Figure 1.6 summarizes the emerging human development divide with pairs of indicators, measuring progress over the last decade in one basic and one enhanced indicator for each of three key human development dimensions: health, education and access to technologies. Across human development groups there are two opposing trends in gradients for basic and enhanced capabilities. Inequalities are falling in basic capabilities because lower human development countries are making larger progress on average. When the ones that are behind grow faster, there is convergence. By contrast, inequalities are growing in enhanced capabilities because high and very high human development countries are getting ahead, leading to divergence. The Report documents later that these trends are also observed within countries. The basic indicators in the figure all reflect narrowing inequalities between countries in different human development groups. For instance, in life expectancy at birth (driven mainly by survival to age 5), in access to primary education and in access to mobile phones, lower human development countries are making faster progress. They are catching up with higher human development countries. In contrast, the more advanced indicators in the figure reveal widening inequalities. Higher human development countries start with an advantage in life expectancy at age 70, in tertiary education enrolment and in broadband access—and they are increasing their lead in these areas. The effect of these widening gaps— representing just few examples of enhanced capabilities—will be revealed over the 21st century. And that effect will impact those born today, many of whom will see the 22nd century. The remainder of this section considers the dynamics of convergence and divergence in health and education in more detail.
Health: The well-off are living healthier and longer in the 21st century Health inequalities can be a clear manifestation of social injustice (see chapter 2 for a more detailed discussion). These inequalities also reflect shortcomings in meeting basic human rights, such as those defined by article 25 of the Universal Declaration of Human Rights (box 1.2).
BOX 1.2 Article 25 of the Universal Declaration of Human Rights: The right to a basic standard of living “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. “Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.” Source: www.un.org/en/universal-declaration-human-rights/.
Inequalities in health outcomes are widespread Life expectancy at birth is a helpful indicator to track health inequalities. As one of the three components of the HDI, it has been used as a proxy for long and healthy life since the first Human Development Report in 1990. Here, the analysis extends life expectancy beyond that at birth to that at different ages in order to identify the dynamics of health through the lifecycle. This lifecycle approach makes it possible to capture changes in both the demographic and the socioeconomic transitions. And it shows how, across various indicators, not only do deep inequalities persist, but new gaps are also opening. Life expectancies—both at birth and at older ages—are considerably higher in countries with higher income or higher human development (figure 1.7)—this is often called a health gradient. People born in very high human development countries are expected to live almost 19 more years (or almost a third longer) than people in low human development countries. 22 People at age 70 in very high human development countries are expected to live almost 5 more years (around 50 percent longer) than people in low human development countries. The gaps are also very large when the quality of health is considered (box 1.3).
People born in very high human development countries are expected to live almost 19 more years (or almost a third longer) than people in low human development countries
Chapter 1 Inequality in human development: Moving targets in the 21st century | 37
