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The Great Escape: Health, Wealth, and the Origins of Inequality [Hardcover]

Angus Deaton
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Book Description

16 Aug 2013

The world is a better place than it used to be. People are wealthier and healthier, and live longer lives. Yet the escapes from destitution by so many have left gaping inequalities between people and between nations. In The Great Escape, Angus Deaton--one of the foremost experts on economic development and on poverty--tells the remarkable story of how, starting 250 years ago, some parts of the world began to experience sustained progress, opening up gaps and setting the stage for today's hugely unequal world. Deaton takes an in-depth look at the historical and ongoing patterns behind the health and wealth of nations, and he addresses what needs to be done to help those left behind.

Deaton describes vast innovations and wrenching setbacks: the successes of antibiotics, pest control, vaccinations, and clean water on the one hand, and disastrous famines and the HIV/AIDS epidemic on the other. He examines the United States, a nation that has prospered but is today experiencing slower growth and increasing inequality. He also considers how economic growth in India and China has improved the lives of more than a billion people. Deaton argues that international aid has been ineffective and even harmful. He suggests alternative efforts--including reforming incentives to drug companies and lifting trade restrictions--that will allow the developing world to bring about its own Great Escape.

Demonstrating how changes in health and living standards have transformed our lives, The Great Escape is a powerful guide to addressing the well-being of all nations.

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Product details

  • Hardcover: 376 pages
  • Publisher: Princeton University Press (16 Aug 2013)
  • Language: English
  • ISBN-10: 069115354X
  • ISBN-13: 978-0691153544
  • Product Dimensions: 23.8 x 16.3 x 2.9 cm
  • Average Customer Review: 3.8 out of 5 stars  See all reviews (4 customer reviews)
  • Amazon Bestsellers Rank: 145,796 in Books (See Top 100 in Books)
  • See Complete Table of Contents

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Product Description


One of Bloomberg/Businessweek Best Books of 2013, selected by Christopher L. Eisgruber (president of Princeton University)

One of Forbes Magazine's Best Books of 2013

Honorable Mention for the 2013 PROSE Award in Economics, Association of American Publishers

Shortlisted for the 2014 Spear's Book Awards in Financial History

Longlisted for the 2013 Business Book of the Year Award, Financial Times/Goldman Sachs

A "Best Business Book of the Year for 2013" selected on LinkedIn by Matthew Bishop, Economics Editor of The Economist

Featured in The Sunday Times 2013 Holiday Roundup

"[O]ne of the most succinct guides to conditions in today's world. . . . The story Deaton tells--the most inspiring human story of all--should give all of us reason for optimism, so long as we are willing to listen to its moral."--David Leondhardt, New York Times Book Review

"[A]n illuminating and inspiring history of how mankind's longevity and prosperity have soared to breathtaking heights in modern times. . . . [Deaton's] book gives a stirring overview of the economic progress and medical milestones that, starting with the Industrial Revolution and accelerating after World War II, have caused life expectancies to soar."--Fred Andrews, New York Times

"A truly elegant exploration. . . . It offers an erudite sojourn through history, all the way to the domestic and international policy issues pressing in on us today. Unusual for scholarly works in economics, this book is rendered in easily accessible prose, supported by fascinating statistics presented graphically."--Uwe E. Reinhardt,'s Economix blog

"As the title of his book suggests, Deaton sketches out the story of how many people have escaped from poverty and early death. It is a powerful tale. In Deaton's hands, the all too frequently forgotten accomplishments of the last century are given prominence that is both refreshing and welcome."--Edward Hadas, Reuters BreakingViews

"The Great Escape combines, to a rare degree, technical sophistication, moral urgency, the wisdom of experience, and an engaging and accessible style. It will deepen both your appreciation of the miracle of modern economic growth and your conviction that the benefits can and should be much more widely enjoyed."--Clive Crook, Bloomberg News

"This is a book that deserves to be read by as many people as possible, so that the poverty debates we have in India go beyond ideological grandstanding and the usual television dramatics. . . . The recent years have seen several leading economic thinkers write excellent books for the ordinary reader, and the new Deaton book is firmly in that category."--Niranjan Rajadhyaksha, Mint

"Is the world becoming a fairer as well as a richer place? Few economists are better equipped to answer this question than Angus Deaton of Princeton University, who has thought hard about measuring international well-being and is not afraid to roam through history. Refreshingly, Mr Deaton also reaches beyond a purely economic narrative to encompass often neglected dimensions of progress such as better health. . . . [T]he theme requires a big canvas and bold brushwork, and Mr Deaton capably offers both."--Economist

"Deaton's lucid book celebrates the riches brought by growth while judiciously explaining why some people are always 'left behind'. He draws a distinction between the inequalities that are opened up by advances in knowledge and those caused by flawed political systems. . . . The book's rich historical and geographical context adds to the power of this message."--John McDermott, Financial Times

"In The Great Escape, he dons the hat of an economic historian to provide a fresh perspective on the march of human progress (and its pitfalls) that should inform our current debate about income inequality."--Konrad Yakabuski, Globe & Mail

"It's a privilege to know the author of one of the most important books I've read, not least because it acts as entry point into other significant related books, research and debates. . . . Deaton's work reflects this combined pursuit of economics and ethics, manifested through research in to the wealth and health of nations."--John Atherton, Crucible

"It would make for delightful reading for economists, donors and policy makers."--Charan Singh, Business Standard

"[A] fantastic book about the origins of global poverty. Deaton's humanitarian credentials are unimpeachable, yet he thinks almost all non-health related foreign aid is making global poverty worse. He proposes a variety of alternatives, like massive investments in medical research and cracking down on the small arms trade, that might actually help."--Zack Beauchamp, Think Progress

"[T]hese are wonderful essays, each combining the essential Deaton ingredients of theoretical insight, careful analysis of evidence and graceful writing. There are thought-provoking chapters on the history of health improvements and what has driven them; on material well-being in the US; and on the damage caused by aid to developing countries. Deaton has dedicated many years to thinking about each of these issues, with a long list of academic papers to show for it. Here, he seems to step back and reflect on what he has learned, offering us a sage's wisdom."--Kitty Stewart, Times Higher Education

"The Great Escape is a thoughtful work, extensively illustrated with data, from a distinguished economist who tackles a central controversy of our time in a style refreshingly free of ideological baggage."--John Kay, Prospect

"Angus Deaton has written a wonderful book, The Great Escape: Health, Wealth, and the Origins of Inequality. . . . Deaton's book is a magisterial overview of health, income, and wealth from the industrial revolution to the present, taking in countries poor and rich. Not just jargon-free but equation-free, the book is written with a beautifully lucid style. . . . [P]owerfully argued and convincing."--Michael Marmot, Lancet

"Splendid."--Judith Sloan, Australian

"In his new book, The Great Escape: Health, Wealth, and the Origins of Inequality, economist Angus Deaton questions the usefulness of all aid, and describes how the greater proportion of the world's poor are found not in Africa but in the booming, yet radically unequal, economies of China and India."--Paul Theroux, Barron's

"The Princeton economist makes a compelling case against the naysayers of economic growth, marshalling a wealth of data and clear- eyed observations to explain how growth allows people to live more freely. . . . Mr. Deaton's seemingly inexhaustible knowledge of all things historical is bound to edify even the most erudite of readers."--Andrew Lewis, Pittsburgh Post-Gazette

"[C]areful and magisterial . . ."--Pooja Bhatia, Ozy Media

"[A] genuine contribution to the emerging literature on rethinking development."--Andrew Hilton, Financial World

"[E]loquently written and deeply researched. . . . For those interested in world poverty, it is unquestionably the most important book on development assistance to appear in a long time."--Kenneth Rogoff, Project Syndicate

"Deaton . . . is perhaps the single most level-headed student of economic development in the world today. . . . The Great Escape is an extended meditation on the sources and consequences of inequality."--David Warsh,

"Tops my list of must-read books for 2013. Deaton tackles big topics--global improvements to health and well-being, worrisome levels of inequality within nations and between them, and the challenges to curing poverty through foreign aid. His powerful, provocative argument combines careful analysis, humane insight, lucid prose, and a fearless willingness to challenge conventional wisdom. Whether you agree or disagree with its conclusions, this book will force you to rethink your positions about some of the world's most urgent problems."--Christopher L. Eisgruber, president of Princeton University, Bloomberg Businessweek

"[A] masterful account . . ."--Anne-Marie Slaughter,

"The book deserves to be read by all, especially by the students of economic development."--Tirthankar Roy, Economic & Political Weekly

"Professor Deaton hits the psychological nail on the head when he suggests that aid is 'more about satisfying our own need to help.' He identifies the related issue of 'aid illusion'--the belief that poverty in poor countries can be solved by rich people transferring money."--Peter Foster, Financial Post

"This is a fascinating book on health, wealth and inequality."--Bibek Debroy, Businessworld

"Development economist Deaton draws on his lifelong interest in and considerable knowledge of economic development to tell the story of modernization and the rise from worldwide poverty. Chapters illustrating demographic and economic trends utilize well-crafted charts and graphs to depict the rising paths that countries, first the US and western Europe and more recently China and India, have taken as their populations improve their health, education, and income-making abilities."--Choice

"If you want to learn about why human welfare overall has gone up so much over time, you should read The Great Escape: Health, Wealth, and the Origins of Inequality . . ."--Bill Gates

"The Great Escape is an eloquent and passionate description of what sickness and health look like for the world's populations and economies. Deaton's history of health and wealth offers a compelling narrative for both the general reader and academics alike. It raises a range of questions of why some countries falter, why others succeed and what can be done to close gaps between them."--John Parman, EH.Net

From the Inside Flap

"There is nobody better than Angus Deaton to explain why our lives are longer, healthier, and more prosperous than those of our great-grandparents. The story he tells is much more than an inexorable march of progress--it has also been unequal, uneven, and incomplete, and at each step, politics has played a defining role. This is a must-read for anybody interested in the wealth and health of nations."--Daron Acemoglu, coauthor of Why Nations Fail

"At once engaging and compassionate, this is an uplifting story by a major scholar."--Paul Collier, author of The Bottom Billion

"Magisterial and superb."--William Easterly, author of The White Man's Burden

"The Great Escape tells the two biggest stories in history: how humanity got healthy and wealthy, and why some people got so much healthier and wealthier than others. Angus Deaton, one of the world's leading development economists, takes us on an extraordinary journey--from an age when almost everyone was poor and sick to one where most people have escaped these evils--and he tells us how the billion still trapped in extreme poverty can join in this great escape. Everyone who wants to understand the twenty-first century should read this book."--Ian Morris, author of Why the West Rules--for Now

"Deaton's account of global advances in health is magisterial. It is especially convincing in disentangling economic progress from technological growth as sources of health improvements. A very big story, this book should affect the way we think about human development and the role of science and science-based government programs. The language is modest and graceful, the use of evidence compelling, and the illustrations highly attractive."--Samuel Preston, University of Pennsylvania

"This factual, sober, and very timely book deals with issues surrounding the higher incomes and longer lives enjoyed by an increasing proportion of the world's population. It assesses improvements in conditions that would have seemed almost a fantasy for people living only a few generations ago. Deaton's arguments, written in an elegant and accessible style, are powerful and challenge conventional opinions."--Branko Milanovic, author of The Haves and the Have-Nots

"This splendid book discusses how, in the last two hundred fifty years, large numbers of people have achieved levels of well-being that were previously available only to a few individuals, and how this achievement has given rise to equally unprecedented inequalities. Unique in its focus and scope, exceptional knowledge and coherence, and careful argumentation, The Great Escape is highly illuminating and a delight to read."--Thomas Pogge, Yale University

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Customer Reviews

3.8 out of 5 stars
3.8 out of 5 stars
Most Helpful Customer Reviews
10 of 12 people found the following review helpful
5.0 out of 5 stars Highly readable and fascinating 1 Nov 2013
By markr TOP 500 REVIEWER
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I greatly enjoyed reading this book, which for me as a general reader, achieves just the right balance of readability and learning. Focusing on health and wealth around the world and over time, the author, Angus Deaton (a professor of Economics and International Affairs), provides a clear and interesting account of how the world has become healthier, with people enjoying longer life expectancy pretty much across the globe over the last 75 years, and how this continues to improve. The book shows clearly how China and India continue to contribute so much to the overall improvement in worldwide wellbeing statistics, with over 1 billion people escaping from poverty,with all that such escape brings, in recent times. Today 80% of people around the world are literate - in 1950 the literacy rate was 50%. However, over a billion people still live in abject poverty around the world, and this book explains why this situation remains and explores what might be done to adddres this.

The links between health and wealth are well known, but this book is full of fascinating facts, and delivers clear explanations that greatly help in understanding the roots and consequences of various types of inequality, and of improvement in living standards in absolute as well as relative terms. Illustrated throughout with easy to follow, and clearly explained graphs, this is a very informative and entertaining book indeed.

I would have struggled to believe, for example, that life expectancy in India is today higher than it was in Scotland in 1945 had I not read this book which also explains why such changes have occurred and concludes with well argued ideas about how greater equality around the world could and should be achieved.

Really superb - I have strongly recommended this book to several family members and friends - although I have read so many bits out to them that they may feel they have read it already..
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An excellent review of the escape that countries try to make and the difficulties they face with the aid industry and the democratic deficit deficit they face by being accountable to donors and not their own people! A must read for anyone involved in the world of development or people who want to learn about the success or failure of states as they politically develop!
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3.0 out of 5 stars Nothing groundbreaking 18 May 2014
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A good and genral introduction to the issues but no more than that. It does though make the point that our views on much of this have changed over the decades.
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0 of 1 people found the following review helpful
2.0 out of 5 stars Mmmmm 30 April 2014
By Helen
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Obviously a lot of work has gone into assembling this analysis but compared to other books on the subject, it bored the hell out of me. Sorry, but Why Nations Fail offers a far more dynamic view of how nations escape poverty, and how they so easily slide back into it.
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Most Helpful Customer Reviews on (beta) 3.8 out of 5 stars  31 reviews
53 of 58 people found the following review helpful
3.0 out of 5 stars Essentially a survey course 28 Oct 2013
By MT57 - Published on
I was underwhelmed. Professor Deaton is highly regarded in his field of development economics, and there is one chapter, the penultimate, that focuses on that sector and it was hard-hitting, pithy, and insightful. Professor Deaton is a proponent of the theme that external aid does not make much difference in the least developed countries, due in large measure to corruption within the recipient nation. He lays out his case forcefully. For those who have encountered the philosophical, non-empirical argument of Peter Singer in favor of such aid, this chapter is a very effective rejoinder.

But otherwise, the book is basically a survey course -- at a 50,000 foot, totally macro level -- of the developments, mostly positive, in material wellbeing and health over the last couple of centuries -- the "Great Escape " of the title -- with some very high-level consideration of the reasons why they have not been uniform and the implications of the lack of uniformity. Pretty much everything is studied at the level of comparing statistics collected at the national level, which I find to be maddeningly frustrating as there are so many differences one can find between any pair of nations. And then one gets to the chapter on cross-border aid, and the author completely switches his vantage point and says that you can't limit your scrutiny of cross-border aid to the nation-to-nation level, you have to look at what is going on inside the recipient nation. I agree, but by the same token doesn't that perspective conflict undermine the nation-to nation comparisons that make up the prior chapters?

There are definitely insights of value -- for instance, that improvements in health and income are not as closely correlated as one might expect, and that economic inequality can be a spur as much as a constraint -- but I felt an inordinate amount of pages was devoted to setting up every point, as if the reader were an undergraduate student with no prior exposure to any of the issues. For a specific example, there is a chapter on "Material Wellbeing in the United States" of 50 pages length, but it largely rehashes themes and materials that you can find in the New York Times and other sources on the web. The work of Piketty and Saez is laid out for instance (as the NYT does every year when they update their work) and a few of the limitations in their data collection that skew the analysis to overstate inequality are noted (as Cato and others do every year in response) and then the author moves on. If you are not familiar with that work at all, I guess this is an introduction - just as you would get in a survey course - but it is not particularly insightful relative to other work already published much of which is available for free on the web.

I found the title partially misleading. There was very little about the "origins" of inequality in here, unless you count the chapter on globalization. And, to reiterate my theme, however strong or weak that link may be, did you not already know that globalization has been linked to increases in economic inequality before you read this book? Again, I felt I was getting a survey course level of presentation.

There is a secondary theme that runs through this book that I would have liked to have seen played up more, which is that, repeatedly in making his points, Professor Deaton shows that an economic hypothesis is based on a skewed collection of data, on incomplete data, or ignores conflicting data and does not hold up under moderate scrutiny from an unbiased analyst. I personally would have found it much more compelling a read had this point been played up more explicitly, although it probably would not have endeared him to his colleagues in the economics profession. I wondered whether the professor was being cunning and embedding the criticisms in a book that, on its face, appears to be more aligned with the point of view of the academy and ngo community that might be most inclined to pick it up. Although a book called "The Great Hoax; How Economists Obscure Reality to Convince You They Have Magic Powers" might sell more copies, albeit through different channels.

Other reviewers have noted that the book is quite readable and indeed it is, although I suggest the readability is in part a bug and not a feature, because so much time is devoted to setting up points. That is what makes it readable, I think, but also, to me, slowed it down and made it less efficient than I would have liked.

Although one might think that a 3-star review conflicts with the other, 5-star reviews, I think if you read the higher-starred reviews and this review, you will see that we are basically saying the same thing about the book, as a descriptive matter; our differences lie in how much value we assign to its level of generality. I hope this added point of view will be "helpful" to you as you decide whether to acquire the book.
23 of 26 people found the following review helpful
5.0 out of 5 stars A once-in-a-decade book about economic and social development 16 Oct 2013
By Guy P. Pfeffermann - Published on
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This is an important book by one of the foremost development economists in the world. It is highly readable, indeed written in an entertaining manner. Deaton paints on a vast canvas in time and space, embracing both developed and developing worlds. His theme is how in the course of history, and especially during the past three decades, hundreds of millions of people managed to escape abject poverty. He brings new insights into the sequencing and the many interwoven and often counter-intuitive linkages between growth and quality of life, especially health and longevity. His story begins when we were all hunters/gatherers and ends in 2013 in the unresolved aftermath of the financial crisis.

One of Deaton's main themes is that economic growth does not necessarily produce improved quality of life, especially when income is distributed very unequally - as is the case in today's United States. So for example, in spite of lower economic growth in France than in the United States, because of a less unequal distribution of income, "all but the top 1 percent of the French population did better than all but the top 1 percent of the American population". (p. 260)

In discussing the relationships between rich and poor countries, I very much like Deaton's implicit framework, which distinguishes "us" (the people of the North), "we" (the Northern governments), aid recipients ("their governments"), and "they" (the people of the South). This helps to cut through a lot of semantic and conceptual confusion, especially when discussing "development assistance".

The book concludes with a chapter about how to help those left behind the "Great Escape" from poverty. While I tend to agree with his main thrust: that foreign aid works best where it is least needed, i.e., where governance is reasonably good, and works worst in poorly-governed countries where the people are most miserable. But from all I have seen, the evidence on aid effectiveness is inconclusive, largely, as Deaton notes, because the data are so bad. Deaton is very critical of aid, but illustrates his argument with selected examples, when one can almost always find counter-examples. However, one can only agree with his observation that increased flows of money don't help - quite the opposite - when recipient countries lack basic capacities and/or are poorly governed.

Although he doesn't say it quite this way, Deaton implies throughout much of the book that while is quite easy for development experts to come up with lists of conditions that are necessary for successful development - including for example respect for the Rule of Law and sound macroeconomic policies - nobody has yet come up with a list of sufficient conditions.
10 of 11 people found the following review helpful
4.0 out of 5 stars Inequality, Infant Mortality, and Foreign Aid 17 Dec 2013
By Mal Warwick - Published on
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Has the human race made progress since the days when all our lives were nasty, brutish, and short?

Some might think this question patently silly, since it would appear to answer itself. But Angus Deaton finds in it a point of entry into his inquiry on “health, wealth, and the origins of inequality,” the subtitle of his ambitious new book. He is in no doubt that humanity has progressed, not steadily but by fits and starts — and continues to do so to this day. “Today,” he writes, “children in sub-Saharan Africa are more likely to survive to age 5 than were English children born in 1918 . . . [and] India today has higher life expectancy than Scotland in 1945.”

In The Great Escape, Deaton, a veteran professor of economics and international affairs at Princeton, explores inequality — between classes and between countries — with a detailed statistical analysis of trends in infant mortality, life expectancy, and income levels over the past 250 years. He concludes that the large-scale inequality that plagues policymakers and reformers alike in the present day is the result of the progress humanity has made since The Great Divergence (between “the West and the rest”) since the advent of the Industrial Revolution. “Economic growth,” Deaton asserts, “has been the engine of international income inequality.”

No argument there: Deaton is far from alone in this belief. Other scholars have written extensively about this topic in recent years. A Farewell to Alms: A Brief Economic History of the World, by Gregory Clark, is just one example.

Late in the 18th Century, the countries of Northern Europe and North America on the one hand and those of Asia, Africa, the Middle East, and Latin America on the other hand were not that far apart as measured by the available indicators of health and income. Deaton cites “one careful study [that] estimates that the average income of all the inhabitants of the world increased between seven and eight times from 1820 to 1992.” However, that average obscures a harsh reality. The ever-quickening rate of change in “the West” since 1760 or so has widened the gap between (and within) countries to an extreme degree. Deaton terms the freedom from destitution and early death that so many of us now enjoy “The Great Escape,” taking his title from the 1963 film of that name about a massive escape of prisoners from a German P.O.W. camp in World War II.

Only now is the gap closing between the rich nations and China and India (by far the world’s two biggest countries, with nearly 40 percent of the planet’s population and half the world’s poor). Deaton doesn’t consider a bright future for all a certainty, not by any means, in view of global climate change and the ever-present threat of killer pandemics. But, assuming the species continues to thrive, there is sufficient data available now to have some confidence that the gross inequality now existing among nations will not persist forever. After all, five sub-Saharan African countries are now growing their economies faster than China’s.

However, that misleading factoid ignores the outsize role that China has played in “the Great Escape” globally. Deaton notes, as have other observers, that “the number [of] people in the world living on less than a (2005) dollar a day fell from about 1.5 billion in 1981 to 805 million in 2008 . . . [This] decline in numbers is driven almost entirely by the Chinese growth miracle; if China is excluded, 785 million people lived on less than a dollar a day in 1981 compared with 708 million in 2008.” (This reality is one of the principal reasons why Paul Polak and I insist in The Business Solution to Poverty that traditional methods to end poverty have largely failed. After all, China’s methods were hardly traditional!)

In the course of exploring the historical record of growing inequality on the world stage, Deaton delves deeply into the role of foreign aid (officially, Overseas Development Assistance, or ODA) and finds it comes up short. ”You cannot develop other countries from the outside with a shopping list for Home Depot, no matter how much you spend,” he writes. With the exception of outside interventions in public health programs — including such breakthroughs as the eradication of smallpox and the near-success with polio — Deaton finds that foreign aid has done more harm than good. He argues that where the conditions for development are present, outside resources are unnecessary. Where they’re absent, ODA entrenches local elites, distorts the local economy, and discourages local initiative. The author insists that “the record of aid shows no evidence of any overall beneficial effect.”

But that’s only part of the story.

In 2012, ODA totaled about $136 billion. Throw in another $30 billion or so from NGOs, and total outside assistance comes to under $200 billion annually. However, net resource transfers from developing countries to rich countries are well in excess of $500 billion annually. (Transfers reached a peak of $881 billion in 2007, fell with the Great Recession, but are rising again.) Quite apart from the fact that an estimated 70 percent of “foreign aid” is actually spent on products and services from donor nations, ODA merely puts a dent in the huge disadvantage that poor countries suffer as a result of lopsided trade policies and prevailing political and commercial imbalances. In any case, just one factor in those resource flows — remittances from overseas residents of poor countries to their families back home — are twice as large as ODA.

The Great Escape is a worthy effort from a senior scholar whose wide-ranging studies have led him to big-picture conclusions. Policymakers and practitioners should be listening carefully.
8 of 10 people found the following review helpful
5.0 out of 5 stars Healthier Wealthier and More Unequal 22 Dec 2013
By Shalom Freedman - Published on
This book is about the overall development of humanity in regard to Health and Wealth. The major thesis is that Mankind has made considerable progess and this especially so in the past two- hundred and fifty years. Initially this led to great development in Western Europe and North America bringing about 'The Great Divergence' between the West and the rest. In recent decades a good share of the world, most notably China and India have made great progress in raising both Health standards and Wealth. Moreover Health and Wealth are in most cases related, and those societies richer in economic resources are also generally richer in the health of their populations. However Progess and Increase in Health and especially in Wealth often lead to greater Inequality both within and between societies.And in the concluding part of this book , and perhaps its most controversial part Deaton provides a certain strategy for reducing Inequality. He argues that it is not lack of Money which is most responsible for poor development in societies. Rather it is poor Governance. And his argument is that pouring money into the hands of corrupt leaders enables them to escape confronting the ills of their societies and the demands of their people. His idea is that true progress can be made only when there is a proper relationship between a nation's leaders and its people, one in which there is a kind of contract, mutual demands and obligations and checks on fulfilling these.
Deaton notes the delterious effects of Inequality on the general well- being of the Society and is especially worried about the growing gaps in Income in the United States. He points out having great wealth can lead to having no real interest in providing those broad communal services for the great majority of the people which the very wealthy can attain privately.
This book makes a strong argument against those who believe that Humanity has made no Progress in its overall historical development. It shows how in two of the fundamental elements in human well- being Humanity has progressed considerably, even at an accelerated rate in the past century. It does not offer a panacea to the Inequality problem but offers important ideas on how this should be addressed, now and in the future.
10 of 13 people found the following review helpful
3.0 out of 5 stars Analysis of relationship between economic growth and improvement in health through time and spillovers of the interplay 20 Nov 2013
By A. Menon - Published on
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The Great Escape is an overview of the changing nature of life expectancy and income through time. These are big subjects but the author focuses on the interplay between health and wealth as well as the spillovers of the drivers of knowledge and how they spillover into inequality. The book tackles many things but really focuses on the way that life expectancy has changed and how it is currently changing, how income affects life expectancy and how income has changed and finally how to improve the base conditions for economic growth where there remains poverty.

The book is split into three major sections - Life and Death, Money, and Help. Life and death goes through the malthusian world humanity lived in for most of its history and then discusses how major breakthroughs changed life expectency through medical knowledge. Understanding of germ theory was essential in improving sanitation and decreasing child mortality. Initially the author discusses how essentially the big step in extending life expectency was not by changing conditional life expectency at age 10 but by decreasing infant mortality. The author then discusses when that benefit accrued, improving life expectency moved from infectious disease to solving chronic illness, a much slower space of incremental progress. The ideas in this chapter are pretty straightforward and understanding how the birth death dynamical process affects distribution of age and mean and median ages is well articulated. At the same time the underlying ideas are not particularly complicated and many readers will understand the lumpy benefit to curing childhood disease on expected life versus coming up with hip replacements. The author charts life expectency in time and how there is an income component which places one on the life expectency curve; one sees that time and the knowledge that is generated in time that moves us further along the understanding disease space, is the most powerful driver of extending life rather than income.

The author then discusses economic growth and divergence in the world. It starts out with the historical account and discusses the great divergence. It discusses income inequality, how it has evolved over time and where we are today. It is a descriptive account rather than prescriptive. It discusses concepts like the Gini coefficient and the process of economic growth. It also discusses qualitative aspects of life though it is noted that such a concept is hard to measure. Measure's life life satisfaction are discussed and how satisfaction and income though often claimed to be separate have many other data points which show that increased income does strictly improve one's self reflection. The author discusses how it is difficult to translate GDP/capita across countries given the non-tradeable nature of the economy and how purchasing power is not an easy concept to quantify robustly. The author also discusses global growth and India and China and how their growth has lifted so many from poverty but if one averages across countries without focusing on population average poor growth rates dont necessarily lead to higher growth. The chapter gives a good overview of globla growth and inequality, how it has changed and what is happening to these variables in a local as well as global setting. In particular the author describes how locally inequality has been growing but there is data that also shows it is reducing globally, these are potentially spillovers from labour becoming more tradeable with increasing returns going to capital.

Finally the author discusses aid and its costs and benefits. The author is a skeptic and largely argues that institutions are critical for growth and hence aid, dispersed through official channels, empowers regimes with poor institutions and hence perpetuates problems. This argument is very much in line with the writings of William Easterly "The Elusive Quest for Growth: Economists' Adventures and Misadventures in the Tropics". The author argues against the view of jeffrey Sachs and believes that money is ineffective in the wrong institutional setting. The logic is powerful but is also disheartening and I'm sure many readers will remain on the fence on this issue.

The Great Escape covers some relatively large topics. I think it is informative for people who are unfamiliar with the subject matter. The writing is clear and certain dynamical processes in economics are made concrete through the writing in particular how information improves the life expecency/income curve. The organization i dont think is particularly great and there is a lot of coverage of subject but not a particularly well defined thesis. Things like the impact of changing youth mortality and its marginal impact on life expectency vs solutions to chronic diseases is fairly obvious though and much time is spent on concepts which are very easy to absorb. All in all i thought the book was a good read but the material can be found elsewhere and is nothing particularly revolutionary.
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