Health, well-being and inequality over the long term

Citizens’ lives have greatly improved during the 20th century in terms of income and health, but the uneven pace of improvement has led to substantial cross-country inequality.

This dissertation explores the idea that citizens’ well-being is a much broader concept than income. A broader perspective on welfare is important for understanding its evolution during the first half of the 20th century in Europe. During this period, most improvements in living standards did not come from increases in income, but rather from higher life expectancy, less inequality and shorter working hours.

This research also shows that historically – in contrast to more recent developments – global differences in income can be accounted for to the same extent by differences in human and physical capital as by differences in productivity. In addition, the effect of health on labor productivity is of great importance for explaining both the growing income inequality since 1900 and part of its decline during the second half of the 20th century.

As far as health is concerned, this thesis shows that clean water provision at the turn of the 20th century had a limited influence on health. Using Germany as a case study, a drastic reduction in disease and mortality only took place when water supply was provided in combination with modern sewerage networks.