“Economists are usually more concerned with money, wealth, and income, not so much with health. But health should come before money,” Deaton said at the Lincoln Center campus on Sept. 24—his first “non-Zoom” presentation in 18 months. “Money and health means very little if you’re not alive to enjoy it.”
Deaton was the keynote speaker at the fourth event of the biennial conference “The Health of Nations: Pope Francis’ Call for Inclusion,” co-hosted by Fordham’s Graduate Program in International Political Economy and Development (IPED) and the U.S. affiliate of the Vatican foundation Centesimus Annus Pro Pontifice. The goal of the conference is to bring together international experts to address poverty and development issues raised by Pope Francis through the lens of Catholic social teaching. Deaton was joined by several speakers, including Frank J. Caggiano, bishop of the Catholic Diocese of Bridgeport, Connecticut, and award-winning economist and University of Notre Dame professor Joseph P. Kaboski for a moderated discussion.
Deaton’s work is a critical part of Fordham’s IPED curriculum, said Henry Schwalbenberg, Ph.D., program director and associate professor of economics.
“His work on measuring poverty guides our stuents in preparing our annual publication of Fordham’s Pope Francis’ global poverty index, and his writing on deaths in the tropics is at the core of how we teach our students about public health issues in the developing world,” Schwalbenberg said at the conference. “Because of Professor Deaton’s exceptional writings as well as the outstanding professional field experiences provided by Catholic Relief Services, our students are that much more prepared to understand and contribute to international efforts to reduce—hopefully, reduce—global poverty.”
Many global health inequalities are driven by low infant and child mortality rates in poor countries, said Deaton. The U.S. can help them by requesting that organizations like the National Institutes of Health research more diseases that greatly impact poorer countries, he said. The U.S. government can also increase the distribution of global public goods, like the Pfizer-BioNTech and Moderna COVID-19 vaccines, to countries that desperately need them. In addition, the U.S. can reduce arms sales, he said.
“America makes huge amounts of money through exporting arms. I don’t know what we think we’re doing when we’re sending aid to countries at the same time we’re selling arms to them,” Deaton said. “When my students come to me and say, ‘What should we do to help people in poor countries?’ … I say, ‘The country you should go to is Washington, D.C. and you should tell people to stop harming people in poor countries.’ We can do a tremendous amount of that without actually going there and pretending to help or trying to help.”
What doesn’t work very well, he said, is transferring monetary funds from rich to poor countries, what we commonly view as “aid.” What those countries need more than money is an “internal social contract” between the government and its people, he said.
“We complain about our government, but we mostly pay our taxes … and in exchange, they give us all these things—police, defense, roads, laws, health, pensions and education—and that’s because we’re organized in a way that in exchange for our taxes, the government can give us these things back,” Deaton explained. It is the lack of this “contract” that is characteristic of poor countries. In other words, he said, financial aid from rich countries often prevents the governments of poorer countries from being held accountable for their people.
“The governments don’t bother to look after their people because they don’t need to. Most African countries get more than 70% of the government budget from aid … You cannot get development without an internal social contract, without an internal community first. Whatever we do, we should try not to destroy that,” Deaton said.
But the U.S. has its own problems to deal with as well, he said. Since 1980, adult life expectancy has steadily risen in rich countries across the world, but the U.S. is an exemption, said Deaton. Many Americans are dying “deaths of despair,” including accidental drug overdose and suicide. A large part of that population lacks a four-year college degree. They have been facing a declining labor market thanks to robots, globalization, and the increasing costs of health care. This loss of jobs has had negative ripple effects across their financial, social, and mental well-being, he said.
“The key takeaway is that [in]the labor market, jobs for people without a four-year college degree have been vanishing … jobs that really gave meaning to people’s lives, gave them a chance at promotion,” Deaton said. “This failing labor market has brought social dysfunction in many forms and in many communities across America.”
In the pandemic, the less-educated and minorities have continued to suffer, while the rich and those with pensions in the market have increased their wealth. This division is troubling, said Deaton.
“We really have built ourselves a two-class society in which the happy few are doing well, and the two-thirds are increasingly not being recognized as full citizens,” Deaton said. “One of the issues about inequality that I think is the key one is equality of moral standing within society. We want not equality of opportunity—we want equality of outcome … We’re all moral individuals within equal dignity, and that’s failing in America.”
Watch a full recording of the conference below: