Periods of rapid structural change are particularly likely to lead to decline in the quality of life of some sections of the affected population. Change creates winners and losers; and it is common that the gains and losses are channeled into very distinct groups of people. This is true during periods of large-scale migration, technology change, and structural change within an economy. Important components of life quality include health, nutrition, education, economic wellbeing, economic security, and security from violence and coercion. Each of these properties is affected by several important dimensions of social life:
- legal and political institutions
- institutions of economic production and distribution
- economic opportunities and income
- public provision of income supplements
- public provision of food subsidies
- public provision of health care resources
- household support provided by family and community
For example: It is likely that the austerity policies of the Spanish or Greek governments will have a negative effect on the health and nutritional status of the bottom half of those societies. Working people will have lower incomes and they will have reduced access to the social safety net; health status is likely to decline. As another example: Life expectancy in the former Soviet Union declined measurably following the collapse of the Soviet system (link). One part of that decline was the disappearance of the social security net created by state-owned industry -- the smashing of the "iron rice bowl".
This concern is particularly relevant in the context of the rural-urban transformation currently underway in China. Since 1980 China's rural sector has been subject to at least two major kinds of structural change. One has to do with the economic and political institutions that governed daily life for rural households, from communes to market institutions. And the other has to do with the rapid structural transformation of China's economy from agriculture to export-led manufacturing. The first set of changes led to a withdrawal of forms of "social insurance" that had been associated with the commune system, including healthcare and old-age care. The second has led to mass migration of younger workers from villages and towns to factories in cities. This migration leaves the remaining population in the countryside older, poorer, and less economically secure.
These observations have several important implications. Foremost among these is the crucial importance of maintaining effective systems for monitoring and measuring life quality across the society. It is important to have good measures of health status, nutritional status, educational status, and old age life quality across regions and sub-populations. So national governments need to create and fund the social research activities necessary to measure health and other quality of life properties across the population. (Here is a recent post on a spatial study of quality of life in China based on 1982 data; link.) Sen argues that it was the availability or lack of availability of information about famine conditions that explained the difference in outcomes between China during the Great Leap Forward and post-independence India; Poverty and Famines: An Essay on Entitlement and Deprivation.
Second, when it turns out that there are large numbers of "losers" in a large social process of change, it is important for the state and non-governmental actors to find institutions and resources that will help to improve their outcomes. "Winners" need to help to fund the amelioration of harms created by the processes that led to their gains. If NAFTA led to the increase of overall national income for Canada, Mexico, and the United States, but also led to the displacement of workers in a significant set of industries -- then it makes sense to tax part of those gains to compensate the losers. And in fact, the NAFTA agreements were premised on such compensation, though this has not occurred reliably (link). This means redistribution across sectors and regions; and it is justified by the fact that the overall gains created by the transformation would not have been possible without imposing these losses on the disadvantaged sector or region.
What might this kind of redistributive policy look like in the context of China's rural-to-urban transformation? It would seem that public moneys will be needed for several types of problems:
- Maintenance of income and quality of life and health for the elderly
- Investments that increase the productivity of labor and the level of employment in rural areas
- Investments that work to ameliorate the negative environmental effects of rapid change
- Investments in the institutions of public health -- clinics, hospitals, and medical personnel
In The Paradox Of Wealth And Poverty: Mapping The Ethical Dilemmas Of Global Development I argued that a developing nation should choose an economic development strategy that spreads the benefits of growth over a broader population, over a strategy with a higher growth rate but with substantially greater inequality. I still think this is the right answer to the question. And this approach has the best likelihood of improving the quality of life of the poorest segment of society. The graphs below make the case based on three stylized strategies:
- NL neo-liberal growth: choose those policies and institutional reforms that lead to the most rapid growth: unfettered markets, profit-maximizing firms, minimal redistribution of income and wealth
- PF poverty-first growth: choose those policies and institutional reforms that lead to economic growth favorable to the most rapid growth in the incomes flowing to the poorest 2 quintiles
- WF immediate welfare improvement: direct as much social wealth as possible into programs that immediately improve the welfare of the poor (education, health, food subsidies, housing subsidies)
The neo-liberal strategy consistently maximizes GDP; but the poverty-first strategy, which is more redistributive from the start, leads to consistently better improvement for the income for the bottom 40% of the economy. It embodies the idea that Hollis Chenery advocated forty years ago in Redistribution with Growth: Policies to Improve Income Distribution in Developing Countries in the Context of Economic Growth.