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The Great Escape

The Great Escape

Health, Wealth, and the Origins of Inequality
by Angus Deaton 2013 376 pages
3.82
2k+ ratings
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Key Takeaways

1. The Great Escape: Humanity's journey from deprivation to prosperity

The Great Escape of this book is the story of mankind's escaping from deprivation and early death, of how people have managed to make their lives better, and led the way for others to follow.

Historical context: For thousands of years, humanity struggled with poverty, disease, and short lifespans. The Great Escape began in the mid-18th century with the onset of the Industrial Revolution and the Enlightenment. This transformation brought unprecedented improvements in living standards, health, and longevity for many, but not all.

Key developments:

  • Scientific and technological advancements
  • Improvements in sanitation and public health
  • Spread of education and knowledge
  • Economic growth and increased productivity

However, this escape has been uneven, creating new inequalities between those who have escaped and those left behind. The challenge now is to extend these benefits to all of humanity while addressing the unintended consequences of progress.

2. Measuring progress: The complexities of assessing global wellbeing

Wellbeing cannot be judged by its average without looking at inequality, and wellbeing cannot be judged by one or more of its parts without looking at the whole.

Multidimensional approach: Assessing global wellbeing requires considering multiple factors beyond just economic indicators. Key dimensions include:

  • Health and life expectancy
  • Education and knowledge
  • Political freedom and civic participation
  • Environmental quality
  • Social connections and relationships

Challenges in measurement:

  • Data limitations, especially in developing countries
  • Difficulty in comparing across cultures and time periods
  • Balancing objective measures with subjective experiences

The author emphasizes the importance of looking at both averages and distributions, as well as considering how different aspects of wellbeing interact. This holistic approach provides a more accurate picture of human progress and highlights areas where further improvement is needed.

3. Health revolution: Dramatic improvements in life expectancy worldwide

In the past century, life expectancy in the rich countries increased by thirty years, and it continues to increase today by two or three years every ten years.

Drivers of health improvements:

  • Germ theory of disease and improved sanitation
  • Vaccines and antibiotics
  • Better nutrition and living conditions
  • Advances in medical technology and treatments

Global disparities: While overall life expectancy has increased dramatically, significant gaps remain between rich and poor countries. For example:

  • Life expectancy in Japan: 84 years
  • Life expectancy in Sierra Leone: 54 years

The health revolution has been one of humanity's greatest achievements, but challenges remain in extending these benefits to all. Future progress will depend on addressing emerging health threats, improving healthcare systems in developing countries, and reducing health inequalities within and between nations.

4. Economic growth: The engine of prosperity and inequality

Economic growth has been the engine of international income inequality.

The double-edged sword of growth:

  • Positive effects: Lifting millions out of poverty, improving living standards, funding technological advances
  • Negative effects: Creating new inequalities, environmental degradation, social disruption

Key factors in economic growth:

  • Technological innovation
  • Investment in human and physical capital
  • Institutional quality and good governance
  • International trade and globalization

The author argues that while economic growth has been crucial for improving human wellbeing, it has also created new challenges. The benefits of growth have been unevenly distributed, both within and between countries. Addressing this inequality is essential for ensuring sustainable and inclusive development in the future.

5. The paradox of aid: Good intentions, unintended consequences

Aid and aid-funded projects have undoubtedly done much good; the roads, dams, and clinics exist and would not have existed otherwise. But the negative forces are always present; even in good environments, aid compromises institutions, it contaminates local politics, and it undermines democracy.

The aid dilemma:

  • Positive impacts: Funding essential infrastructure, providing emergency relief, supporting health initiatives
  • Negative impacts: Undermining local institutions, creating dependency, distorting economic incentives

Challenges in aid effectiveness:

  • Misalignment of donor and recipient priorities
  • Lack of accountability and transparency
  • Difficulty in measuring long-term impacts
  • Unintended consequences on local politics and economies

The author argues for a more nuanced approach to foreign aid, recognizing both its potential benefits and its limitations. He suggests focusing on initiatives that support local capacity-building, promote good governance, and address root causes of poverty rather than symptoms.

6. Global poverty: Challenges and successes in reducing extreme deprivation

The escape of hundreds of millions from a traditional and long-established poverty qualifies as the greatest escape of all.

Progress in poverty reduction:

  • Extreme poverty rate (living on less than $1.90/day):
    • 1990: 36% of global population
    • 2015: 10% of global population

Key factors in poverty reduction:

  • Economic growth, particularly in China and India
  • Improvements in health and education
  • Technological advancements benefiting the poor
  • Global efforts like the Millennium Development Goals

Remaining challenges:

  • Persistent pockets of extreme poverty, especially in sub-Saharan Africa
  • Rising inequality within countries
  • Vulnerability to economic shocks and climate change

While significant progress has been made in reducing global poverty, the author emphasizes that much work remains to be done. He argues for a focus on inclusive growth, improving governance, and addressing structural barriers that keep people in poverty.

7. The future of development: Rethinking our approach to helping the poor

What surely ought to happen is what happened in the now-rich world, where countries developed in their own way, in their own time, under their own political and economic structures.

Shifting paradigms:

  • Moving away from top-down, donor-driven approaches
  • Empowering local communities and governments
  • Focusing on building institutions and capacity

Key areas for future focus:

  • Investing in education and skills development
  • Promoting good governance and fighting corruption
  • Supporting technological innovation and adaptation
  • Addressing global challenges like climate change

The author argues for a fundamental rethinking of development approaches, emphasizing the importance of local ownership and context-specific solutions. He suggests that rich countries should focus on removing barriers to development, such as unfair trade policies, rather than imposing their own visions of progress. Ultimately, sustainable development must come from within countries themselves, with external support playing a facilitating rather than directing role.

Last updated:

Review Summary

3.82 out of 5
Average of 2k+ ratings from Goodreads and Amazon.

The Great Escape explores inequality, health, and wealth across nations. Deaton argues economic growth fuels inequality but has improved living standards globally. He critically examines foreign aid, suggesting it often harms rather than helps. Readers appreciate Deaton's data-driven approach and insights on development, though some find the writing dry. The book offers a balanced view of progress and lingering challenges in global health and poverty reduction. Reviewers praise Deaton's nuanced analysis but debate his conclusions on aid effectiveness.

Your rating:

About the Author

Angus Stewart Deaton is a renowned economist who won the Nobel Memorial Prize in Economic Sciences in 2015 for his work on consumption, poverty, and welfare. Born in Britain, he later became an American citizen. Deaton's research has significantly contributed to understanding how individuals and households make economic decisions, particularly in developing countries. His work bridges economics with other social sciences, focusing on health, well-being, and economic development. Deaton's approach combines theoretical insights with empirical analysis, often challenging conventional wisdom in development economics and public policy.

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