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WORLD DEVELOPMENT. 1992 Apr; 20(4):481-96.Global warming (GW) and ozone depletion (OD) have been the focus of intense interest as major environmental problems. This view comes from the belief in an intergenerational value system. However, based on the current evidence, the problems of clean water and proper sanitation pose much greater risks to the world than do climate change. In order to solve the problems of GW and OD, severe measures must be taken that will significantly restrict the chances for economic development in developing countries. In the past, resource constraints have been viewed as the limiting factor to economic development; however, it is inadequate access to safe drinking water, sanitation, and urban air pollution that threaten the world's welfare far more than resource constraints. GW and OD pale in comparison to the loss of welfare caused by unsafe drinking water and poor sanitation. For example, the sea level rise predicted by global warming is currently estimated to cost only 0.03% of the world GNP by the end of the 21st century. If OD causes food costs to rise by even 10% over the next century, this loss will be offset by advances in genetic manipulation of plants and improvement in agricultural technology. If the interests of future generations are to be preserved, it must be done i n a way that ensures prosperity to the people of the developing world. If we put this development on hold to solve relatively insignificant problems, the toll of human suffering will be far greater.
Social Science and Medicine. 1992 Apr; 34(8):837-42.Researchers analyzed data from 117 countries taken from 2 1988 World Bank publications to determine the relative importance of health care resources in predicting infant mortality within developed, developing and underdeveloped countries. Overall the variance of infant mortality, accounted by only socioeconomic resources, was 32.8% in underdeveloped (p<.01), 34.3% in developing countries (p<.05), and 60.6% in developed countries (p<.1). Further almost all these variables had constant directions of relationship with infant mortality across the 3 subgroups. For example, GNP and education were always negatively associated with infant mortality and urbanization and water were always positively associated with infant mortality. In fact, water had the greatest effect in developing countries and the smallest in underdeveloped countries. Further education was the only statistically significant socioeconomic variable in underdeveloped and developing countries (p<.05). Energy was inversely related with infant mortality in underdeveloped and developing countries, but positively related with it in industrialized countries. Further calorie had an inverse relationship with infant mortality in underdeveloped countries, but a positive relationship in developing and developed countries. In terms of health resources, the variance of infant mortality was not significant and was only an additional 8.6% of that above the variance explained by socioeconomic resources in underdeveloped countries, 5.6% in developing countries, and 3.3% in industrialized countries. Yet the association between inhabitants/ physician was consistent across all subgroups. Further the physician's role in reducing infant mortality was greatest in developing countries. The other 2 health care variables were inhabitants/nurse and inhabitants/hospital bed. In addition, as life expectancy increased, the effects of health care resources on infant mortality fell.