When economists, policymakers, and media commentators discuss growth or compare living standards across countries, they typically turn to a single measure: Gross Domestic Product (GDP). In layman’s terms, GDP is the monetary value of all goods and services made or exchanged in a country during a specific period of time. The calculation of a nation’s GDP is complex and takes in a multitude of country-specific caveats, but the final figure per capita is supposedly a proxy for a nation’s economic health.

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Using GDP as a measure of welfare, however, has multiple problems. Just ask Dr. Amit Kapoor, an expert in economic development and business strategy, who rebuts the focus often placed on the importance of GDP. As the chair of the Shared Value Institute of India, president and CEO of the India Council on Competitiveness, and as an affiliate faulty member with the Institute of Strategy and Competitiveness of the Harvard Business School, Kapoor has spent a great deal of time and effort working with the governments of India and other countries on measuring social progress and developing living standards, performance, and progress indices. In a recent lecture as part of APARC’s South Asia Colloquia, Kapoor made his case for looking past GDP when considering the overall well-being of nations.

GDP, says Kapoor, originated in the 1940s as a wartime estimate to provide a window into a region’s economic situation and is based on the paradigm that economic objectives equal social objectives. Yet economic development doesn’t always lead to advancements in social progress and human prosperity. To gain a complete understanding of a nation’s growth, he argued, it is important directly to measure social progress, which includes indicators of human well-being such as access to education, equal opportunity, health services, sanitation and clean water, social inclusion, and even tolerance.

 Our world as we know it is facing multiple threats, Kapoor reminds us, from environmental extinction to the rise of populism and to the crisis of capitalism. We can only address these issues “by creating alternate measures of how we assess human well-being.”

Kapoor points to the apparent growing gap between economic gains and social parity as evidence that GDP-centricity gives a very pixelated, partial picture of national development. In the past 80 years, economies as a whole have gained exponentially, as indeed reflected in GDP measurements, but progress on issues such as basic human needs, personal well-being, and opportunities for individual fulfillment have seemed to lag.

Kapoor’s issue with GDP is that it fails to account for these other kinds of social, environmental, and cultural factors. To this end, he advocates considering other means of measuring success and development, such as the Human Development Index, or his research to gauge and codify “ease of living” measurements in his home country of India.

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That research, says Kapoor, shows there exists a non-linear relationship between ease of living and per capita GDP. Therefore, the impact of economic development on a population’s ease of living will depend on where the region is placed. Moreover, if one is at a lower level of economic development, then investing in economic well-being will translate into social well-being, but after the cutoff is reached, higher economic development will lead to a fall in the ease of living.    

“In an economy with well-being at its heart, economic growth will simply be another tool to guide it in the direction that the society chooses. In such an economy, the percentage points of GDP, which are rarely connected with the lives of average citizens, will cease to take the center stage. The focus would instead shift towards more desirable and actual determinants of welfare.”

You can read more of Amit Kapoor’s perspectives and learn more about his work to redefine development in India in his Harvard Business Review article, “GDP Is Not a Measure of Human Well-Being.”

In a recent interview with People's Daily Online, APARC Fellow Thomas Fingar reflects on some of the milestones in the developing and diversifying relationship between the United States and China over the past forty years. The interview is part of a series of short documentaries produced by People's Daily Online West USA to commemorate the 40th anniversary of the establishment of formal diplomatic relations between the United States and China in 1979. The series was premiered at the San Francisco Public Library on January 18, 2020.

"So much of my career has been devoted to this relationship, [to] making this relationship work," says Fingar. He recounts how his own interest in China was sparked as a student in an anthropology class, where he began trying to understand why China and the United States "did things differently."

That initial question led him to a lifetime of building connections between the two countries, both in academia and government. Fingar was instrumental in launching Stanford's U.S.-China Relations Program in 1975, which promoted the exchange of learning, technology, and training between U.S. academics and students and their Chinese counterparts.

The focus on promoting U.S.-China engagement continues to inform Fingar’s perspectives today. "I'm concerned about the relationship [between the U.S. and China], but I'm not worried about it. I'm confident that both sides understand the stakes, [and] both sides understand the pressures to make this work".

Watch the interview below:

Using a dynamic microsimulation model, a research team, including APARC Deputy Director and Asia Health Policy Program Director Karen Eggleston, shows that there are differentially positive health gains of smoking reduction among subgroups of smokers in South Korea, Singapore, and the United States.

Tobacco use is responsible for the death of approximately eight million people worldwide, estimates the World Health Organization, and countries are increasingly making tobacco control a priority. Indeed the relationship between smoking and the burden of chronic diseases such as cancer, lung disease, and heart disease, and, in turn, premature mortality, is well documented. Yet little is known about the health effects of smoking interventions among subgroups of smokers.

Do interventions targeted at heavy smokers relative to light smokers lead to disproportionately larger improvements in life expectancy and prevalence of chronic diseases? And how do these effects vary across populations? In today’s rapidly aging world, it is crucial to understand the potential health gains resulting from interventions to reduce smoking, a leading preventable risk factor for healthy aging.

That’s why a research team, including APARC Deputy Director and Asia Health Policy Program Director Karen Eggleston as well as Stanford Health Policy faculty member Jay Bhattacharya, set out to examine the health effects of smoking reduction. To do so, the team simulated an elimination of smoking among subgroups of smokers in South Korea, Singapore, and the United States.

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The team’s findings, discussed in a new paper published by the journal Health Economics, show that smoking reduction can achieve significant improvements in lifetime health as measured by survival while also reducing the prevalence of major chronic diseases, though the effects are heterogeneous. Whereas interventions in both subgroups and in all three countries led to an increased life expectancy and decreased prevalence of chronic diseases, the life-extension benefits were greatest – 2.5 to 3.7 years – for those who would otherwise have been heavy smokers, compared with gains of 0.2 to 1.5 years among light smokers.

The team developed a dynamic microsimulation model to estimate the health gains of reducing smoking among heavy smokers and light smokers. Microsimulation models are powerful tools for assessing the value of health promotion: they model individual health trajectories while accounting for competing risks, thus providing valuable information about the impact of interventions and how they may interact with the changing demographics and socioeconomic profile of a population to determine future health. The team’s study applied microsimulation models tailored to the demographic and epidemiological context in the three countries, then compared the gains in survival and reduction in chronic disease prevalence from a given reduction in smoking and how these impacts vary depending on initial smoking intensity.

The team’s findings indicate that there are differentially positive health effects from smoking reduction. The life‐year gain among heavy smokers quitting well exceeds that of light smokers quitting in each country, but the magnitudes differ substantially: 11.2 times for South Korea, 6.8 times for Singapore, and 1.7 times for the United States. The lower life expectancy among Americans is related to the greater extent in which they suffer from risk factors, such as obesity, relative to the Asian counterparts in the study.

The findings illustrate how smoking interventions may have significant economic and social benefits, especially for life extension, that vary across countries. They are particularly important for aging societies that are concerned about the sustainability of their health insurance systems in the face of increasing burden of chronic disease.