Health and rapid economic change in the late twentieth century

Rapidly expanding economies, such as the post-war Tiger Economies, are asso ciated with increasing health and rapidly contracting economies, such as Ce ntral and Eastern Europe in the early 1990s, are associated with declining health. In Central and Eastern Europe health decline in association with ec onomic contraction has been mediated by changes in income distribution and, also, by health-determining aspects of civil society. The nations of Centr al and Eastern Europe are an example of swift economic and political transf ormation occurring concurrently with economic decline; with increasing disp arity in income distributions; and with high levels of distrust in civil in stitutions. Concurrent with these declines was a marked reduction in health status, described here in terms of life expectancy. Conversely, the nation s of Southeast Asia experienced rapid economic growth and increasing life e xpectancies. Though data are scarce, the experience of the Tiger Economies appears to be one of economic growth; a virtuous cycle of increased investm ent in education and housing. and increasing parity in income distribution based upon a relatively equitable distribution of returns on education. (C) 2000 Published by Elsevier Science Ltd. All rights reserved.