, they are taller and stronger, and their children are less likely to be sick or to die. Better health makes life better in and of itself, and it allows us to do more with our lives, to work more effectively, to earn more, to spend more time learning, and to enjoy more and better time with our families and friends. Health is not a single quantity like temperature; someone might have terrific eyesight but poor physical stamina, or might live for many...

    • THREE Escaping Death in the Tropics
      (pp. 101-125)

      FOR THE MAJORITY OF the world’s population not fortunate enough to be born in a rich country, the battles against infectious disease had hardly been joined by 1945. Yet history did not have to be relived, or at least not at the same glacial pace. In 1850, the germ theory had yet to be established. By 1950, it was common knowledge, so that at least some of the improvements that had taken a century in the leading countries could happen more quickly in those that followed. That India today has higher life expectancy than Scotland in 1945—in spite of...

    • FOUR Health in the Modern World
      (pp. 126-164)

      SINCE WORLD WAR II, people in poor countries have begun to see the health benefits that people in rich countries have long enjoyed. The germ theory of disease had made possible a great reduction in the burden of infectious disease, but the science and science-based policies took more than a century to spread from their origins to the rest of the globe. If this had been the whole story, the late adopters would have eventually caught up with the pioneers, and the history of global health would have been the story of the gradual elimination of the inequalities in international...


    • FIVE Material Wellbeing in the United States
      (pp. 167-217)

      STARTING IN THE MIDDLE of the eighteenth century in Britain, longevity slowly began to improve in countries around the world. As people made their escape from disease and early death, living standards began to improve too, and, to a large extent, health and the level of living moved in parallel. The ideas of the Scientific Revolution and the Enlightenment eventually brought a revolution in material wellbeing, just as they brought a revolution in the length of life. These parallel revolutions, driven by the same ultimate causes, brought better and longer lives for many, but also created a world of difference...

    • SIX Globalization and the Greatest Escape
      (pp. 218-264)

      IN THE YEARS SINCE World War II, the modern world has seen the greatest escape of all. Rapid economic growth in many countries has delivered hundreds of millions of people from destitution. Material wellbeing has risen as death rates have fallen, and people are living longer and richer lives. As always, progress has not been even; some of the most rapidly growing countries have narrowed the gap with the rich countries, but their progress has opened up new gaps between them and the countries left behind. Once-poor countries in Asia have moved into the middle, leaving chasms between them and...


    • SEVEN How to Help Those Left Behind
      (pp. 267-324)

      ALMOST A BILLION PEOPLE still live in material destitution, millions of children still die through the accident of where they are born, and wasting and stunting still disfigure the bodies of nearly half of India’s children. Those people are among the many that the Great Escape has left behind. As in the past, the very enormity of the inequality points to ways to eliminate it. The scientific and technological advances that supported the escape are available to all, and I need hardly restate the benefits of escaping or the horrors of being left behind. Some countries in South and East...

  6. POSTSCRIPT: What Comes Next?
    (pp. 325-330)

    MY STORY OF THE GREAT ESCAPE is a positive one, of millions saved from death and destitution, and of a world that, in spite of its inequalities and of the millions still left behind, is a better place than at any time in history. Yet the movie that I have used as a running metaphor did not have a happy ending. All but a handful of the escapees were recaptured, and fifty of them were executed. Can we be confident that our Great Escape will be different?

    Probably not, but it is reasonable to hope.

    Our children and grandchildren cannot...