Saturday, January 08, 2022

Poor, Cold, Hungry, and Oppressed

I try not to fall for the "If there was only One Thing you could tell (the young, the Church, non-Americans, fill-in-the-blank) about (marriage, mental health, etc) what would it be?" because I know that if I picked an answer, even a good one, I would think of a better tomorrow, but the quote would be down and the chance lost. Yet for a few years now I have had a recurring wish to smack people talking about history and trying to use it to prove some modern political point, and reminding them that nearly everyone, everywhere was poor, cold, and oppressed until very recently, and even that only sporadically. For "cold" you can substitute too hot, too dry, too rain-soaked, too diseased or a few other generally-shared environmental situations, often in combination. I plugged Robert Fogel's remarkable book The Escape From Hunger and Premature Death, 1700-2100, way back in 2007 despite his writing style. Even the prosperous had meager portions come February and March every year, and some years were worse. Plus, not that many were prosperous. Hunger was real, year after year, and even starvation would overtake a place a few years over a lifetime - of everyone.

It is true that some had it worse than others, and that oppression was real, and seeing those patterns and understanding them as a way of mitigating injustice today is an entirely reasonable enterprise. But to take an extreme example, the death rate on slave ships was the same for crew and cargo. Does that mean I am saying there was no diffference and would just as soon be one as the other?  Of course not. Terrible situations can be made even worse, and usually are, as the people on rung three try to kick back rung two, who in turn are trying to heartlessly kick rung one.

It's just remembering the background that everyone had lives we would find almost unendurable up until about last Tuesday.


RichardJohnson said...

From the link to your old review:
Fine, then. Good to know. I wish I hadn't had to plow my way through learning about Waaler Surfaces and slight changes in BMI's in Denmark between 1840-1880 in order to get there. After four chapters of this numbing statistical analysis, feeling confident that he has firmly established the point It's the early nutrition, stupid, and not the subsequent medical care that causes low life expectancy and chronic medical problems.

Yes, it is.
From 1973 to 1989- when the eevul Pinochet regime was in power- Chile's Infant Mortality rate went from 8th best to 3rd best in Latin America.

Country Name 1973 1989
Argentina 56.3 25.5
Bolivia 132.4 86.8
Brazil 94.7 54.4
Chile 63.4 17.2
Colombia 63.4 29.7
Costa Rica 48 14.6
Cuba 26.7 11.5
Dominican Republic 80.1 47.9
Ecuador 88 43.9
El Salvador 97.3 48.4
Guatemala 106.7 61.6
Haiti 150.6 102.7
Honduras 90.6 46.9
Mexico 69 37.7
Nicaragua 106.9 52.6
Panama 44.1 26.2
Paraguay 56.2 37.5
Peru 96.8 59.4
Uruguay 47.9 21
Venezuela, RB 44.2 25.6

Consider how the eevul Pinochet regime did compared with that paragon of lefty virtue, Castro's Cuba.

Cuba Infant Mortality (deaths per 1,000 births)
1960 47.1
1978 20.3

Chile Infant Mortality (deaths per 1,000 births)
1976 47.5
1983 20.7

From 1960-1978, the Castro regime reduced Infant Mortality from 47.1 to 20.3, a reduction of 26.8 in 18 years.

From 1976-1983, the Pinochet regime reduced Infant Mortality from 47.5 to 20.7, a reduction of 26.8 in 7 years.

Combating Poverty: Innovative Social Reforms in Chile during the 1980s by Tarsicio Castaneda gives some detail.

RichardJohnson said...

From Tarsicio Castaneda'a book:

The main reasons for the decline in mortality indicators appear to
have been the drastic shift in policies toward services for mothers and
children and the health and nutrition interventions in the areas with the
highest mortality rates. In 1974-1975, the government began targeting
public spending on the poorest population and most vulnerable groups.

While the long tradition and extensive coverage of Chile's public health
care is an important factor in the reduction of mortality indicators, it is
unlikely that the nation would have been able to achieve the recent
results by continuing the policies and delivery systems of the 1960s and
early 1970s, without major increases in social spending. Targeting was
absent in policy and practice, and major inefficiencies affected the
public health delivery system. 21

The greatest reduction in infant and maternal mortality has taken
place in the poorer rural areas, where mortality rates were more than
double those in urban areas such as Santiago (Table 3.11). The decline
was achieved by reducing the differences in access to basic services such
as potable water and sewerage (see Chapter 4) and in the amount and
quality of social services provided to mothers and children. More access
was possible because of the great emphasis on investments in health
posts and low-technology medical facilities in the late 1970s, which
permitted a considerable expansion of health services in remote areas
by well-trained community auxiliary personnel. This personnel also
actively promoted other health-related measures, such as the construction of latrines, improvements in the disposal of refuse, and better
nutrition. The rapid elimination of the regional differences in services
for mothers and children is responsible more than any other factor for
the leveling of the differences in mortality rates across the regions
(Castaneda 1985a).

Other factors accounting for the decline in mortality rates are the
increase in growth monitoring and checkups for children and pregnant
women, together with nutritional intervention, which helped drastically reduce the malnutrition of children under six years of age.

Children under the growth-monitoring program in the SNSS comprised
over 80 percent of the population up to six years old in 1975, the first
year for which systematic nutrition information was collected. This
high coverage of children has permitted rapid detection and treatment
at rehabilitation centers of the worst cases, and preventive measures for
pregnant mothers and children at risk. The population covered by the
SNSS has declined recentl:y, apparently because of the rapid expansion
of the ISAPREs. As shown in Table 3.12, undernutrition has declined
drastically in Chile since 1975. (

Evaluations of the PNAC program have documented its great impact in reducing malnutrition both directlly, through food supplementation for poor families, and indirectly, through the program of growth monitoring for mothers and children (Harbert and Scandizo 1985;

RichardJohnson said...

Page 108-110.

A further point about comparing Pinochet and Castro is that Cuba began the 1960's with 1 physician per 1,0000 inhabitants. Chile, from 1960 to the early 1980s, had 1 physician per 2,000 inhabitants.

Chile had a similar improvement in Life Expectancy, but I chose to focus on Infant Mortality. (IIRC, Chile went from 8th to 2nd in Life Expectancy from 1973-89.)