The Great Escape: Health, Wealth and the Origins of Inequality by Angus Deaton

Large scale poverty is the result of political and organisational failures
November 14, 2013
“The Great Escape” is escape from ill-health and deprivation. Angus Deaton illustrates it through the story of his own family. Deaton’s father was brought up in a coal mining village and his first employment was at the pit. Leslie Deaton became an engineer by studying at night school. Leslie’s son became a professor of economics and emigrated to the United States. In turn, his two children, both Princeton-educated, are, respectively, a financial planner and a hedge fund manager.

Deaton records this evolution from coal face to hedge fund with no sense of irony. Yet one of the central subjects of his book, the near elimination of infant mortality and premature death among adults, is indeed an inspiring story. Deaton spells out a key lesson: the main sources of these advances are environmental changes achieved by collective action—better sanitation, pre and post natal advice, and reductions in the incidence of infectious diseases. The consequences of individualised expenditure in what Deaton describes as the physician-patient healthcare system are relatively minor.

That observation helps drive Deaton towards his conclusion. Continued large scale poverty and deprivation is avoidable, and the result of political and organisational failures. Deaton goes on to launch a stinging attack on foreign aid, which he believes simply underwrites such failures. The Great Escape is a thoughtful work, extensively illustrated with data, from a distinguished economist who tackles a central controversy of our time in a style refreshingly free of ideological baggage.