Finding Winners on National Preston Curve Trajectories: The Myth of Exemplary Progress Meets the Data

Carolina Cardona , Johns Hopkins Bloomberg School of Public Health
David Bishai, Johns Hopkins Bloomberg School of Public Health

This paper aims to assess the promise and pitfalls of scouring the world’s picture album of country trajectories along their own Preston Curves to find high-performing countries. We categorize the various possible trajectories that 189 countries had between 1950-2009 into one-of-five typologies: i) Preston-behavior (Health growth + Economic growth); ii) Health growth + Economic recession; iii) Health decline + Economic growth; iv) Health decline + Economic recession; and v) Suspiciously Linear. Over the 9,450 country-years analyzed, 66% of them exhibited Preston-behavior. Contrary to assumptions, the input-output relationship where both life expectancy and GDP per capita are simultaneously growing fails to hold up much of the time. Once countries were categorized by typology, we assessed the rapidity of the Preston curve decade by decade across countries at various stages of population health. We find that the list of the top-five exemplary countries was neither consistent across decades nor across LEB stratum.

See paper

 Presented in Session 177. Gains and Gaps in Life Expectancy