Health vs education
If you want to make a difference with your philanthropic donations it is important to donate to a good charity, rather than buying books for a school that has no teachers and so on. But how do we decide? It is all very well to say that a charity that saves 100 lives is better than a charity that saves 10 lives for the same cost, but not all charities are so easily comparable. Here I will try to compare health and education interventions.
The Competitors – And Their Weights
First let me present health, coming in with a mighty possible $3.50 for a year of life at full health. The reigning champ, in that most of the charities I have seen recommended on this website support health interventions.
Next we have education, coming in with a mighty $2.50 for a year of schooling. To clarify, this is the absolute minimum cost that a charity could put in to let a child in a developing country attend primary schooling for another year.
So we are roughly comparing the benefit of 1 year of life at full health to 1.5 years extra primary schooling in a developing country
Round 1: Direct Benefits to Individuals
Would you lose out on health for a year to gain the happiness brought to you by being better educated, to gain the ability to read and count? Can we put a value on such a thing? Not easily.
Let’s consider what data is available. The World Values Survey asked people how happy they consider themselves, how much education they had achieved and their state of health. The results showed that, taking into account the extra benefits of education such a better paid job, being educated did not tend to make people happier. Health, on the other hand, had the biggest direct impact on happiness of any factor.
These results need to be treated with caution. They may vary with factors such as the recipient’s age or nationality, and there are other plausible ways of comparing the direct benefits. Yet the survey strongly suggests that health has a much bigger direct impact on people’s happiness than education. So round 1 goes to health.
Round 2: Indirect Benefits – Individuals Achieve More
Educated individuals will earn more and achieve more. In developing countries, one additional year in school will increase wages in later life by about 10%. It is reasonable to suppose that people would sacrifice some degree of health to be that 10% better off, (especially where that 10% can mean food on the table). Healthier people will also earn more, but not to the same degree. At first glance education looks to be winning this round hands down.
Or so it may seem. The big problem here is that in developing countries increasing education has almost no effect on the average wage. This is because education is used as a way of selecting employees. The students who stay longer in education will be offered better jobs. Most less developed countries are educating enough people (to primary level) to fill all the jobs that need educated people.
What we really need to consider are the benefits of education upon society as a whole and the benefits of health interventions on society as a whole. Round 2 is declared a draw.
Round 3: Indirect Benefits to Society
Further increasing levels of primary education in developing countries has shown minimal or no economic benefits. A study in China found that on average one year in school led to a 1% increases in income. On the other hand in times of rapid technological development, such as the Green Revolution in India, basic education had a significant effect.
Health interventions can have a significant economic impact. As can be imagined, if people are healthier and stronger they can work harder and longer. For example one study that compared areas with different levels of malaria estimated that eradicating malaria in an area would give a 3% increase in income.
It is hard to get an accurate estimation of exactly how much the economy benefits from health or education interventions, and it could vary drastically upon the intervention. For these reasons I will declare round 3 a draw, with a personal leaning towards health interventions.
Round 4: Health Benefits of Education Interventions and the Education Benefits of Health Interventions
Making children healthier will allow them to spend longer in school. The effect on education of a health intervention depends on the particular intervention. The very best case scenarios I have found (deworming) provide one year of schooling for every one year of life at full health.
There are however huge health benefits to educating children. The most staggering one of these is that one year of extra education for women can lead to a reduction in infant mortality rates by 5-10%. This is astounding – it means that by encouraging education you could save a child’s life for about $160. Round 4 is won by education.
Some Conclusions
Overall, health interventions look more promising. The most effective health interventions for reducing infant mortality save about 1 child for every $30, but when choosing an intervention we should consider how it impacts health and education. Further, when trying to estimate the effectiveness of a charity, it is reasonable to treat education as a health intervention, as increasing health is the biggest positive effect of increasing education.
‘Boo!’ I hear you shout we wanted a knock out not some kind of pansy meeting of ways. It is all so vague and approximate. Just because we cannot know for sure, does not mean that we should not follow our best guesses.
Other factors to be considered are the benefits of secondary and further education for developing countries. Also you may be losing out by not educating the possible next Einstein or Ghandi. Maybe you believe that we all have a right to basic education and that it should be supported as something that is good in and of itself.
And if some of you are wondering how reducing infant mortality compares to improving the health of adults and older children, then tune in at an unspecified future date for Reducing Infant Mortality vs Improving Health.
For further reading with a little more economics I recommend: this.