Mathematician/philosopher turned software engineer, working in public health. Single mum. Interested in philosophy, public health, feminism, parenting, and lots of other things!
alexhill
Karma: 102
Great question. It certainly seems likely that this may effect may be contributing to the trend in some places. But hard to answer definitively because of the lack of standard definition and lack of monitoring of near-miss events in general. There are also other reasons why morbidity could be rising in some contexts—e.g. rising obesity levels and older age of mothers and in principle it could also be that most of the gains in mortality have come from reducing mortality causes that, if survived, don’t typically cause chronic disability, so don’t give to rise to many YLD. Major causes of mortality are haemorrhage, sepsis, high blood pressure and obstructed labour, and I think the last one contributes most of the YLD.
It would be really interesting to understand this more. The WHO is encouraging HIC to focus much more on near-miss events now that mortality rates are low, and much more data is needed overall!
On paternalism, just a note to point out that unlike Nussbaum, Sen and others have resisted offering specific capabilities, the idea being that these should not be handed down by economists but democratically derived. (I’m not sure how workable this is in practice or to what extent it’s been tried, would be interested if anyone knows more!)