Intended for healthcare professionals


Economic progress and health improvement

BMJ 2009; 339 doi: (Published 12 November 2009) Cite this as: BMJ 2009;339:b4575
  1. Martin Weale, director
  1. 1National Institute of Economic and Social Research, London SW1P 3HE
  1. M.Weale{at}

    Performance indicators should reflect both

    The economic performance of countries is generally compared using the concept of gross domestic product (GDP). This is a measure of economic activity developed in 1940 by two British Nobel prize winning economists, James Meade and Richard Stone.1 The concept and the associated data framework—national accounts—were designed to manage the economy in wartime. The extent to which it has gained much wider currency is perhaps surprising.

    Even with a very restricted notion of welfare, the link between GDP and welfare is not straightforward,2 and it has been recognised for many years that there is more to welfare than consumption.3 In 2008 President Sarkozy was concerned that France’s opinion of itself suffered because it compared badly with some other advanced countries on the basis of GDP per capita. A part of the reason for this “underperformance” is that France’s per capita labour supply is lower because the typical working week is shorter in France than in the United States and the average retirement …

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