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Technology, Information and the Evolution of Social Policy: The Chips for Neurons Revolution and Socio-Economic Change
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Bell Canada Papers, John Deutsch, Institute for Study of Economic Policy, Queen's Univ., November 1995

Follow this link to view or print out the actual slides in the presentation.

I. INTRODUCTION

One of my colleagues has pointed out that since the Agricultural Revolution 10,000 years ago, which had a transforming effect on hunter-gatherer societies, Home Sapiens has been engaged in what might be termed continuing experiments in civilization. Technological innovation has had a major effect on these experiments in civilization and resulting social organization. In describing technological change and the effects on societies since the Agricultural Revolution, Leonard Dudley (1991), Following some of the arguments of the late Harold Innis, comes to the following conclusion in his recent book, The Word and the Sword:

Historical change appears to have its origins in innovations that alter the optimum scale of organizations. By modifying the efficiency of either the state's military organization or its fiscal bureaucracy, new weapons and informational technology change the optimal tax rate and territorial boundaries. Conflicts among or within states then lead to new patterns of territorial boundaries and modification in the degree of government intervention. There are four possible types of innovation, centralizing, liberalizing, feudalizing and atomizing -- each with a characteristic effect on state borders and tax levels. Overall, there has been a trend to larger political units, accompanied by a cycle of expansion and contraction in the importance of the public sector within each state. At present, the atomizing innovations in information technology are threatening the fiscal equilibrium and territorial integrity of the largest and most heterogeneous states.

This quote summarizes what has been going on since the Agriculture Revolution and provides a framework for considering what is happening today. It is clear that major technological change in the past has led to socio- economic change and new forms of governance. If, as many believe, we a now in a period of major technological change, social policy changes should be considered within the framework of our understanding from our past experience with major technological innovation and the socio-economic response. The history of mankind shows that with major technological advance there are substantial changes in the economic, social, institutional and political characteristics and the health and well-being of societies (Dudley, 199x, Boserup, 1981; Rosenberg and Birdzell, 1986). Attempts to integrate a understanding of technological change, economic growth, social cohesion political freedom and health and well-being have been difficult. There is little evidence to date that societies can easily make use of our improved under- standing about the relationship among these factors to minimize the negative effects of major technological change on the quality and characteristics of or societies and our political systems.

Dahrendorf (1995), whose background is in economics and political science, pointed out that the present developed economies of the West an Asia are in a precarious balance as they cope with forces driving all creation in the new economy and the effects on social cohesion and political freedom. He considers that the forces of economic opportunity and the desire to sustain civic societies and political liberty are in growing conflict and the developed economies will not be able to resolve the conflict and sustain tolerant, liberal, democratic states. Whether Dahrendorf’s pessimism: justified is open to debate, but there is little doubt that it will take a great de; of imagination and political will to create social policies during this period of technological change that can help sustain civic, tolerant, democratic society. In this presentation I will attempt to explore some of our understanding < the relationships among technological change, economic growth, stability on social environments and the health and well-being of populations. One of the best markers of a prosperous and civic society is the overall health and well being of the population.


II. TECHNOLOGICAL CHANGE AND SOCIETY

Although many terms are used to describe the technological revolution that we are in (e.g., Information Age, The Information Highway, The Learning Society, etc.), I prefer a simple description "chips for neurons". The substitution of low-level intelligent devices (they can sense, decide and act) for low- level human intellectual functions is a deep and broad technological revolution, like the harnessing of fossil fuel as an energy source, that is affecting all aspects of society.

We now have some sense of how major technological revolutions penetrate deeply into all activities in a society and spread throughout society. This is well described in Lipsey and Bekar's (1994) paper in the third volume of the Bell Canada Papers. The present revolution appears to be as powerful as the harnessing of fossil fuels to replace muscle power and water power in the Industrial Revolution. We know the Industrial Revolution was a crucial factor in Western countries becoming rich and democratic with universal suffrage (Rosenberg and Birdzell, 1986; Mokyr, 1990) and was associated with a massive improvement in the health and well-being of populations in Western countries (McKeown, 1976a; Fogel, 1994). Thus, in a space of 250 years Western societies moved from 80% or more of their populations living in relative poverty, serfdom and slavery to 80% or more living in relative prosperity and the introduction of universal suffrage and the kinds of civil liberty and democracy we are familiar with today.

The present technological revolution may have as powerful an effect on the economic, political and social character of societies as earlier major technological revolutions. The full effects of major technological change are hard to predict. Some of the characteristics of this chips for neurons revolution appear to be:

The replacement of low-level intellectual functions by electronic devices -- the bank machine, autonomous robotic devices, the "electronic pilots" commercial aircraft, security devices, automation of services, automated and flexible manufacturing, global information systems, etc. - This is changing productivity and the nature of work.

The capacity to make enormous bodies of knowledge instantly available to individuals linked through the electronic networks and the creation of learning networks, that cross existing gee-political boundaries. This is changing our approach to learning and our education institutions.

The opportunity to interact through virtually instantaneous global networks for a variety of functions ranging from education and training to entertainment, financial markets and business and military activities.

Virtually instantaneous global transmission to individuals in all regions through news media and other institutions of "information", whether objective or biased. This could change values, beliefs and cultures.

The prosperity of regions, the nature and concepts of work, income equity, values, cultures and social and political systems will change as a result of this technological revolution. If we look at how Home Sapiens has coped with other deep and broad technological revolutions, there may be some insights that might be relevant to how we cope with the "chips for neurons" revolution Dudley: 1991; Lipsey and Bekar, 1994). What is clear is that social policies and institutions in Western countries that helped sustain political freedom and civic societies for the developed economies of this century are not sustainable in the face of the forces unleashed by today's techno-economic revolution.


III. HOMO SAPIENS AND SOCIAL ORDER

In thinking about our species and its existence on the planet, it is helpful to remember the history of the planet and our insignificant time as a species. It' can give us a sense of humility. Our planet is about 4.5 billion years old; life has existed for at least 3.5 billion years. The total amount of living matter on the planet has been constant for over 3 billion years -- only the species have changed (The Canadian Institute for Advanced Research, 1995). Primates, as a species, have only been around for a few million years and our species for about 200,000 years. The behavior, biology and the health and well-being of our species are rooted in this relatively recent history of primates. A basic observation is then, since primates are social animals, change in their social environments affect their health and well-being, Home Sapiens is no exception.

For about 90% of existence of our species, we lived in groups of 5 0 to 100 in hunter and gatherer societies. These communities or groups, as far as we can tell, had a minimal effect on their physical environment, were communitarian in their social order, with women having a dominant community role, but were subject to the hazards of their physical environment and availability of food (Boserup, 198 1). Their social order reflected the fact that most primate species are social animals and do not do well without social support networks, and thus tend to form groups that can provide this support, particularly for the rearing of the young (Boserup, 1981; Cheney and Seyfarth, 1990; The Camegie Corporation, 1994). It is important to remember that our biological systems are based on primate evolution over millions of years and the fact that we are a social species. All young primates, including humans, are strongly influenced by the quality of the social environment in which they are reared and this has a direct effect on their coping skills, health and well-being throughout life (The Camegie Corporation, 1994; Keating and Mustard, 1993; Frank and Mustard, 1994). The cult of individualism and laissez-faire economics, taken to the extreme, with disruption of social environment could, because of the needs of early childhood and our biological characteristics, lead to long-term negative effects on the affected populations.

If we think about our species' existence on the planet in terms of calendar year rather than in tens of thousands of years, the time perspective (changes in our society are more easily grasped. (See Figure 1.) On this tiny scale, we lived in small groups of 50 to 100 until the middle of November. As a result of the Agricultural Revolution (a deep and broad technological change), it became possible to support population engaged in activities other than trying to find food. It is at this point that v begin our experiments with civilization.

Slide (93-028): Figure 1: Population and Major Events in the Life of Home Sapiens
Note: This shows the 200,000 years of human existence as one calendar year Source: The Canadian Institute for Advanced Research (1995).

When Home Sapiens began the experiments with civilization in the middle of November (10,000 years ago), we began to create new kinds of geopolitical and social orders with a variety of institutional arrangements to create and sustain the environments in which people live and work. Up to this time, there were no civilizations, as we describe them, no written language, no governments, no large social organization or concepts of work and leisure. The Agricultural Revolution spawned, among other things, towns, cities, cultures, history, writing, governments and organized religions on a large scale. These new societies required planning ahead -- it made time-telling and calendars important. Property rights, conflicts, laws and non-violent means of trying to settle disputes emerged during this period. In contrast to our previous existence, there were now things to steal (thieves) and plunder (armies). The kinds of "civilizations" that have emerged over the last 10,000 years have been strongly influenced by further technological revolutions following the Agricultural Revolution (Dudley, 1991; Boserup, 1981). Among the technological changes were:

The emergence of alphabets and written language.
New materials to write on.
The printing press.
New materials for peaceful and military uses including gun powder. ·
New energy systems.
New transportation systems.
Today's electronic systems.

These revolutions produced changes in economies, social structure and order, health and well-being, and the distribution of power and governance (Dudley, 1991;Boserup, 15)81; Lipsey and Bekar, 1994; Frank and Mustard, 1994). A few generalizations can be made about the effects of technological changes following the Agricultural Revolution.

Each major information revolution has tended to be associated with changes in the socio-economic characteristics of a society, social order, culture, and the scale, scope and systems of governance.

Some information revolutions have helped break the power blocks controlling societies and unlocked the creative power of the human race leading to enhanced prosperity and improved social and physical environments in which individuals live and work.

Recently in our history the printing press and the development of paper made it possible to provide information to a larger portion of the population than that provided by the church, landlords and the aristocracy and their forms of governance and control. This information revolution contributed to undermining the power and controls of feudal societies and led to changes in territorial boundaries and governance.

The freeing up of Western countries from feudalism, autocratic governance, control by the church and other groups, led to releasing human ingenuity and the Industrial Revolution. The Industrial Revolution led to major socio-economic, institutional and political changes as summarized earlier. One of the dramatic effects of this revolution and its affects on societies was the improvement in 'the health and well-being of citizens in Western countries (McKeown, 1976a; Fogel, 1994).

One of the best markers of a successful economy and social order is the health and well-being of its population (Fogel, 1994; Sen, 1993). The health of a population is largely determined by the quality of the social environment in which people live and work. This relationship and the biological pathways involved, which were poorly understood until recently, have given us a much better understanding of the determinants of health and the role of the social environment (Frank and Mustard, 1994; Sen, 1993; Evans et al., 1994).


IV. PROSPERITY, SOCIAL ENVIRONMENT AND HEALTH

The standard assumption has been that the health of Western populations improved because of medicine and public health measures (Rosenberg and Birdzell, 1986; Last, 1980). McKeown (1976b), a physician, studied the changes in mortality and disease patterns in the United Kingdom following the Industrial Revolution (Figure 2). He found that 75% of the decline in mortality was not due to public health measures or medicine. By exclusion, he came to the conclusion that the primary factor was the better nutrition of the population, resulting from the enhanced prosperity associated with the Industrial Revolution. McKeown's conclusion generated considerable opposition from his profession and many economists. Fogel (1994), an economic historian, along with a number of colleagues, took up the challenge of McKeown s work (Figure 3). They found that the evidence from the records in Western countries showed that with the improved prosperity associated with the Industrial

Slide (92-037): FIGURE 2: Determinants of Health
Note: This is adapted from Tom Mckeown’s work. It shows the decline in mortality from respiratory tuberculosis in England and Wales. Source: McKeown (1976b),p.81

Slide (94-064): FIGURE 3: The Secular Trends in Mortality Rates in France: 1752-1974
Note: This shows the decline in the crude death rate in France from 1752- 1974 Source: Fogel (1994)

Revolution, there was better food production and more equitable distribution in Western societies. Neither Fogel or McKeown could estimate the other changes that enhanced the lives of Western population, but they did demonstrate that the improved health was not primarily due to the factors that are conventionally taught, such as medicine and traditional public health measures. McKeown concluded that traditional public health measures accounted for about a quarter of the improvement in life expectancy following the Industrial Revolution.

In the historical analysis of Western countries, Fogel (1994) found that when the state of the economy stagnated or declined there was a corresponding negative effect on life expectancy. He concluded that such factors as the state of the economy, income distribution and urbanization are significant factors influencing health and well-being. We know today from recent studies of Eastern Europe and the former Soviet Union that countries undergoing major socio-economic change show adverse effects on the health and well-being of the populations (Hertunan, 1995; Bobak and Marmot, 1996; Marmot et al., 1995; Watson, 1994). The life expectancy gap between Eastern and Western Europe has substantially increased over the last two to three decades. The gap has further widened since the collapse of the communist regimes in 1989 in association with the economic, social and political turmoil in these countries. Attempts to explain the deterioration in the health of the former communist countries of Central and Eastern Europe and the regions of the old Soviet Union have ranged from changes in the quality of health care services, excessive pollution, excess smoking and drinking to socio-economic factors (Hertunan, 1995; Bobak and Marmot, 1996). The most recent appraisals indicate that the dominant factor is Socio-economic change (Hertunan, 1995; Marmot et al., 1995).

When a nation reaches a certain level of prosperity, the gains in life expectancy with increased prosperity are small (Wilkinson, 1992). However, within affluent developed societies there is substantial variation or inequalities in health when measured by mortality against social economic factors. The higher a person is in the social economic gradient, the better their health. In some affluent Western countries the gradients are steep while in others the gradients are small. It is useful to remember that these are gradients and do not have thresholds for health (i.e., those in poverty versus the rest.) Kitagawa and Hauser (1973) found compelling evidence in the United States, between 1930 and 1960, of different rates of mortality by social class. Even though the mortality rates in the United States have continued to decline, the social gradient in health is still present and the difference in mortality rates for individuals in the different parts of the gradient has widened. In contrast, in Scandinavian countries the gradient in health has not widened and life expectancy has increased for all social classes (Frank and Mustard, 1994). Japan shows similar health outcomes to Sweden (Marmot and Smith, 1989). Both countries have had a high degree of income equality with social stability (The Economist, 1994).

One of the most powerful studies that provides some clue about the factors influencing gradients in health are the studies by Michael Marmot and his colleagues of the Whitehall Civil Service (Evans et al., 1994; Marmot, 1994; Marmot et al., 1995). (See Figure 4.) These studies show that in a middle class population, the higher you are in the job hierarchy, the lower the risk of your dying from major causes of death such as strokes, heart attacks and smoking and non-smoking-related cancers. There is also a gradient for deaths from suicides and accidents (Table 1). In all developed societies in which similar studies have been carried out, there are clear non-disease- specific gradients in health when measured against social economic markers such as jobs, levels of education, income, etc. (Frank and Mustard, 1994; Evans et al., 1994). Figure 5 shows the mortality gradient from Michael Wolfson's studies on Canadian males retired under the Canada Pension Plan (Wolfson et al., 1992).

Slide ? FIGURE 4: U.K. Civil Service: Mortality - All Causes
Note: This shows the all-cause cumulative mortality over ten years for 17,500 Whitehall Civil Servants, working in London, by grades of employment. Source: Adaptation from Marmot (1986)

Table 1: U.K. Civil Service

Relative Mortality in Ten Years


Cause of Death
Admin.
Prof.
Clerk & Exec
Other
Lung Cancer
0.5
1.0
2.2
3.6
CHD
0.5
1.0
1.4
1.7
Chronic Bronchitis
0.0
1.0
6.0
7.3
Gastro-Intestinal Dis.
0.0
1.0
1.6
2.8
Genito-Urinary Dis.
1.3
1.0
0.7
3.1
Accidents & Homicide
0.0
1.0
1.4
1.5
Suicide
0.7
1.0
1.0
1.9



Source: Marmot (1986).

Slide (92-047): FIGURE 5: Mortality Rates: Ages 65-70
Note: This shows the mortality rate after age 65 for more than 500,000 males who have retired under the Canadian Pension Plan, against their average earnings from age 43 to 64 Source: Wolfson et al. (1992).

Whatever is producing the gradients or inequalities in health affects the whole of society not just those in poverty. Although the effect of Socio- economic factors on access to medical care in the United States may explain some of the health gradient in that country, it does not explain the observations in Canada and the United Kingdom where health care is available, without financial barriers, to all members of society. Health selection has been proposed by some as the explanation for the gradients in health. With the exception of some mental health problems, there is no evidence to support health selection as the primary factor. Furthermore, longitudinal studies are beginning to establish the relationship between early childhood and health risks in adult life (Marmot et al., 1995; Wolfson et al., 1992). The quality of the environments in which children are reared appears to be an important factor in determining vulnerability to many of the disorders in adult life.

Fogel(1994) concluded from his work that a key factor in improving the health of populations in Western countries following the Industrial Revolution was the better nourishment of children (Frank and Mustard, 1994). This conclusion was based on his studying the relationships among prosperity, provision of food and changes in the mean height and life expectancy of populations. Mean height is determined by the genetic characteristics of a population and how well children are nourished before maturity. Poorly- nourished children do not reach their proper height, leading to a shorter mean height for the population. Fogel found that the life expectancy of a population improved when the mean height of the population increased and went the other way when the mean height of the population shortened.

Although neither Fogel nor McKeown could measure the nurturing or stimulation of children (an important factor in human development), it is likely that this also improved along with the prosperity and better nutrition of children. Fogel also came to the conclusion that the risk for many of the chronic diseases of adult life are set in early childhood (Fogel, 1994). There is a growing body of evidence to support this conclusion (Frank and Mustard, 1994; Evans et al, 1994; Hertzman, 1994; Power et al., 1991; Barker, 1992). Attempts are now being made to assess how much of the gradient in health in adult life is set in early childhood.

We now have some understanding of the biological pathway by which an adverse early childhood can set risks for health and well-being in adult life that is compatible with Fogel's conclusion from his historical analysis and the non- disease-specific gradients in health found in developed countries.

One clue as to how socio-economic factors affect health is the emerging story about coronary artery disease risk. The risk of dying from a heart attack is greatest in the lowest tier of the Whitehall Civil Service and lowest in the top tier (Marmot and Mustard, 1994). The bulk of that risk gradient cannot be explained by conventional risk factors such as cholesterol, smoking and blood pressure. What then could provide an explanation? A clue comes from work showing that individuals in high demand jobs with little control have a higher incidence of coronary artery disease symptoms than individuals in high demand jobs with high control (Karasek and Theorell, 1990). In the bottom tier of the U.K. Civil Service substantially more individuals consider they have high demand jobs with little control in contrast to the top tier where most individuals feel they have high demand jobs with high control. Thus, how well individuals cope with the challenges in the environments in which they work and other aspects of life appears to be important in setting health risks. What factors influence competence and coping skills and how does this relate to social policy and social order?


V. COMPETENCE AND COPING SKILLS

How well individuals cope with challenges -- the fright and flight response - in the environments in which they live and work appears to be an important factor influencing vulnerability to disease expression. There is now a substantial body of evidence showing how competence and coping skills are related to the development of the cortex of the brain in early childhood. We now have clues about how competence and coping skills affect the biological pathways that influence disease expression in adult life. It is this new framework of understanding that is providing insights into the factors causing the gradients in health (Frank and Mustard, 1994; Evans et al., 1994).

There are two lines of research that provide insight into the pathways that influence disease expression. The first comes from research in neuroscience which is providing a better understanding of how the billions of neurons in the cortex of the brain differentiate and develop their specific functions in early life (Cynader, 1994). Since this part of the brain and its close connections determine cognitive capacity, behavior, competence and coping skills, its development in early life has a profound influence on how well we function in later life. For the neurons to differentiate and develop their specific functions in well-nourished individuals during this early stage, the quality and quantity of the stimulation (signals) the undifferentiated neurons receive during the sensitive periods sets many of their basic characteristics for later stages in life. The neurons undergo most of their basic differentiation as the brain develops during the late stages in utero and the early years of life -- before school. It is difficult at later stages in life to overcome the defects in neuronal function resulting from poor stimulation in early life. Table 2 prepared from the Camegie Corporation's (1994) recent report Starring Points summarizes the key findings from research in the neurosciences. The quality of the social environments in which children are brought up -- interaction with peers and adults -- has major effects on the quality of stimulation (nurturing) in early life and thereby competence and coping skills in later life.

The second line of evidence comes from our better understanding of the effects on the body's biological pathways of how effectively individuals cope with challenges. Challenges to individuals have a major effect on the endrocine pathways of the body (fright and flight syndrome). These hormones, particularly steroids that are released in response to the challenges, affect other body systems -- generally suppressing their function (Sapolsky, 1992; Suomi, 1991, Reichlin, 1993; Coe, 1993).

Among the systems inhibited by the steroids is the immune system which is part of the body's host defense system. Animals that do not cope well with challenges, do not quickly restore their hormone levels to the resting state (Sapolsky, 1992; Suomi, 1991). Thus, a poor response to challenges could lead to more persistently elevated steroid levels with depression of the host defense system and other body functions, thereby increasing vulnerability to expression of disease. The steroids also affect the hippocampus of the brain and excess levels can permanently injure neurons in the hippocampus and this can occur in the young (Carnegie Corporation, 1994; Sapolsky, 1992). The new observations have created a better understanding of the mind-body relationship that in turn provides an understanding of how the development of competence and coping skills in early life influence a wide variety of causes of death in adult life, including suicides, accidents, some cancers and cardiovascular disease.

Table 2: Neuroscience and Children

· brain development before age 1 is more rapid and extensive than previously realized,
· brain development is more vulnerable to environmental influences than suspected,
· the effects of early environment are long lasting,
· the environment affects the number of brain cells and the way they are "wired", we now have evidence for the negative impact of early stress on brain development and function.
Source: Canegie Corporation(l994).


VI. COMPETENCE, COPING SKILLS AND THE LEARNING SOCIETY

As our knowledge about the development of the cortex of the brain in early life has improved, so has our understanding of the relationship of early childhood experience to learning in schools and in adult life. Again, like health, cognition and behavioral characteristics are also influenced by childhood. There are socio-economic gradients for these characteristics in populations. In some countries these gradients are shallow while in others they are steep. For example, in international tests in science and mathematics, there is a very small social gradient in the performance of Japanese students and a very steep gradient in student performance in the United States (Case, 1991) when assessed against the father's job classification (Figure 6).

An important question, in view of the increasing evidence about the importance of early childhood affecting our competence, coping skills and health and well-being in adult life, is what, if anything, can be done to reduce the risks to children in inadequate social and family environments? The intense debates about genetic versus social factors and daycare and early kindergarten attest to the ideological battle about this subject. The evidence comes from two lines of investigation about early life conditions and events in later life. The first set are animal studies ranging from rats to non-human primates. In these studies, it is possible to do complete life cycles, which is not feasible for an investigator studying human subjects. The evidence from the animal studies (Sapolsky, 1992; Suomi, 1991; Coe, 1993; Kolb, 1989) is robust in demonstrating that conditions in early life have a profound effect on the development of the cortex of the brain and function in the later stages of life. In rhesus macaque monkeys it has been found that when the genetically-vulnerable group are poorly nurtured they have a bad outcome in terms of their ability to cope and their well-being. When challenged, they have a large secretion of the hormone mediators of stress and do not return to resting levels quickly. However, the genetically vulnerable group that are well nurtured when they are young do well and often become the leaders (Suomi, 1991). When stressed, these animals have the same extensive secretion of stress mediators as the poorly nurtured group, but return to resting levels quickly.

Slide (97-003): FIGURE 6: International Comparison of Grade 8 Math Achievement
Note: Grade eight mathematics achievement from the second international study of mathematics against father’s occupation status. Case (1991). Source: Data from analysis of Second International Study of Mathematics by Wolfe and Case (in progress).

While genetics is important, the nurturing or social factors influencing early childhood appear to be even more important in respect to the development of competence and coping skills and susceptibility to events later in life.

Because of the difficulties in studying our own species, the evidence from human studies is incomplete and less substantial than the primate studies. A small, but important study is The High Scope Study (Weikart et al., 1984; Weikart et al., 1993) which illustrates the long-term effects of events in early childhood Children living in poor social environments, between the ages of three and six, were randomized into an intervention and non-intervention group. The intervention group were given "substitute parenting or teaching" five days a week in groups of five to six. The "preschool" intervention was stopped at the age of six. The children in the intervention group did not show significant improvement in IQ over the non-intervention group. However, in later life the children in the intervention group showed a much higher retention in the school system, 40% fewer teenage pregnancies, better employment records, and less crime and drug use (Table 3). The group has been re- examined in their late 20s. Again, the performance of those in the intervention group was substantially better than the others. An important aspect of this assessment was the fact that the mental health problems were substantially less in the intervention group. It is increasingly recognized that many of the mental health problems in early life are a product of adverse circumstances in early childhood. It has been calculated that for every dollar invested in the three to six intervention in this study, the returns at least seven dollars. This study, which is consistent with findings from animal studies, illustrates the long reach of early childhood into adult life and the value of social support networks for children in early childhood to prevent problems in later life.

Based on the emerging knowledge about how the cortex of the brain develops, we suspect that the results for the High Scope Study would have been better if the intervention had been started earlier. There are some observations about interventions in the first two years of life and the effects on development by age two. A group of high risk Jamaican children were randomly allocated at birth into four groups - no intervention, nourishment, stimulation, stimulation plus nourishment -- and followed until the age of two (Grantham-McGregor er al., 1991). The group given both stimulation plus nourishment reached the same level of development as the normal group of children by age two (Figure 7). The groups given either stimulation or nourishment achieved 50% of the development of the control group by the age of two.

Table 3: HIGH/SCOPE Perry Preschool - USA Preschool Enrichment for High Risk Children

Intervention Group vs. Control Group
· Employment - twice as good
· High school completion 1/3 higher
· Crime 40% less
· Teenage pregnancies 40% less
· Drug use substantially less

Source: Weikart et al. (1984)

Slide (93-040): FIGURE 7: Mental Development of Undersized Children (Low Height for Age) - The Jamacian Study
Note: The effect on the development of high risk infants during the first two years of life of improved nutrition (supplement), better nurturing (stimulation) and both improved nutrition and nurturing. Source: Adapted from Grantham-McGregor et al. (1991).

An interesting finding from this study is that the quality of the stimulation (nurturing) had as big an effect as improved nourishment. Fogel, in his historical analyses, could only assess nourishment from the records (changes in mean height). It may well be that the period he was examining also led to better nurturing environments for children as well as better nutrition. Unfortunately there have been no studies of the effect of these early interventions with children at risk in relation to later stages of development and health risks in adult life although studies are in progress.

There are observational studies that are congruent with the results from the intervention studies. Werner's observation (Werner and Smith, 1992) on a group of children born on the island of Kauai in the 1950s, has shown that children in poor socio-economic environments who were able to interact with "substitute parents or grandparents" during their early life did much better in later life than those that could not get this adult support. This also shows, as is the case with rhesus macaques, that the adult support for children does not have to come from the biological parent.


VII. HUMAN CAPITAL AND ECONOMIC GROWTH

The improved health characteristics that McKeown (1976) and Fogel (1994) observed in Western countries following the Industrial Revolution reflected a higher quality population in terms of competence and coping skills and health status. Fogel (1994) concluded, from his studies, that 50% of the economic growth in the United Kingdom following the Industrial Revolution, was due to the better health and well-being of the population. Since the quality of human capital is important for economic growth and since social policy in its effects on the social environment has a major effect on human development, particularly early childhood, factors influencing human development are a major long-term economic issue as well as a social issue and should therefore be important in social policy.

Fogel also noted that during subsequent periods of major technological changes, some societies failed to capture the new economic opportunities, with a decline in their prosperity, increased income inequalities, degradation of their social environments, and a deterioration in the health and well-being of the population and a shortening of the population's mean height.


VIII. PROSPERITY, SOCIAL POLICY, SOCIAL ENVIRONMENTS AND TECHNOLOGICAL CHANGE

A classic example of a country that failed to capture effectively the prosperity from the technological revolutions in this century is Great Britain. The pools of wealth in the United Kingdom, following the success of the Industrial Revolution, ceased making strong investments the new technologies and related businesses and became more concerned with short-term returns from investments in financial markets. Britain slipped from being the world economic leader at the turn of the century to 23rd today. The health status of the population around the financial markets (London) is much better than that in the regions that were the heart of the original Industrial Revolution - Manchester, Newcastle, Liverpool, Sheffield, etc. (Eames et al., 1993). See Figure 8. Part of the socio-economic change caused by inadequate investment in the new economy can be picked up by the increasing income inequality, higher unemployment and welfare in these regions remote from London. This may mean that in periods of major economic change, some countries will have difficulty developing policies for investing in the new technologies of economic growth that sustain high quality social environments with resulting negative effects on the health and well-being of their populations.

Slide (94-009): FIGURE 8: Social Deprivation and Standard Mortality Ratios (SMR), All Causes
Note : The relationship between social deprivation [unemployment, welfare, Income, etc.] and mortality for different regions in England, 1981 to 1985. Source: Adapted from Eames et al. (1993)

While we now have better understanding of the determinants of health and human development, our understanding of major technological change and the determinants of economic growth is less complete. In its broadest sense, economic growth is about how societies create and distribute resources to sustain and enhance their standard of living, and the quality of their social environments In discussing the subject of economic growth, The Economist magazine, in an essay entitled, "Explaining the Mystery" pointed out that economists have had little to say about what determines economic growth (The Economist, 1992). Today it is increasingly recognized that technological innovation is a major driving force in economic growth and that technological innovation is strongly influenced by socio-economic factors (Dudley, 1991; Rosenberg and Birdzell, 1986; Lipsey and Bekar, 1994; The Economist, 1992. Romer, 1994). Understanding and applying the full implications of this knowledge in the theoretical framework of economics in public policy has been slow, particularly in English-speaking societies.

Britain is an example of a country that failed to invest adequately in the technology of this century and yet introduced social programs it could not afford (Bamett, 1991; Button, 1995). Can our societies do a better job this time? We know more about the determinants of human development, health and economic growth than we did 100 years ago.

As a result of our changing economy and decline in our relative wealth base, can we create policies, with diminished resources, to sustain the quality of our social environments and the civic quality of our societies as we try to build the new economy?

A marker of the emerging problems in, our own society is the increasing number of children who have trouble coping with the school system when they enter kindergarten. In some public schools in Canada over 30% of the male children entering kindergarten cannot cope and become antisocial, creating problems that are difficult for schools to handle (Tremblay et al., 1992; Lipman et al., 1994). These children disrupt the classes as they go through the system and they are the source of most of the dropouts. In one study it was found that 28% of the antisocial group, identified in kindergarten, were delinquent by the age of thirteen (Tremblay, 1992). All the evidence shows that interventions by the time these children are picked up in the school system is much less effective than intervention in the preschool period (Tremblay and Craig,1995). These effects of social change on children are a marker of how well a society is coping with the change and the effectiveness of social policies.


IX. TECHNOLOGICAL CHANGE, SOCIAL POLICY AND CIVIC SOCIETIES

We now know enough about the determinants of economic growth, human development and health and well-being to state that two primary goals of a society during a period of major technological change should be; (I) to adopt policies that promote economic growth based on our new understanding of the determinants of economic growth, not business cycles); (ii) with diminished resources, help communities maintain stable social environments and civic societies that minimize negative effects on early childhood development and vulnerable members of the adult population.

Based on Paul David's (1991) observation about the change from electricity to steam, it may take another 20 to 30 years to build the new economy based on the "chips for neurons" revolution. If we understand the time frame of the change we are in and the importance of maintaining stable social environments as we build the new economy, and develop suitable social policies, we may build a prosperous state for the future.

At present, our institutional structures, policies and incentives to invest in the new economy are weak, while the incentives to speculate in global financial markets are high. Unless we can set up policies and incentives to make it a high priority to invest our savings in the new economy, we will have difficulty sustaining our prosperity and could suffer the same decline as the U.K. during this century, with corresponding negative effects on social policy and the social environment. Social policies will be very dependent on the health of the new economy. If we cannot build the new economy quickly, our social environment will decline and we may not be able to maintain suitable social policies to help sustain civic societies. An unstable, un-civic society will severely handicap our capacity to build the new economy.

Since the new economy is dependent on a high quality pool of human ingenuity, there has to be investment in and mobilization of resources that ensure a high quality social environment for early childhood, that take into account the revolution in family structures and the effects of economic forces on these structures. There is a growing body of evidence that the quality of social environments is influenced by the understanding and commitment of individuals in communities (Putnam, 1993; McKnight, 1995). Individuals and groups in communities can organize themselves to provide resources, financial and otherwise, that support all stages of life where there are needs. It is argued that civic societies tend to have horizontal groups of individuals that cut across the vertical structures of society and narrow self-interest groups. It is these horizontal groupings that bring together individuals from diverse backgrounds for better understanding and cooperation in responding to the challenges facing the community. These communities appear to be better able to compromise and support their systems of local governance.

If these strategies are part of the mechanisms for helping societies adjust to the changes then they have implications for the social policies of central government. Government support for communities should be allocated in a manner that strengthens the horizontal networks that help sustain civic communities. Governments should resist changes in programs that will undermine the civic quality of our societies because of pressure from groups with short- term financial interests. Changes in social support for communities should be tested against how they will influence the civic quality of communities. It is important to remember that a society that allows its social environments to deteriorate with negative effects on early childhood will ultimately pay a high price. If we degrade a large part of the next generation and create a large underclass, we will have to use an increasing part of our limited resources for security from and containment of the underclass. Individuals that have no sense of belonging or commitment to a society will have little reason to value laws in a society and support political freedom and democracy.

A society, to cope with the changes we are going through, should integrate its economic and social policies -- taking into account what we now know about the effects of deep and broad technological change, the determinants of health and the determinants of human development, and use measures that let us know how well we are coping with the changes. There are a few things that can be done now:

· Design and use a real measure of economic growth. GNP is misleading and inappropriate for the period we are now in.
· Put in place policies that create incentives to build the new economy.
· Develop and use measures that combine estimates of economic growth and changes in social environments. A new socio-economic index is needed that measures our prosperity and the civic quality of our society. Manitoba has established a data system that allows it to monitor the health status of the population by communities against socio-economic factors (American Health Association, 1995). Why not apply this across the country?
· Make children the highest socio-economic priority and put in place measures of what is happening to children.
· Take steps to avoid creating an underclass.
· Ensure government programs help sustain civic communities -- remember communities vary and there is no single-best solution.
· Ensure government programs do not create barriers to communities integrating the use of scarce resources.
· Set up a program to help communities define their problems and programs to help them identify the resources that they have to try and solve their problems.
· Use the new Information Highway to make it possible for communities to talk to each other. They can learn from each other what works and does not work. They also create or reinforce a basic need of Canadians in respect to their concerns about the quality of their communities.

Intelligent communities will be those that understand the issues that have been discussed and can come together to address them. Societies that engage in chaotic individualism and do not come together to define their problems in order to meet the challenges will probably not make it in terms of being prosperous and civic with political liberty for all citizens. Societies that express the needs of individuals in a social context, will probably do a better job (civic communities). The attitudes and values necessary for civic communities will largely be driven by forces at the local or regional level of our country and, thus effective governance will be strongly local during the present period of change. There are some who see that present technological revolution leading to smaller units of government.

Because of the effects of globalization, there will be a need for larger forms of governance to deal with international issues that influence local development. The geopolitical characteristics of the future will be strongly influenced by how effective our existing governing structures cope with the changes and establish an appropriate balance between local government and the higher levels of government which will obviously include stronger international institutions. Maintaining an appropriate balance will be difficult and complex given the economic forces unleashed by the "chips for neurons" revolution, the pressures on social environments, the diverse cultures in the world, the different values in different regions and the varying rates of population growth. There is already in place an Anglo-Saxon form of capitalism and social structure, a Western European (excluding the United Kingdom) form of capitalism and social structure and an emerging Asian form. Regions that evolve forms of capitalism that are sensitive to their social con- test may be the most stable democratic societies in the future. Some, however, have framed the choice in the following manner -- economic growth and political freedom without social cohesion versus economic growth and social cohesion without political freedom (Dahrendorf, 1995). As was pointed out at the beginning of this paper, the outcome is uncertain and social policies in regions will have to adapt to the economic forces and globalization.

There are, based on the knowledge we now have, some steps societies can take to achieve economic growth, social cohesion and political freedom during this change.

Improve our understanding and integration of the knowledge about economic growth, health and human development with emphasis on the present technological revolution and its effects on the determinants of economic growth (this is different from business cycles) and social institutions. Create incentives and institutions that will help us build the new economy. This will require a fundamental change in many policies including our tax policies.

In order to maintain quality social environments, develop policies and strategies to help communities sustain, with diminished resources, stable equitable civic societies during this change. (Privatization of health care and curtailment of public education are examples of actions that would weaken the civic strength of communities.)

· Monitor how effectively we are supporting young children during this socio-economic change and take steps to reverse negative trends.

· Ensure that the development and application of the new technologies (e.g., The information Highway) augment the social structures needed by humans to survive and do not lead to chaotic individualism and poor social environments which will ultimately have a negative effect on economic growth and the health and well-being of our species.

· Ensure that we all appreciate that the change taking place will considerably alter institutional structures and lead to new concepts of work, family, social organization, territoriality, income distribution and govenance. Ensure that people have things to do in society that are of meaning to them and their communities. This should be a primary goal of social policy.

I am optimistic that if we use what we know about the relationship among economic growth, social order, human development and health and well-being, intelligently during this period of major technological change we will be able to continue our experiment in civilizations and sustain prosperous, civic, democratic communities. This cannot be done if we continue to fail to integrate our knowledge about economics, health and human development. Integrating this knowledge is a difficult challenge. Government departments, programs, and our political institutions presently have substantial barriers to the integration of this knowledge and development of suitable policies.


X. SUMMARY

In the present period of major technological change, it is difficult to predict how social policy will evolve. The predictions can range from good to disastrous. The changes in our society, as in the past, will be created by those that control society. Fortunately, the revolution we are in, "chips for neurons" make it possible to work from a superb shared quality knowledge base and to communicate in new ways with all sectors of society. The knowledge and information base necessary to build the new economy and social institutions is potentially available to everyone. Those communities that can handle the opportunity within the complex value and cultural issues that affect all of this, will succeed. Societies that become captured by narrow self-interest groups, who distort and fragment the knowledge base, will have difficulty coping with the change and run the risk of degrading their social environment and will not be able to create effective social policies. These societies will be at risk of becoming regions with social disintegration and conflict. Unfortunately in periods of major technological and economic change, the governing system can be captured by narrow self-interest groups that can lead to inadequate social policies that enhance social disintegration. These societies could become controlled by authoritarian powers (in part, because of security needs) with many of its citizens living as second- or third-class members of the society. It will be very difficult to create policies for civic societies and social equity in these circumstances. Social policies that sustain and enhance the civic quality and civic equity will only be possible in societies that can build the new economy, evolve appropriate democratic governing structures, and avoid the capture of governments at all levels by narrow self-interest groups.

However, as Dahrendorf (1995) has stated, "Western societies face a precarious balance in adjusting to the new economic forces and sustaining civic democratic societies". There is no simple solution. Awareness of the issues and the relationship between economic growth and the social environment and the effects of the quality of social environments on human development and health will give intelligent communities a good chance of meeting the challenge in our continuing experiment with civilization. The key policy challenge for government is to integrate the new knowledge into a socio-econommc policy framework that promotes economic growth and sustains and enhances civic, democratic communities.


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Subject (s):Technology -- Social impact
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Date:11/01/1995
Author (s):J. Fraser MustardLanguage:English
Doc #: fn-pp-9
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