Health for Empowerment and Growth

Promoting empowerment of disadvantaged groups through incentives to broaden ownership of capital has had mixed results in terms of social justice and long-term growth. Experience in Malaysia and South Africa for instance shows that such schemes have certainly enhanced the wealth of a select few of the “previously disadvantaged.” But broader trickle-down effects to the poor have been much harder to find. And the costs have been high, with serious questions about the extent to which they might have impeded longer-term productivity growth as a result of implicit taxes on wealth and creation of a rent-seeking business society. As a result, there is growing pressure in Malaysia to abandon the “bumiputra” policy. Some of the loudest voices belong to those who were supposed to be the beneficiaries of the program.

These countries should take note of some new research findings from the US. A recent report by Chay, Guryan and Mazumder shows the startling and large effects of improvements in basic health care for black infants in the 1960s arising from hospital integration. They show that better infant health care explains substantial improvements in educational achievement, independently of other causes such as school integration and changes in family backgrounds.

The lesson for countries like Malaysia and South Africa is clear. If you want to promote empowerment of disadvantaged groups, use basic health and education to tackle the root causes of inequality and the real barriers to economic opportunity. The resulting improvements in human capabilities will pay additional dividends in the form of higher long-term productivity growth as well.