Mortality and economic development in Western, non-Western nations and China having different health policy implications, 1960–2023
Mario CocciaPurpose
This study examines mortality trends from 1960 to 2023 across Western countries, non-Western countries and China during their different dynamics of economic growth. In particular, it analyzes how the long-run relationship between economic development and mortality in society has evolved among these geoeconomic regions to explain differences in patterns and inform future health governance strategies.
Design/methodology/approach
Using descriptive statistics, growth rates, simple, multivariate and spline regression models, the study evaluates the effects of economic development, measured with Gross Domestic Product (GDP) per capita, on the dynamics of mortality rates among geoeconomic regions, controlling for population aging, health expenditure, obesity and air pollution.
Findings
Results reveal a marked decline in mortality in non-Western regions, closely linked to rising GDP per capita. Conversely, China and Western countries exhibited modest mortality increases, despite sustained economic growth. Quadratic and spline regression models show that as GDP per capita rises, mortality drops significantly, but past $25,091, further increases in GDP per capita can be associated with a net increase in mortality.
Research limitations/implications
Findings suggest that in advanced economies, continuous economic growth, beyond a certain threshold (estimated here at $25,091) can deteriorate socioeconomic system and environment, and as a consequence, public health progress because of interrelated factors in development.
Practical implications
Policymakers can understand directional reversal associated with over-development, driving the “diseases of affluence”.
Social implications
The findings suggest that economic growth alone is an unreliable proxy for population health: mortality can fall rapidly with rising incomes in lower-income regions, yet plateau or worsen in advanced and fast-developing societies as aging, environmental harms, ultra-processed food, risky work and lifestyle-related disease accumulate. This implies a need to reframe economic and health governance toward sustainability, prevention and equity – strengthening environmental protections, safer workplaces and healthier living conditions – while aligning social development with human, ecological and social well-being, not GDP targets.
Originality/value
Long-run cross-macro region comparison of income–mortality relationship suggesting the diseases of over-economic development in nations.