More than one hundred years of improvements in living standards : the case of Colombia

This paper examines the long-term trends observed in the standard of living of the Colombian population during the past one hundred years, with special attention on health. We construct a historical index of human development for Colombia (HIHDC) for the 19th and 20th centuries by gender. We find that there were no major advances in living standards during the nineteenth century due to the stagnation of Colombia’s GDP per capita as a result of the lack of dynamism in exports. On the contrary, significant advances in all components of the HIHDC were seen in the twentieth century, especially those for women. During the first half of the century, improvements in the quality of life were mainly driven by a higher per capita income, while improvements after the 1950s were driven by greater public investment, for example, in education and health. Next, we analyze health achievements, considering health is one of the components of the HIHDC that has been less studied in the Colombian economic history literature. We construct a new dataset using statistics reported by the Colombian government, which included annual information on the main diseases and causes of mortality during the period of 1916-2014 disaggregated by territorial units. The data show that the percentage of deaths from tuberculosis, pneumonia, and gastrointestinal diseases decreased significantly throughout the century. On the contrary, deaths caused by cancer and heart diseases have increased considerably in recent decades. Results from difference-in-difference models show that the decline in the total mortality rate and in the mortality rate for waterborne diseases was largely related with the expansion in the provision of public goods, namely aqueducts and sewerage services. **** Este trabajo examina las tendencias a largo plazo observadas en el nivel de vida de la poblacion colombiana durante los ultimos cien anos, con especial atencion en la salud. Construimos un indice historico de desarrollo humano para Colombia (IHDHC) para los siglos XIX y XX por genero. Encontramos que no hubo avances importantes en los niveles de vida durante el siglo XIX debido principalmente al estancamiento del PIB per capita de Colombia. Por el contrario, se observaron avances significativos en todos los componentes del IHDHC en el siglo XX, especialmente los de las mujeres. Durante la primera mitad del siglo, las mejoras en la calidad de vida se debieron principalmente a un mayor ingreso per capita, mientras que las mejoras posteriores a la decada de 1950 se debieron a una mayor inversion publica, por ejemplo, en educacion y salud. A continuacion, analizamos los logros de salud, considerando que la salud es uno de los componentes del IHDHC que ha sido menos estudiado en la literatura de historia economica colombiana. Construimos un nuevo conjunto de datos utilizando estadisticas reportadas por el gobierno colombiano, que incluyeron informacion anual sobre las principales enfermedades y causas de mortalidad durante el periodo de 1916-2014 desagregadas por departamentos. Los datos muestran que el porcentaje de muertes por tuberculosis, neumonia y enfermedades gastrointestinales disminuyo significativamente a lo largo del siglo. Por el contrario, las muertes causadas por cancer y enfermedades del corazon han aumentado considerablemente en las ultimas decadas. Los resultados de los modelos de diferencia en diferencias muestran que la disminucion en la tasa de mortalidad total y en la tasa de mortalidad por enfermedades transmitidas por el agua estuvo relacionada en gran medida con la expansion en la provision de servicios de acueductos y alcantarillado.