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Authors: Amartya Sen

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In Europe and North America, women tend, generally, to outnumber men by substantial numbers. For example, in the United Kingdom, France and the United States, the ratio of women to men
exceeds 1.05. The situation is quite different in many countries in the third world, especially in Asia and North Africa, where the female-male ratio can be as low as 0.95 (Egypt), 0.94 (Bangladesh, China, West Asia), 0.93 (India), or even 0.90 (Pakistan). The significance of these differences is of interest in analyzing female-male inequalities across the worlds.
43
Figure 4.2
presents this comparative information.

In fact, more boys than girls are born everywhere (typically about 5 percent more). But there is much evidence that women are “hardier” than men and, given symmetrical care, survive better. (Indeed, it appears that even female fetuses have a higher survival rate than do the male fetuses; the proportion of male fetuses in conception is even higher than that in birth.
44
) It is through the lower mortality rates of females that the high female-male ratio of the “West” comes about. There are also other causes for this preponderance of women. There is some remaining impact of deaths of males in past wars. There has been, in general, a greater incidence of smoking among men and also greater proneness toward violent death. But it seems clear that even when these other effects are taken out, women would tend to outnumber men, given symmetrical care.

The low female-male ratios in countries in Asia and North Africa indicate the influence of social factors. It is easily calculated that if these countries had the female-male ratio that obtains in Europe and the United States, there would have been millions more women in these countries (given the number of men).
45
In China alone the number of “missing women,” calculated on the basis of the European or American ratio, would be more than 50 million, and on that basis, for these countries taken together, many more than 100 million women may be seen as “missing.”

It may not, however, be appropriate to use the European or American ratio, not just because of such special features as wartime deaths. Because of lower mortality rates of females in Europe and America, the female-male ratio rises gradually with age. A lower ratio would be expected in Asia or North Africa partly because of the lower general life expectancy and higher fertility rate. One way of dealing with this issue is to take as the basis of comparison not the female-male ratio in Europe or America, but that in sub-Saharan Africa, where there is little female disadvantage in terms of relative mortality rates, but where life expectancy is no higher and fertility
rates are no lower (quite the contrary). Taking the sub-Saharan female-male ratio of 1.022 as the benchmark (used in my earlier studies and in those with Jean Drèze) yields an estimate of 44 million missing women in China, 37 million in India, and a total for these countries still in excess of 100 million.
46

Another way of dealing with this problem is to calculate what the expected number of females would be had there been no female disadvantage in survival, given the actual life expectancy and the actual fertility rates in these respective countries. It is not easy to calculate that directly, but illuminating estimates have been made by Ansley Coale, through using model population tables based on the historical experience of “Western” countries. This procedure yields 29 million “missing women” in China, 23 million in India, and a total for these countries of around 60 million.
47
While these are lower numbers, they too are fiercely large. More recent estimates, based on the use of more scrutinized historical data, have tended to yield rather larger numbers of missing women (about 90 million, as estimated by Stephan Klasen).
48

Why are overall mortality rates for females higher than for males in these countries? Consider India, where the age-specific mortality rate for females consistently exceeds that for males until the late thirties. While the excess mortality in the childbearing age may be partly the result of maternal mortality (death during or just after childbirth), obviously no such explanation is possible for female disadvantage in survival in infancy and childhood. Despite occasional distressing accounts of female infanticide in India, that phenomenon, even if present, cannot do anything to explain the magnitude of extra mortality, nor its age distribution. The main culprit would seem to be the comparative neglect of female health and nutrition, especially—but not exclusively—during childhood. There is indeed considerable direct evidence that female children are neglected in terms of health care, hospitalization and even feeding.
49

Even though the Indian case has been studied more extensively than others (there are more researchers working on this issue in India than in any other country), similar evidence of relative neglect of the health and nutrition of female children can be found in the other countries as well. In China there is even some evidence that the extent of neglect may have increased sharply in recent years, particularly
since the compulsory family restrictions (such as the one-child policy in some parts of the country) were introduced, along with other reforms, around 1979. There are also some new, ominous signs in China, such as a radical increase in the reported ratio of male births to female births—quite out of line with the rest of the world. It can, quite possibly, indicate “hiding” of newborn female children (to avoid the rigors of compulsory family restriction), but it can, no less plausibly, also reflect a higher female infant mortality—whether or not induced (with new births and new deaths both going unreported). However, recently, the brunt of the antifemale bias in family composition seems to be in sex-selective abortion, which has become quite widespread in China with the progress of technology.

CONCLUDING REMARKS

Economists are sometimes criticized for concentrating too much on efficiency and too little on equity. There may be some ground for complaint here, but it must also be noted that inequality has received attention from economists throughout the history of this discipline. Adam Smith, who is often thought of as “the Father of Modern Economics,” was deeply concerned with the gulf between the rich and the poor (more on this later, in
chapters 5
and
11
). Some of the social scientists and philosophers who are responsible for making inequality such a central subject of public attention (such as Karl Marx, John Stuart Mill, B. S. Rowntree and Hugh Dalton, to take writers belonging to very different general traditions) were, in terms of substantive involvement, devoted economists, no matter what else they might also have been. In recent years, economics of inequality as a subject has flourished, with major leadership coming from such writers as A. B. Atkinson.
50
This is not to deny that the focus on efficiency to the exclusion of other considerations is very evident in some works in economics, but economists as a group cannot be accused of neglecting inequality as a subject.

If there is a reason to grumble, it rests more on the relative importance that is attached, in much of economics, to inequality in a very narrow domain, viz.,
income inequality
. This narrowness has the effect of contributing to the neglect of other ways of seeing inequality and equity, which has far-reaching bearing on the making of
economic policy. Policy debates have indeed been distorted by overemphasis on income poverty and income inequality, to the neglect of deprivations that relate to other variables, such as unemployment, ill health, lack of education, and social exclusion. Unfortunately, the identification of economic inequality with income inequality is fairly common in economics, and the two are often seen as effectively synonymous. If you tell someone that you are working on economic inequality, it is quite standardly assumed that you are studying income distribution.

To some extent, this implicit identification can be found in the philosophical literature as well. For example, in his interesting and important paper “Equality as a Moral Ideal,” Harry Frankfurt, the distinguished philosopher, provides a closely reasoned and powerful critique of what he calls “economic egalitarianism,” defining it as “the doctrine that there should be no inequalities in the distribution of money.”
51

The distinction, however, between income inequality and economic inequality is important.
52
Many of the criticisms of economic egalitarianism as a value or a goal apply much more readily to the narrow concept of income inequality than they do to the broader notions of economic inequality. For example, giving a larger share of income to a person with more needs—say, due to a disability—can be seen as militating against the principle of equalizing
incomes
, but it does not go against the broader precepts of economic equality, since the greater need for economic resources due to the disability must be taken into account in judging the requirements of economic equality.

Empirically, the relationship between income inequality and inequality in other relevant spaces can be rather distant and contingent because of various economic influences other than income that affect inequalities in individual advantages and substantive freedoms. For example, in the higher mortality rates of African Americans vis-à-vis the much poorer Chinese, or Indians in Kerala, we see the influence of factors that run in the opposite direction to income inequality, and that involve public policy issues with strong economic components: the financing of health care and insurance, provision of public education, arrangements for local security and so on.

Mortality differences can, in fact, serve as an indicator of very deep inequities that divide races, classes and genders, as the various
illustrations in this chapter bring out. For example, the estimations of “missing women” show the remarkable reach of female disadvantage in many parts of the contemporary world, in a way that other statistics may not adequately reflect. Also, since the incomes earned by family members are shared by others in the family, we cannot analyze gender inequality primarily in terms of income differences. We need much more information than is usually available on the division of resource use within the family to get a clearer idea of inequalities in economic affluence. However, statistics on mortality rates as well as other deprivations (such as undernourishment or illiteracy) can directly present a picture of inequality and poverty in some crucial dimensions. This information can also be used to relate the extent of relative deprivation of women to the existing inequalities in opportunities (in earning outside income, in being enrolled in schools and so on). Thus, both descriptive and policy issues can be addressed through this broader perspective on inequality and poverty in terms of capability deprivation.

Despite the crucial role of incomes in the advantages enjoyed by different persons, the relationship between income (and other resources), on the one hand, and individual achievements and freedoms, on the other, is neither constant nor in any sense automatic and irresistible. Different types of contingencies lead to systematic variations in the “conversion” of incomes into the distinct “functionings” we can achieve, and that affects the lifestyles we can enjoy. I have tried to illustrate in this chapter the different ways in which there can be systematic variations in the relationship between incomes earned and substantive freedoms (in the form of capability to lead lives that people have reason to value). The respective roles of personal heterogeneities, environmental diversities, variations in social climate, differences in relational perspectives and distributions within the family have to receive the serious attention they deserve for the making of public policy.

The argument is sometimes made that income is a homogeneous magnitude, whereas capabilities are diverse. This sharp contrast is not entirely correct, in the sense that any income evaluation hides internal diversities with some special—and often heroic—assumptions.
53
Also (as was discussed in
chapter 3
), interpersonal comparisons of real income give us no basis for interpersonal comparisons even of
utility (though that hiatus is often ignored in applied welfare economics through the imposition of wholly arbitrary assumptions). To get from the comparison of the means in the form of income differences to something that can be claimed to be valuable in itself (such as well-being or freedom), we have to take note of circumstantial variations that affect the conversion rates. The presumption that the approach of income comparison is a more “practical” way of getting at interpersonal differences in advantages is hard to sustain.

Furthermore, the need to discuss the valuation of diverse capabilities in terms of public priorities is, I have argued, an asset, forcing us to make clear what the value judgments are in a field where value judgments cannot be—and should not be—avoided. Indeed, public participation in these valuational debates—in explicit or implicit forms—is a crucial part of the exercise of democracy and responsible social choice. In matters of public judgment, there is no real escape from the evaluative need for public discussion. The work of public valuation cannot be replaced by some cunningly clever assumption. Some assumptions that give the appearance of working very nicely and smoothly operate through concealing the choice of values and weights in cultivated opaqueness. For example, the assumption—often implicitly made—that two persons with the same demand function must have the same relation between commodity bundles and well-being (no matter whether one is ill and the other not, one disabled and the other not, and so on) is basically a way of evading the need to consider many significant influences on well-being (as was discussed in
chapter 3
). That evasion becomes transparent, as I have tried to illustrate, when we supplement income and commodity data with information of other types (including matters of life and death).

The issue of public discussion and social participation is thus central to the making of policy in a democratic framework. The use of democratic prerogatives—both political liberties and civil rights—is a crucial part of the exercise of economic policy making itself, in addition to other roles it may have. In a freedom-oriented approach, the participatory freedoms cannot but be central to public policy analysis.

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