Biological Health Risks and Economic Development: Comparative Evidence across the Globe

Elizabeth Frankenberg, Duke University
Jessica Y. Ho, Duke University
Duncan Thomas, Duke University

Metabolic-related diseases are the primary cause of one-third of deaths across the globe; while their incidence is constant in the poorest and richest countries, they increase dramatically with income in middle-income countries. These cross-country patterns parallel levels of BMI and obesity rates. Using population-representative individual-level survey data from eight countries, we systematically describe the evolution of five key metabolic-related biomarkers for adult males and females by age and socio-economic status and relate the variation to levels of development. For example, BMI rises with SES in low and middle income countries, flattens out in higher income countries and falls with SES in richer countries. Similar evidence is presented on hypertension, pulse pressure and total cholesterol and HDL levels. We combine measured biomarkers with reported medication use to identify variation by level of development in measured risk factors, and to examine how controlled and diagnosed risk vary with age, gender and SES.