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Authors: Amartya Sen

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FIGURE
2.2:
Improvements in Life Expectancy in England and Wales, 1901–1960

Sources:
S. Preston, N. Keyfitz, and R. Schoen,
Causes of Death: Life Tables for National Population
(New York: Seminar Press, 1992).

Did this make any real difference to health and survival? Was there, in fact, a correspondingly faster mortality reduction in these periods of support-led policies in Britain? It is, in fact, confirmed by detailed nutritional studies that during the Second World War, even though the per capita availability of food fell significantly in Britain, cases of undernourishment also
declined
sharply, and extreme undernourishment almost entirely disappeared.
19
Mortality rates also went down sharply (except of course for war mortality itself). A similar thing had happened during the First World War.
20

Indeed, it is remarkable that interdecade comparisons, based on
decadal censuses, show that by a very wide margin the most speedy expansion of life expectancy occurred precisely during those two “war decades” (as shown in
figure 2.2
, which presents the increase in life expectancy in years during each of the first six decades of this century).
21
While in the other decades life expectancy rose rather moderately (between one year and four years), in each of the two war decades it jumped up by nearly seven years.

We must also ask whether the much sharper increase in life expectancy during the war decades can be explained alternatively, by faster economic growth over those decades. The answer seems to be in the negative. In fact, the decades of fast expansion of life expectancy happened to be periods of
slow
growth of gross domestic product per head, as shown in
figure 2.3
. It is, of course, possible to hypothesize that the GDP growth had its effects on life expectancy with a time lag of a decade, and while this is not contradicted by
figure 2.3
itself, it does not stand up much to other scrutiny, including the analysis of possible causal processes. A much more plausible explanation of the rapid increase in British life expectancy is provided by the changes in the extent of social sharing during the war decades, and the sharp increases in public support for social services (including nutritional support and health care) that went with this. Much light is thrown on these contrasts by studies of health and other living conditions of the population through the war periods, and their connection with social attitudes and public arrangements.
22

DEMOCRACY AND POLITICAL INCENTIVES

Illustrations of linkages can come from a great many other connections. Let me briefly comment on one more: that between political liberty and civil rights, on the one hand, and the freedom to avoid economic disasters, on the other. The most elementary vindication of this connection can be seen in the fact, on which I commented earlier (in
chapter 1
, and indirectly—in discussing the China-India contrast—in the present chapter) that famines do not occur in democracies. Indeed, no substantial famine has ever occurred in a democratic country—no matter how poor.
23
This is because famines are extremely easy to prevent if the government tries to prevent them, and a government in a multiparty democracy with elections and free media has strong political incentives to undertake famine prevention. This would indicate that political freedom in the form of democratic arrangements helps to safeguard economic freedom (especially freedom from extreme starvation) and the freedom to survive (against famine mortality).

FIGURE
2.3:
Growth of GDP (U.K.) and Decadal Increases in Life Expectancy at Birth (England and Wales), 1901–1960

Decadal Improvement in Life Expectancy, England and Wales (Left Scale)

Percentage Decadal Growth of GDP per Capita in U.K., 1901–1960 (Right Scale)

Sources:
A. Madison,
Phases of Capitalist Development
(New York: Oxford University Press, 1982); S. Preston et al.,
Causes of Death
(New York: Seminar Press, 1972).

The security provided by democracy may not be much missed when a country is lucky enough to be facing no serious calamity, when everything is running along smoothly. But the danger of insecurity, arising from changes in the economic or other circumstances
or from uncorrected mistakes of policy, can lurk behind what looks like a healthy state. When this connection is discussed more fully (in
chapters 6
and
7
), the political aspects of the recent “Asian economic crisis” will need to be addressed.

A CONCLUDING REMARK

The analysis presented in this chapter develops the basic idea that enhancement of human freedom is both the main object and the primary means of development. The objective of development relates to the valuation of the actual freedoms enjoyed by the people involved. Individual capabilities crucially depend on, among other things, economic, social, and political arrangements. In making appropriate institutional arrangements, the instrumental roles of distinct types of freedom have to be considered, going well beyond the foundational importance of the overall freedom of individuals.

The instrumental roles of freedom include several distinct but interrelated components, such as economic facilities, political freedoms, social opportunities, transparency guarantees and protective security. These instrumental rights, opportunities and entitlements have strong interlinkages, which can go in different directions. The process of development is crucially influenced by these interconnections. Corresponding to multiple interconnected freedoms, there is a need to develop and support a plurality of institutions, including democratic systems, legal mechanisms, market structures, educational and health provisions, media and other communication facilities and so on. The institutions can incorporate private initiatives as well as public arrangements and also more mixed structures, such as nongovernmental organizations and cooperative entities.

The ends and means of development call for placing the perspective of freedom at the center of the stage. The people have to be seen, in this perspective, as being actively involved—given the opportunity—in shaping their own destiny, and not just as passive recipients of the fruits of cunning development programs. The state and the society have extensive roles in strengthening and safeguarding human capabilities. This is a supporting role, rather than one of ready-made delivery. The freedom-centered perspective on the ends and the means of development has some claim to our attention.

CHAPTER 3
FREEDOM AND THE FOUNDATIONS OF JUSTICE

Let me begin with a parable. Annapurna wants someone to clear up the garden, which has suffered from past neglect, and three unemployed laborers—Dinu, Bishanno and Rogini—all very much want the job. She can hire any one of them, but the work is indivisible and she cannot distribute it among the three. Annapurna would get much the same work done for much the same payment from any of them, but being a reflective person, she wonders who would be the right person to employ.

She gathers that while all of them are poor, Dinu is the poorest of the three; everyone agrees on that fact. This makes Annapurna rather inclined to hire him (“What can be more important,” she asks herself, “than helping the poorest?”).

However, she also gathers that Bishanno has recently been impoverished and is psychologically most depressed about his predicament. Dinu and Rogini are, in contrast, experienced in being poor and are used to it. Everyone agrees that Bishanno is the unhappiest of the three and would certainly gain more in happiness than the other two. This makes Annapurna rather favorable to the idea of giving the job to Bishanno (“Surely removing unhappiness has to be,” she tells herself, “the first priority”).

But Annapurna is also told that Rogini is debilitated from a chronic ailment—borne stoically—and could use the money to be earned to rid herself of that terrible disease. It is not denied that Rogini is less poor than the others (though certainly poor) and also
not the unhappiest since she bears her deprivation rather cheerfully, used—as she has been—to being deprived all her life (coming from a poor family, and having been trained to reconcile herself to the general belief that, as a young woman, she must neither grumble nor entertain much ambition). Annapurna wonders whether, nevertheless, it might not be right to give the job to Rogini (“It would make the biggest difference,” she surmises, “to the quality of life and freedom from illness”).

Annapurna wonders what she really should do. She recognizes that if she knew only the fact that Dinu is the poorest (and knew nothing else), she would have definitely opted for giving the work to Dinu. She also reflects that had she known only the fact that Bishanno is the unhappiest and would get the most pleasure from the opportunity (and knew nothing else), she would have had excellent reasons to hire Bishanno. And she can also see that if she was apprised only of the fact that Rogini’s debilitating ailment could be cured with the money she would earn (and knew nothing else), she would have had a simple and definitive reason for giving the job to her. But she knows all the three relevant facts, and has to choose among the three arguments, each of which has some pertinence.

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