The Health Transition: A Conference in Memory of Robert Fogel

Hoyt Bleakley, University of Chicago and NBER; Dora Costa; and Adriana Lleras-Muney, University of California at Los Angeles and NBER

Trends in Health, Education and Income in the United States, 1820- 2000 (NBER Working Paper 19162)

Bleakley, Costa, and Lleras-Muney document the correlations between early childhood health (as proxied by height) and educational attainment, and investigate the labor market and wealth returns to height for United States cohorts born between 1820 and 1990. The 19th century was characterized by low investments in height and education, a small correlation between height and education, and positive but small returns for both height and education in non-farm occupations. The relationship between height and education was stronger in the 20th century and stronger in the first part of the 20th century than later on (when investments in both education and height stalled), but never as strong as in developing countries. The labor market and wealth returns to height and education also were higher in the 20th compared to the 19th century. The authors relate their findings to the theory of human capital formation and speculate that the greater importance of physical labor in the 19th century economy, which raised the opportunity cost of schooling, may have depressed the height-education relationship relative to that of the 20th century. Their findings are consistent with an increasing importance of cognitive abilities acquired in early childhood.

Bernard Harris, University of Southampton, Roderick Floud, University of London and NBER, and Sok Chul Hong, Sogang University

Food for Thought: Comparing Estimates of Food Availability in England and Wales, 1700-1914 (NBER Working Paper 20177)

Recent publications have included several efforts to estimate the number of calories available for human consumption in Britain since the 13th century. Although these papers have often drawn on similar sources, they have sometimes reached quite divergent conclusions about both levels and trends. These disagreements have profound implications for our understanding of a range of issues, including the measurement of basic living standards, the relationship between diet and health, and the impact of food availability on economic growth. In this paper, Harris, Floud and Hong follow a number of other authors in seeking to navigate a route between the conflicting estimates. The first section offers a detailed summary of some of the major publications and their findings. The author then offers a more detailed analysis of some of the reasons for the differences between them. The final section highlights some of the problems associated with the attempt to construct composite series and relates this discussion to the analysis of trends in real wages, height and mortality.

Jay Olshansky, University of Illinois at Chicago

The Future Course of Longevity and Health in the U.S.

During the last 150 years the rise in human longevity occurred swiftly and without precedent. Advances in public health saved the young, and medical technology saved those at middle and older ages, but an important question before us now is whether longevity and health can continue to improve in the future as it has in the past. Olshansky suggests that forecasts about the future of longevity and health must begin with an understanding of the biology that drives longevity determination. He demonstrates that duration of life is limited, even in the absence of genetically fixed programs that regulate aging and death, and that competing forces are now working simultaneously to raise and lower health status and longevity in the future. For some, health and longevity in the future will exceed current expectations, while for others it appears that declines in life expectancy and worsening health have already begun.

Tommy Bengtsson, Lund University

The Mortality Transition in Sweden: Diet or Disease?

Bengtsson examines the timing of the great mortality decline, which was strikingly similar in the countries of Western and Northern Europe despite differences in economic structure and development. The decline started in the middle of the 18th century, became more pronounced around 1800 and then continued. The decline in North America was similar. Life expectancy at birth, starting around 35 years, increased by about one month per year between 1750 and 1840, and thereafter by almost three months per year to reach more than 80 years by the end of the 19th century. With the great mortality decline there came a change in the composition of the causes of death, away from epidemics and toward infections and chronic diseases. Few scholars today would argue that a single factor, like economic growth, was the main determinant of the great mortality decline. In fact, economic growth is not likely to be even a major determinant, at least not in the initial stages of the great mortality decline, and perhaps far less than expected during later stages.

James Heckman, University of Chicago and NBER; John Eric Humphries, University of Chicago; and Gregory Veramendi, Arizona State University

The Effects of Educational Choices on Labor Market and Health Outcomes

Using a sequential model of educational choices, Heckman, Humphries, and Veramendi investigate the effect of educational choices on labor market and adult health outcomes. They find that between one third and one half of the observed difference in health outcomes and wages is causal. Unobserved cognitive and socio-emotional endowments drive the correlations in unobservables across choice and outcome equations. The authors proxy these endowments with numerous measurements and account for measurement error. For each final schooling level, they estimate models of labor market and health outcomes. This allows them to generate counter-factual outcomes for dynamic choices and a variety of policy and treatment effects. In this framework, responses to treatment vary among observationally identical persons and agents may select into the treatment on the basis of their responses.The authors decompose treatment effects into direct benefits and the continuation value from access to additional education, showing that both components are empirically relevant. They find important effects of early cognitive and socio-emotional endowments on schooling choices, labor market outcomes, and adult health outcomes. Education at most levels causally produces gains on labor market and adult health outcomes. The authors estimate the distribution of responses to education and find heterogeneity in unobserved endowments on which agents act.