Economic growth, population health and Sustainable Development Goal 8
Economic growth, population health and Sustainable Development Goal 8
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经济增长、人口健康和可持续发展目标 8
DOI：
10.1093/eurpub/ckaa165.1089
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发表时间：
2020
影响因子：
4.4
通讯作者：
Brunner E
中科院分区：
文献类型：
--
作者：
Brunner E
包括英国、德国和日本在内的高收入国家正在减少相对于经济增长的二氧化碳排放。SDG 8提到“可持续增长”，但不区分低收入、中等收入和高收入国家。联合国的目标是到2050年实现二氧化碳净零排放，因此，有充分的理由探讨高收入国家经济低增长或零增长作为限制气候变化机制的影响。一个关键的考虑因素是，如果高收入国家经济停止增长，人口健康方面的进展是否会停滞。我们寻找过去四十年来国民经济轨迹与健康趋势之间的关联。根据WHO死亡率数据库中的全因和原因特异性死亡率计算标准化死亡率。英国、法国和日本的全因死亡率（ACM）同时下降，从1980年至2010年期间的约700/10万下降至400/10万，日本的ACM率最低。1980-2010年，美国ACM发病率下降幅度较小。在银行业危机后的十年紧缩中，美国和英国的ACM利率停止下降。在1990年以后的20年经济停滞中，日本的ACM率继续迅速下降。日本的冠心病、中风和癌症死亡率（但自杀死亡率则不然）的趋势在最近一段时间里一直是有利的。日本的自然前后实验，即1990年以前的几十年经济高增长和1990年以后的低增长，是一个在长期低增长时期人口健康持续进步的高收入国家的例子。一项基于人口的日本调查系列（1986-2013年）中的主观、自评健康的重复测量增加了客观死亡率趋势的证据。如果高收入国家经济体把重点放在应对气候变化而不是增长上，人口健康方面的进展就不需要停滞。
High-income countries (HICs), including UK, Germany and Japan, are reducing CO2 output relative to economic growth. SDG8 refers to 'sustainable growth' but does not differentiate between low, middle- and high-income countries. The United Nations target is for net-zero CO2 emissions by 2050, therefore there is a strong case for exploring the implications of low or zero economic growth among HICs as a mechanism for limiting climate change. A key consideration is whether progress in population health would stall if HIC economies stopped growing.We examined headline health statistics among HIC countries for evidence of divergence in health trends. We looked for associations between trajectories of national economies and health trends over the past four decades. Age-standardised death rates were calculated from all-cause and cause-specific rates in the WHO mortality database. All-cause mortality (ACM) rates declined in parallel in UK, France and Japan, from about 700 to 400/100,000 in the period 1980-2010, with the lowest rates in Japan. Decline in the ACM rate in USA was shallower 1980-2010. In the decade of austerity following the banking crisis, the ACM rate in USA and UK stopped declining. The Japanese ACM rate continued its rapid post-war decline in the two decades of economic stagnation after 1990. Trends in Japanese coronary heart disease, stroke and cancer mortality rates, but not those for suicide, were consistently favourable in the recent period.The natural before-and-after experiment in Japan, of high economic growth in the decades to 1990, and low growth after 1990, is an example of a HIC with continuing progress in population health in a long period of low growth. Repeat measures of subjective, self-rated health from a population-based Japanese survey series (1986-2013) add to the evidence from objective mortality rate trends. Progress in population health does not need to stall if HIC economies focus on combatting climate change instead of growth.