CoralMercado

CEP302
BookReport
2/11/15

EscapefromHungerandPrematureDeathRobertFogel

RobertFogelearnedhismastersdegreeineconomicsatColumbiaUniversityin1960,
wherehelearnedeconomicsfromGeorgeStiglerandeconomichistoryfromCarterGoodrich.
HeearnedhisPh.D.atJohnsHopkinsUniversityin1963,whereheworkedunderSimon
Kuznets(TheConciseEncyclopediaofEconomics).HewasaNobelPrizewinnerinEconomics
(withDouglassC.North)in1993forhavingrenewedresearchineconomichistorybyapplying
economictheoryandquantitativemethodsinordertoexplaineconomicandinstitutional
change"(NobelPrize,1993)ThismethodologyheusediscalledCliometricsanditapplies
moderneconometrictechniquestoolddatasetstolookathistoryinanewway.
Heusesthesametechniquesinhis2004book
TheEscapefromHungerandPremature
Death,17002100:Europe,America,andtheThirdWorld.
Whilethiswasabookwrittenbya
practitionerofthedismalscience,itwasveryaccessibletoalayreaderanditssmallsize(111
pages)lendeditselftoaquickread.Thebookhastwopartswiththefirst(Chapters13)
analyzingthelinkbetweenincreasedaccesstocaloriesandnutrientsinapopulationandthe
increasedhealth(measuredbyheightandweight)andlongevityofthatpopulation.Accordingto
Fogel,thisincreasedhealthandlongevitycanaccountforaroundhalfofthegrowthinnational
incomeinBritainsince1790becausewhenworkershadmorecaloriestheycouldproducemore
goods(Fogel2004,34).Fogelcallsthisrelationshipbetweenincreasednutrition,technology,
andbodysize,technophysioevolutionwhichhedefinesasa,synergismbetween
technologicalandphysiologicalimprovementsthathasproducedaformofhumanevolutionthat
isbiologicalbutnotgenetic,rapid,culturallytransmitted,andnotnecessarilystable(Fogel
2004,20).
Theseimprovementshowever,werenotfeltequallyamongallsocioeconomiclevels,
withwiththelifeexpectancyoftheupperclassrisingwhileitdecreasedforthoseinthelower
classesformostofthenineteenthcentury(Fogel2004,36).Itisimportanttonotethatthistrend
isnotvisiblewhenoneonlylooksatthetraditionaleconomicdataofthetimebecauseitwould
appearasthoughinequalitystayedconstantbecausepercapitaincomeincreasedduringthis

time(Fogel2004,36)Duringthetwentiethcenturyweseeanincreaseinthesocialinvestment
inpublichealthwhichincluded,federalinvestmentsinbiomedicalresearch,theexpansionof
clinicalmedicineestablishedonscientificprinciples,andtheinternationalexpansionofthe
knowledgeofthebiology,chemistry,andepidemiologyofdisease(Fogel2004,37).Thisledto
areductioninthegapbetweenthelowerandupperclassesandthusincreasedequality(Fogel
2004,38).
Tobolsterhisargumentsheshowsacomparisonoftheprevalenceofchronicconditions
amongUnionArmyVeteransin1910,1983,andVeteransinNHIS,198588whichshowsthat
overtime,theprevalenceofvariousdisorders,affectingthemusculoskeletal,digestive,and
circulatorysystemstonameafew,decreasedby20~60~%dependingonthedisorder(Fogel
2004,31,Table2.1).
Inthesecondsection(Chapters45)considerswhattheselongtermdemographic
changesmeanforhealthcareinthefuture.Fogelseestheraisingamountofmoneyspenton
healthcareintheUnitedStatesassomethingthatshouldbewelcomedbecausewiththecostof
livingdecreasing,thisallowspeopletospendmoreontheirleisureandhealth(James2005,
61).Theeffectsoftechnophysioevolution,besidesthoserelatedtohealthandlongevity,are
increasedproductivityandpersonalincomewhich,accordingtoFogel,leadtomoreleisuretime
andwhathecalls,volwork(Fogel2004,6970).Volworkisworkanindividual
might
bepaid
forbutforwhichthemotivationispurelyvoluntary,asopposedtoearnwork,whichhe
describesasworkthattheindividualmustdotosurvive(Fogel2004,70).Inthepast,volwork
andleisureweretheprovinceoftherichandprivileged,butwiththeaidoftechnophysio
evolution,increasedaccesstoleisureandvolworkismoreequallydistributedamongthe
populationsoftheworld.Fogeldemonstratesthataverageseculardailyhoursspentonwork
hasdecreasedfrom8.5hours(assuminga64hourworkweek)in1880to4.7hours(assuming
a37.5hourworkweek)in1995andthatleftoverleisuretimehasincreasedfrom1.8hoursto
5.8hours(Fogel2004,68,Table4.1).InthesametableFogelpredictsthattimespentworking
willonlycontinuetodecreaseandconverselyleisuretimewillincreasein2040.Healsocitesa
1995pollinwhich48%ofU.S.adultearnworkershadeithercutbackonhoursofwork,
declinedapromotion,reducedtheircommitments,loweredtheirmaterialexpectations,or
movedtoaplacewithaquieterlifeduringthepreceding5years(Fogel2004,72).
Thisleadsintomyfirstcriticismofthebookwhichisthattheaveragedailytimespent
workinghasnotdecreased,atleastnotintheUnitedStates.UsingthesamemetricsFogel
usestocalculatetheaveragedailyamountoftimespentworking,Icalculatedtheamountof

timetheaverageAmericanworkerspendsonworkdaily(basedontheaverageAmericanwork
weekof46.7hours)tobe6.7hoursandatthispointintime,only8%oftheAmericanwork
forceworkslessthan40hours(McGregor2014).Alsosincethe2008recession,with
unemploymentcappingat10%inOctober2009,Idontthinkitsunreasonabletoguessthe
proportionofearnworktovolwork(ifearnworkcouldbeacquiredatall)washighinsteadof
Fogelspredictionsofanincreaseinvolwork(Databases,Tables&CalculatorsbySubject).
Also,Fogelseemstothinkthatincreasednutritionandincomewilleradicateinequalityin
ourpopulations,butincomeinequalityisatitshighestsincetheDepressionEraandthereare
realdifferencesinthehealthoutcomeswhenraceandsocioeconomicstatusistakeninto
consideration.TogiveFogelsomecredithowever,hewasinfavoroftherichsubsidizingthe
poorintermsofhealthcaretaxesandlikelywouldnotbeinfavorofthecurrentdynamic(Fogel
2004,97).
AdditionallythereisalackofanalysisofsimilardataforJapanwhichseemsoddsince
helooksatdatafromIndiaandChinaandgiventhatJapan,atthetime,wasthemost
prosperousAsiancountry,withitspopulationamongthemostlongliveddespitetheirsmall
statureandweight(James2005,61).ItwouldbeinterestingtoplotthesamedataforJapanese
malesintotheWaalercurveandseeifthesamepatternholdstrue.
Despitethesecriticisms,thisbookhighlightsthevalueofnutritionfordesirablehealth
outcomesanditssynergisticeffectontechnologyandoutput.Historically,foodsystemsand
nutritionhavenotbeenconsideredasrigorouslyasothersubsectionsofplanning,butwithnew
researchthathighlightstheeffectsoffooddesertsonthefoodchoicesthatpeoplemake,itis
comingtotheforefrontofplanning.Althoughsomeofthepredictionshemakesareoverly
optimisticinmyopinion,hisanalysisofthehistoricaldatashowsveryimportanttrendsinthe
relationshipbetweennutritionandlongevity.Tome,thisonlyhighlightsthefactthataccessto
propernutritionisanissueofsocialjusticeandfurthermore,ahumanright.
WhileFogelhasalotofhopeforthefutureofmedicineandwhatitcanaccomplish,he
suggestsaprioritiesforpolicymakerswiththefirstbeingthatourprimaryfocusshouldbeon
theexpansionofprenatalandpostnatalcaretargetedparticularlyatyoung,singlemothers
becausethereispersuasiveevidencethatinsults
inutero
thatreducebirthweightandlength
[...]greatlyincreasehealthrisksthroughoutthelifecycle(Fogel2004,104).Oursecondpriority
shouldbetoimprovehealtheducationforneedyindividualswhowewillreachthrough
partnershipswithcommunityorganizationsthatarealreadyexperiencedinoutreach(Fogel
2004,105).Becauseeducationandknowledgedontalwaystranslatetobehaviorchanges,

Fogelalsosuggeststhatperiodichealthscreeningstakeplaceinschools,especiallythosein
underservedneighborhoods,frompreKthrough12toincreaseaccesstohealthcare(Fogel
2004,105).Inthesamevein,hesuggeststhatpublichealthclinicsbeestablishinunderserved
neighborhoodsbecause,evenindividualswithinsurance,[...]failtotakeadvantageofavailable
facilitiesbecausetheyareinconvenient(Fogel2004,105).HisfinalsuggestionisthattheU.S.
increaseitscontributiontotheinternationalcampaigntobringvaccines[...]tochildrenand
adultswhoselivescanbesavedifthereistheinternationalwilltodoso(Fogel2004,106).
WhilesomeofFogelspredictionshavenotmaterializedinthetwentyyearssincehe
wrotethisbook,hisanalysisisrobust,andhissuggestionsarestillrelevanttothehealthand
socialjusticeissuesoftoday.Ionlywishwewereclosertocarryingoutsomeoftheinitiatives
hesuggestssowecouldhaveamoreequitabledistributionofhealthandnutritioninour
society.

Bibliography:

Databases,Tables&CalculatorsbySubject.2015.
BureauofLaborStatisticsData
.
http://data.bls.gov/timeseries/lns14000000.

James,Neil.2005."TheEscapefromHungerandPrematureDeath,17002100:Europe,
AmericaandtheThirdWorld."
Policy
21,no.1:6162.
LegalCollection,
EBSCO
host
(accessed
February8,2015).

McGregor,Jena.2014.TheAverageWorkWeekIsNow47Hours.
WashingtonPost.

Databases,Tables&CalculatorsbySubject.2015.BureauofLaborStatisticsData.
http://data.bls.gov/timeseries/lns14000000.September2.
http://www.washingtonpost.com/blogs/onleadership/wp/2014/09/02/theaverageworkweekis
now47hours/

NobelPrize.1993"PressRelease."October12,1993.AccessedFebruary8,2015.
http://www.nobelprize.org/nobel_prizes/economicsciences/laureates/1993/press.html
.

TheConciseEncyclopediaofEconomics."RobertW.Fogel."AccessedFebruary08,2015.
http://www.econlib.org/library/Enc/bios/Fogel.html
.