Measuring inequalities of development at the sub-national level: From the human development index to the human life indicator.

Despite being one of the most common measures of development, the Human Development Index [HDI] has been much criticized for its consistency, data requirements, difficulty of interpretation and trade-offs between indicators. The 'Human Life Indicator' [HLI] has been proposed as a 'simple effective means' of measuring development and, more specifically, as a viable alternative to the HDI. Reducing inequalities within countries is a core component of the Sustainable Development Goals; yet sub-national HDIs are subject to the same criticisms as national level indices (potentially more so). Our goal in this paper is to demonstrate 'proof of concept' in terms of the systematic application of the HLI to measure development at the subnational level. Using life tables for the United States of America, we calculate, for the first time, HLIs for each state for the period 1959-2016. This country was chosen for the comparatively long run of available sub-national life tables. We also calculate the extent to which mortality is distributed across the life course-a further measure of inequality and the role of the social determinants of health. The HLI clearly shows how striking regional inequalities exist across the United States. We find that HLI and HDI for the most recent time period are strongly correlated. The analysis demonstrates that HLI represents an effective means of measuring development at the sub-national level. Compared to HDI, HLIs are characterized by simpler calculation and interpretation; fewer data requirements; less measurement error; more consistency over time; and no trade-offs between components. A current challenge of producing sub-national HLIs is the lack of comprehensive civil registration and vital statistics systems in many parts of the Global South from which sub-national life tables can be generated. However, as more and more countries develop these systems the potential to produce HLIs will inevitably increase.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.