The Great Escape | Angus Deaton

Summary of: The Great Escape: Health, Wealth, and the Origins of Inequality
By: Angus Deaton


In his insightful book, ‘The Great Escape: Health, Wealth, and the Origins of Inequality’, Angus Deaton addresses the significant rise in overall well-being and the extreme inequality that still exists in today’s world. The summary elaborates on the reasons for increased well-being, such as access to health services, better economic prospects, and improved quality of life but also emphasizes the marked disparities between rich and poor countries. Further, it explores the ways in which inequality can lead to progress, provided that it’s approached in the right manner. The book traces the development of human societies from simple hunter-gatherers to complex modern civilizations, touching on various advancements that have shaped where we are today.

The Bright Side of Life

Despite global inequality, overall well-being has improved considerably, with increased life expectancy and education opportunities in developed countries.

News outlets often focus on negative events, providing a distorted view of the world’s progress. The reality is that, on average, well-being has improved significantly in the last 250 years. Most people used to live in poverty, but today, only a billion face extreme poverty and suffer terrible living conditions. In contrast, people now have access to better healthcare, higher pay, longer lifespans, happiness, education, and general quality of life.

For instance, a white middle-class girl born in the United States today has a life expectancy of over 80 years, with a 50% chance of living to 100. She also benefits from increased educational and economic opportunities compared to her parents. Nevertheless, massive inequalities continue to exist between rich and poor countries. For example, health standards in Sierra Leone are worse than they were in the United States in 1910 when a quarter of children died before age five, and over half of the population in the Democratic Republic of Congo live on less than a dollar per day.

But these inequalities can lead to progress if used well. Poor countries can adopt innovations that improve life expectancy and diminish the gap between rich and poor countries. Although there is still much work left to be done, it’s vital to acknowledge the significant improvements in our well-being so that we can continue to work towards a fairer world.

The Paradox of the Agricultural Revolution

The Agricultural Revolution led to a decrease in well-being and a massive increase in mortality from diseases, despite a decrease in competition for food.

Since the advent of agriculture, humans have experienced a paradoxical decline in their well-being. The hunter-gatherer communities lived healthy lives despite their short lifespan of 40 years, spending their days looking for food and shelter. These tribes enjoyed a very balanced diet, shared what they found with one another, and were able to move on before disease spread. In contrast, the Agricultural Revolution led to a decrease in well-being and a massive increase in mortality from diseases. Although the settled life meant less dependence on the seasons and climate, less travel, and less competition with other tribes for food, early villages and cities were dirty. These early villages and cities placed the food next to the feces of domesticated animals, and the disease spread quickly through trade. As a result, people lived shorter lives and often died young due to diseases or catastrophic famines after droughts. It seems that settling down was not the answer to a better way of life, as hunter-gatherer communities had already found an effective and healthy way of living.

Improving Global Life Expectancy

Global life expectancy has increased due to advances in healthcare, disease prevention, nutrition, and education. Child mortality rates have decreased significantly, with many countries now only at a 0.5% rate. Scientific developments like the germ theory and improved sanitation have also played a role in improving health and mortality rates worldwide. While there have been setbacks such as the Great Famine in China and HIV/AIDS outbreaks, the overall trend has been positive. However, preventable diseases like cholera, measles, and diarrhea still affect children in some areas. Overall, global improvements in health have allowed for longer life expectancies, with many now able to see their grandchildren and even great-grandchildren.

Health Care Inequality

The lack of motivation from governments and inadequate knowledge in poor countries regarding preventive health measures has caused countless deaths from easily treatable illnesses. The most vulnerable, including children, suffer from malnutrition and infections because advanced medicine is accessible only to those who can afford it. Moreover, undemocratic governments prioritize other issues, perpetuating health care inequality. Citizens are unaware of their rights to adequate health care and do not demand change.

Challenges of Extending Human Life

Despite technological advancements, extending the lives of the elderly beyond 50 years is still a challenge. Chronic diseases like cancer, cardiovascular disease, and pneumonia remain leading causes of death. Billions of dollars are invested in research on these diseases, but increasing healthcare spending is not necessarily the solution. Rather, lifestyle changes, better education, and improvements in living standards are vital in preventing illness. People today smoke less, live healthier lifestyles, and know that they can live long lives. It is time for society to prioritize these changes, not solely rely on healthcare initiatives to solve the problem.

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