Pro-market policies for developing countries have long been based on the belief that increasing average income is key to improving public health and societal well-being.
But new research on India published in the journal Social Science and Medicine shows that literacy - a non-income good - has a greater impact on public health in India.
While the researchers, based at Cambridge's Department of Sociology, accept it is broadly true that "wealthier is healthier" across the roughly 500 districts in India's 'major states', accounting for 95% of the total population, they find that poverty and, crucially, illiteracy are much stronger predictors of poor public health than low average income.
A poor district can nonetheless enjoy relatively good public health if it has a high literacy rate, say researchers. Literacy acts as a base, enabling populations to understand medicine labeling, access healthcare, and engage with public health programmes.
Using data on income, education, and under-five and infant mortality, the researchers suggest that policymakers concerned with public health should focus on literacy levels rather than average income.*
Models estimate that for the 'typical' Indian district in the early 2000s, the poverty gap would have had to be reduced by 25% to save one child per thousand live births, whereas a mere 4% increase in literacy rate would have had the same effect.+
And at the level of India's 35 states and Union Territories, literacy is the only significant predictor of public health even poverty gap is not a reliable predictor.
"Economic policies narrowly focused on growth are insufficient when it comes to public health in less developed countries," said Lawrence King, Professor of Sociology and Political Economy and co-author of the study with Cambridge colleagues Keertichandra Rajan and Jonathan Kennedy.
"Higher average income is a statistical red herring: it contributes to better public heal
|Contact: Fred Lewsey|
University of Cambridge