Running head: GLOBALHEALTHANDHUMANDEVELOPMENT 1

Global Health and Human Development

Erich Bonilla

California State University, San Bernardino

GLOBALHEALTHANDHUMANDEVELOPMENT 2

Global Health and Human Development

For a long time, economic growth was the method used to assess the development of a

country. To form a more complete representation of a nations development, the United Nations

created the Human Development Index (HDI) which emphasizes the people and their capabilities

(“Human Development Index (HDI) | Human Development Reports,” 2016). The HDI score is

composed of three indexes, the life expectancy index, an education index, and a gross national

income index, allowing the United Nations to determine a country’s score and rank it against

other nations. HDI can also be used to help determine how governmental policies countries

impact the HDI score of countries with similar Gross National Income (GNI). Being able to

compare these nations, allows for a debate on the effectiveness of those countries policies. HDI

does have its flaws though, it does not take into consideration disparities such as, inequalities,

poverty, empowerment or security (“Human Development Index (HDI) | Human Development

Reports,” 2016). In the case of the United States these disparities continue to be experienced by

some members of their society. This along with the continued high cost of healthcare within the

United States has had an impact on the HDI ranking of the United States. By understanding how

the policies and economy of the United States can influence their HDI rank, and how to address

them could lead to future improvements in HDI rankings

US HDI

The United States is tied for tenth in the Human Development Index rankings, for the

year 2015, the last year the rankings were available, this is a move up from its ranking of

eleventh for 2014 (“| Human Development Reports,” 2016). This ranking was among those

country considered to have very high human development. This Human Development Index

classification is reserved for those countries that have an HDI of .80 or higher, currently there are
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51 countries listed in this category. While upward movement is a positive for the country, there is

still much that needs to be improved. The United States should continue striving to improve the

Human Development Index ranking, to improve the life of its citizens. This could include

reducing healthcare cost, and improving access to healthcare, this could help improve the life

expectancy index, which could help improve the overall HDI ranking of the United States. This

is especially true since this the one index that the United States trails other very high human

development nations.

Human Development Index

1
0.949
0.9 0.92 0.92

0.8 0.8 0.796

0.7 0.701 0.699

0.6
0.55 0.541
0.5

0.4
0.352
0.3
Low Rank Top Rank

Very High Human Development High Human Development

Medium Human Developmet Low Human Development
United States

Life Expectancy

One of the measures used to determine the Human Development Index is the life

expectancy of people living in the country. When comparing the life expectancy measure against

other very high human development nations the United States falls from a top ten nation to a

rank that is in the middle of the group. This could be one of the reasons that the United States
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ranks tenth, instead of higher in the Human Development Index (“| Human Development

Reports,” 2016). This is of concern considering that the United States pays the highest per capita

for healthcare, at about $ 9400 (“WHO | United States of America,” n.d.). Considering that other

nations average approximately $3000 per capita (“usa.pdf,” n.d.), there is a no correlation

between health spending and health outcomes. One could infer that the policies of the United

States have a negative influence on the cost of healthcare cost. This in turn influences the life

expectancy index of the United States.

Global Life Expectancy

90
85 84.2
80 79.6
79.2 79.2
75 75.9

70 70.3 69.7
69.4
65
60
57.7
55
50
48.9
45
Low Life Expectancy High Life Expectancy

Very High Human Development High Human Development

Medium Human Development Low Human Developmet
United States

Maternal and Infant Mortality

When determining the overall health of a nation, one must always look at health statistics.

Two of the most valuable figures that help determine the health of a nation is maternal and infant

mortality. Determining these statistics will help one determine the progress a nation has made
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towards women’s and children’s health. They also help determine overall national development

and influence the human development index. The United States has made improvements in

reducing infant mortality, down to 5.7/1000 in 2015(“GHO | By country | United States of

America - statistics summary (2002 - present),” 2017) as compared to 9.2/1000 in 1990 (“Infant

Mortality -- United States, 1990,” 1993). This is an indicator that overall health for children is

increasing in the United States. As for the maternal mortality with the United States, it is listed at

14/100,000 live births, this though is an increase when compared to the 1990 data of 12/100,000

live births (“GHO | By country | United States of America - statistics summary (2002 - present),”

2017). So, while improvements have been made in children’s health, women’s health appears to

be on the decline. Both these figures also impact the development of a nation, because a drop-in

population would impact the future workforce of a nation. Without a replacement workforce a

country’s gross national index would drop affecting the GNI index of a nation. This drop in the

GNI index would in turn negatively impact the HDI of a nation.

When compared to very high human development nations, the United States trails behind

nations of comparable development (“Infant Mortality -- United States, 1990,” 1993). This is a

trend that has persisted for many years and even as the country makes improvements in this

health statistic, it continues to trail many nations considered to be very high development. This

continues to be an area where further improvement is necessary.

Comparing maternal mortality rates with other very high human development nation, the

United States continues to fall behind other developed nations. When analyzed by race though,

we see a racial disparity among white women and African-American woman. Comparing the

2013 data of these two groups, we see that the maternal mortality rate for white woman was

12.7/100,000 while those of African-American woman was 43.5/100,000 (“Pregnancy Mortality

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Surveillance System | Pregnancy | Reproductive Health | CDC,” 2017). This disparity continues

to exemplify the racial issues faced by the nation. This could also be a marker for policies that

limit access, quality while increasing the cost of healthcare.

U.S. Mortality Rates

16

14 14

12 12

10
9.2
8

6 5.7
4

0
1990 2015

Maternal Mortality Rate Infant Motality Rate

Comparison

When analyzing the data described above we begin to question the effectiveness of the

healthcare system and policies in the United States. The first item we need to question is what

would happen to the Human Development Index score of the United States if their healthcare

spending per capita was comparable to those of other high human development countries. If this

was to occur, would it drop the United States from those countries classified as very high human

development? This is quite possible considering that even with the current spending on

healthcare the United States does not have the longest lifespans of these countries, so by taking

money out of the system we would see a negative impact on the lifespans of the populace.
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Infant and maternal mortality would be an area that would be impacted by the defunding

of the healthcare system in the United States. If these statistics trended in a negative manner,

then we know that there would defiantly be an impact on United States overall HDI ranking. This

would occur because the overall lifespan index in the United States would fall, which would

impact the total Human Development Index rating. Beside a negative impact on the Human

Development Index, an increase in infant mortality could influence the future productivity of a

nation, which could influence future gross national income per capita. A lowing of the gross

national income would also negatively impact the human development index as well as influence

the amount of money that could be invested into healthcare.

Understanding

While the United States has made improvement in the health of its populace, there

continues to be a need for improvement. This is especially true when you compare healthcare

cost with other nations. To reconcile this disparity, healthcare expenditure and lifespan, there

needs to be an analysis of policies and market practices so that the citizens of the United States

can obtain the best value for their investment. Beside the cost of healthcare, there are other

policies need to be analyzed to improve the lives of its citizens. These policies could help

mitigate the disparities faced by many citizens and lead to better health outcomes for many

people. If the United States attempts to improve the policies and cost of healthcare, they could

take an active role in the improvement of the health outcomes of their citizens, at the same time

these policies could improve some of the other disparities faced by members of the populace,

including racism, social inequalities, poverty and a feeling of security within their society.
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References

GHO | By country | United States of America - statistics summary (2002 - present). (2017,

October 20). Retrieved November 12, 2017, from

http://apps.who.int/gho/data/node.country.country-USA

Human Development Index (HDI) | Human Development Reports. (2016). Retrieved November

11, 2017, from http://hdr.undp.org/en/content/human-development-index-hdi

Infant Mortality -- United States, 1990. (1993, March 12). Retrieved November 14, 2017, from

https://www.cdc.gov/mmwr/preview/mmwrhtml/00019835.htm

La| Human Development Reports. (2016). Retrieved November 11, 2017, from

http://hdr.undp.org/en/composite/HDI

Pregnancy Mortality Surveillance System | Pregnancy | Reproductive Health | CDC. (2017,

November 9). Retrieved November 14, 2017, from

https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pmss.html

usa.pdf. (n.d.). Retrieved from http://www.who.int/gho/countries/usa.pdf?ua=1

WHO | United States of America. (n.d.). Retrieved November 14, 2017, from

http://www.who.int/countries/usa/en