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

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

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About the author

Angus Deaton, winner of the 2015 Nobel Prize in economics, is the Dwight D. Eisenhower Professor of Economics and International Affairs in the Woodrow Wilson School of Public and International Affairs and the Economics Department at Princeton University. His many books include The Analysis of Household Surveys and Economics and Consumer Behavior. He is a past president of the American Economic Association.
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Additional Information

Publisher
Princeton University Press
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Published on
Sep 22, 2013
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Pages
376
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ISBN
9781400847969
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Language
English
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Genres
Business & Economics / Development / Economic Development
Business & Economics / Economic History
Health & Fitness / Health Care Issues
History / World
Law / Health
Medical / Public Health
Political Science / Globalization
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Content Protection
This content is DRM protected.
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Brilliant and engagingly written, Why Nations Fail answers the question that has stumped the experts for centuries: Why are some nations rich and others poor, divided by wealth and poverty, health and sickness, food and famine?

Is it culture, the weather, geography? Perhaps ignorance of what the right policies are?

Simply, no. None of these factors is either definitive or destiny. Otherwise, how to explain why Botswana has become one of the fastest growing countries in the world, while other African nations, such as Zimbabwe, the Congo, and Sierra Leone, are mired in poverty and violence?

Daron Acemoglu and James Robinson conclusively show that it is man-made political and economic institutions that underlie economic success (or lack of it). Korea, to take just one of their fascinating examples, is a remarkably homogeneous nation, yet the people of North Korea are among the poorest on earth while their brothers and sisters in South Korea are among the richest. The south forged a society that created incentives, rewarded innovation, and allowed everyone to participate in economic opportunities.

The economic success thus spurred was sustained because the government became accountable and responsive to citizens and the great mass of people. Sadly, the people of the north have endured decades of famine, political repression, and very different economic institutions—with no end in sight. The differences between the Koreas is due to the politics that created these completely different institutional trajectories.

Based on fifteen years of original research Acemoglu and Robinson marshall extraordinary historical evidence from the Roman Empire, the Mayan city-states, medieval Venice, the Soviet Union, Latin America, England, Europe, the United States, and Africa to build a new theory of political economy with great relevance for the big questions of today, including:

- China has built an authoritarian growth machine. Will it continue to grow at such high speed and overwhelm the West?

- Are America’s best days behind it? Are we moving from a virtuous circle in which efforts by elites to aggrandize power are resisted to a vicious one that enriches and empowers a small minority?

- What is the most effective way to help move billions of people from the rut of poverty to prosperity? More philanthropy from the wealthy nations of the West? Or learning the hard-won lessons of Acemoglu and Robinson’s breakthrough ideas on the interplay between inclusive political and economic institutions?

Why Nations Fail will change the way you look at—and understand—the world. 
"A persuasive look at why some U.S. cities have prospered in recent decades while others have declined."—Bloomberg Businessweek


We’re used to thinking of the United States in opposing terms: red versus blue, haves versus have-nots. But today there are three Americas. At one extreme are the brain hubs—cities like San Francisco, Boston, and Durham—with workers who are among the most productive, creative, and best paid on the planet. At the other extreme are former manufacturing capitals, which are rapidly losing jobs and residents. The rest of America could go either way. For the past thirty years, the three Americas have been growing apart at an accelerating rate. This divergence is one the most important developments in the history of the United States and is reshaping the very fabric of our society, affecting all aspects of our lives, from health and education to family stability and political engagement. But the winners and losers aren’t necessarily who you’d expect.

Enrico Moretti’s groundbreaking research shows that you don’t have to be a scientist or an engineer to thrive in one of the brain hubs. Carpenters, taxi-drivers, teachers, nurses, and other local service jobs are created at a ratio of five-to-one in the brain hubs, raising salaries and standard of living for all. Dealing with this split—supporting growth in the hubs while arresting the decline elsewhere—is the challenge of the century, and The New Geography of Jobs lights the way.


"Moretti has written a clear and insightful account of the economic forces that are shaping America and its regions, and he rightly celebrates human capital and innovation as the fundamental sources of economic development."—Jonathan Rothwell, The Brookings Institution
 貝爾經濟學獎得主代表著作迪頓(Angus Deaton)關心全球窮人,要他們過好日子
他分析為何人類獲得有史以來最好的生活水準
深入探討因此而產生的貧富差距及不平等現象
諾貝爾頒獎委員會說:迪頓把應用經濟學發揮得淋漓盡致!

比爾蓋茲、普林斯頓大學校長艾斯格魯柏、賓州大學普列斯頓教授、耶魯大學波吉教授、《紐約時報》、《金融郵報》、《商業世界》、《金融時報》、《彭博資訊新聞》、《經濟與政治周刊》、《商業經濟學》、《富比士》雜誌、《周日泰晤士報》等大力推薦

比爾‧蓋茲(Bill Gates):
如果你想了解為何人類的整體福祉隨著時間而快速進步,一定要讀本書。

※   ※   ※

現今人們變得更富裕、更健康、更長壽
然而當大量人口脫離貧窮後
人與人、國與國之間卻形成極大的不平等!
2015年諾貝爾經濟學獎得主、世界首屈一指的發展經濟與貧窮研究學家──迪頓
探討各國增進健康、財富的舊有和現行模式
提出援助落後國家展開大脫逃的具體作法。

迪頓在《財富大逃亡:健康、財富與不平等的起源》一書中闡述某些影響廣大的創新與不易克服的障礙,例如,人類一方面擁有了疫苗、抗生素、防蟲措施和潔淨水源,一方面必須對抗大饑荒、愛滋病和文明疾病。除了檢視美國歷經長期繁榮之後成長步調趨緩、貧富差距漸增的情況,也提到印度與中國的經濟成長如何改善十多億人口的生活。有鑑於國際援助成效不彰,甚至有害無益,迪頓在書末倡議採取替代措施,包括對製藥公司提供新誘因、取消貿易限制等,讓開發中國家也能展開大脫逃。

迪頓撰寫本書的主旨在討論全球的健康與財富,不僅聚焦於現代,也回顧人類發展的歷程。

首先,探討人類的健康發展史、數十萬年前的狩獵與採集生活為何影響現代人的健康,以及人類從十八世紀開始努力降低死亡率如何奠定現代的健康進步模式。十九世紀末,細菌致病論的發展與採納,為另一波爆炸性的進步奠定基礎,同時也打開另一道鴻溝,使得富國與窮國人民的存活率出現極大差距。

二次大戰結束後,全球加快腳步研究醫療方法,以便拉近自十八世紀開始形成的健康鴻溝。其間獲得許多重大成就,例如運用抗生素、防蟲措施、疫苗注射和乾淨水源,讓數百萬孩童免於死亡。雖然窮國與富國平均壽命差距縮小,但還不夠接近,且全球曾遭遇某些可怕的障礙,例如1958至1961年間人為因素造成的中國大饑荒,以及若干非洲國家近年流行的愛滋病,徹底摧毀了人類對抗死神的三十年進步成果。目前還有許多國家缺乏適當的常設醫護系統、大量孩童因生在「錯」的國家而難逃一死、某些地區還有孩童嚴重營養不良,以印度最出名。

富國和窮國的死亡率差距未能加速拉近的理由之一是,雖然富國的死亡率持續下降,但對成人比較有利,孩童受惠較少。也談到富國死亡率降低的趨勢、男女平均壽命不斷趨近的原因、吸菸扮演的要角,以及心臟病治癒率大於癌症治癒率的因素。

其次,討論物質生活水準。美國的經濟狀況既特殊且極端(例如所得不均的程度),但其他富裕國家也不遑多讓。二次大戰後,經濟成長為美國帶來新的榮景,使得貧窮人口(尤其是非洲裔和年長者)顯著減少。1970年代以前,美國曾是全球重要經濟楷模,此後成長持續減慢,所得差距因富人激增而持續加大。這種不平等有其光明面,例如教育、創新和創意獲得的報償高於往昔;但也顯示出黑暗面,由於美國是金權國家,導致國民的幸福受到政治和經濟的威脅。

全球貧窮人口自1980年開始減少,堪稱人類史上規模最大、速度最快的一次脫逃行動,主因在於人口最多的中國和印度經濟成長表現非凡,改變了十幾億人口的生活。目前全球的生活水準雖然遠勝過1960年代悲觀者預測的情況,但仍有約十億人口三餐不濟;許多人已經逃脫,也有不少人被遺棄。

再次,提出大家應該和不該採取的行動。我們幸運地生在「對」的國家,因此應該善盡道德義務,協助全球減少貧窮和疾病;已經掙脫貧窮和疾病的人,必須幫助依然受困者。很多人認為我們應該以提供外援的方式,以及透過多國政府(大都設有官方援助機構)、世界銀行和世界衛生組織等國際組織,或是在各國國內或國際上營運的非政府救援組織,來履行這些道德義務。但是,如果這類援助會破壞某些國家的成長機會(這正是我的看法),我們就沒有理由抱著「應該做些什麼」的觀念繼續提供救濟,而應該停止援助。過去五十年,援助對於經濟成長和減少貧窮到底功過如何?值得質疑。

最後,迪頓提出一個問題:我們是否渴望展開大脫逃行動,為現今世界創造幸福與快樂。《財富大逃亡》剖析健康與生活水準的提升如何改變我們的生活,是討論所有國家幸福議題的重要指南。
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