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Challenges in Health and Development pp 77–108Cite as

State-Led Growth and Development

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Abstract

The health of the state is a symbolic conceptualization of a collective entity that is made up of geographic territory, institutions, laws, and people. At the national level, health can intersect with concern for state and human security , macroeconomic performance and population health . Two dominant models of state investment developed in the late 20th century. One placed human development , with concern for health and education , at the forefront of policy concern; the second placed macroeconomic growth at the policy apex. Each approach entailed trade-offs which affect both short-and long-term outcomes and opportunities for the nation. Rapid, short-term economic growth can create monetary and material resources that can improve the availability of inputs to health but can also increase health inequalities. If the state does not intervene, these inequalities will cause long-term harm to the poorest, most vulnerable in society. Investment in human health and welfare can achieve equitable health coverage, access to care and gains in health outcomes. However, it can also lead to unsustainable and unsound budgetary practices that impact the macroeconomic performance of the state. Chile and Sri Lanka demonstrate the strengths and weaknesses of the aforementioned approaches to health and development.

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Notes

  1. 1.

    Calculation based on World Bank (2009a, b) data for 1970 and 1975.

  2. 2.

    Calculated based on data in UNCTAD (2009).

  3. 3.

    About 160 social insurance funds existed, each with different benefits (Borzutsky 2002).

  4. 4.

    Some sources place the estimate around 3000 (Ensalaco 1994). However, critics argue the numbers were not based on comprehensive assessments. Other sources place the number of those executed at 15,000 with an additional 2000 disappeared (Graham 1990).

  5. 5.

    In 1984 fiscal contributions accounted for 42.6% of FONASA’s financial base; this decreased to 37.8% in 1990 (Titelman 1999).

  6. 6.

    Annual GDP growth rates ranged from 4 to 6% through the 1980s; BOP deficits as % of GDP declined from double to single digits by 1984 (World Bank 2009a; Central Bank of Sri Lanka 2008, 2009).

  7. 7.

    By 1978, households spent approximately 11% of their income on food, up from 8% in previous years. (Central Bank of Sri Lanka 2008, 2009).

  8. 8.

    Other reports estimate more than 70,000 casualties (Gardner 2007).

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Authors and Affiliations

  1. Josef Korbel School of International Studies, University of Denver, Denver, CO, USA

    Sandy A. Johnson

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  1. Sandy A. Johnson
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Correspondence to Sandy A. Johnson .

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Johnson, S.A. (2017). State-Led Growth and Development. In: Challenges in Health and Development. Springer, Cham. https://doi.org/10.1007/978-3-319-53204-2_3

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  • DOI: https://doi.org/10.1007/978-3-319-53204-2_3

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