Old and new factors in health transitions

Abstract

The introductory section of the paper notes that the health transition literature suggests a greater range of cultural, social and behavioural influences on health, especially child survival, than has attracted the attention of most social science researchers. They concentrate disproportionately on the impact of parental education, especially maternal education, perhaps because these are measures that are easily quantified and readily available in census and surveys. The major part of the paper discusses the implications of the finding by Preston and Haines that there is little evidence that child survival in the United States a century ago was much affected by mother’s literacy, ethnicity or English-speaking ability. This review draws on that evidence to argue that Third World mortality has in contrast been reduced over recent decades by two imports: modern medical technology and the Western scientific attitude that induces a successful collaboration with the former. This attitude is largely a product of modern education and it is this symbiosis in reducing mortality between modern medical technology and the scientific outlook that explains why steep mortality declines in the contemporary Third World depend both upon providing an easily accessible modern health service (with a significant curative component) and the development of mass schooling (particularly for girls). It also explains the steep differentials in child survival by mother’s education. Show more