CHAPTER ONE

GENERAL INTRODUCTION

1.1 Background to the Study

   Life expectancy is a key summary measure of the health and wellbeing of a population (WHO, 2020). A nation’s life expectancy reflects its social and economic conditions and the quality of its public health and healthcare infrastructure, among other factors. Monumental improvements in life expectancy have been the predominant trend for high-income, developed countries over the course of the 20th and 21st centuries (WHO, 2020). Stagnation or declines in life expectancy may signal a decline in the health profile of the population driven by adverse socioeconomic trends, a deterioration in the provision or quality of healthcare services or worsening behavioral factors. For more than two decades, increasing life expectancy and reducing health disparities among Americans have been the two most important health policy goals for the United States (NASEM, 2017). Recent trends in the United States suggest that it has experienced a break from the trajectory of continued gains in life expectancy. In December 2017, the US National Center for Health Statistics reported that the country experienced a decline in life expectancy for two consecutive years. Between 2014 and 2016, overall life expectancy in the USA declined by 0.3 years.

This decline was most pronounced among men, who experienced a decline of 0.2 years in each of the two consecutive years. American women experienced a decline of 0.2 years during 2014-15 and no appreciable change in life expectancy during 2015-16 (NASEM, 2017). The USA now has the lowest life expectancy levels among high-income developed countries, and Americans fare poorly across a broad set of ages, health conditions, and causes of death compared with their counterparts in these countries. Despite being a top spender on health care, the United States is an outlier among its peers on life expectancy. U.S. life expectancy was slightly above the global average of seventy-three years in 2020. Still, many countries that are poorer than the United States have higher life expectancies (NASEM, 2017).

  Education is important not only for higher-paying jobs and economic productivity, but also for saving lives. More education leads to higher earnings that can provide access to healthy food, safer homes, and better health care. Now, more than ever, people with less education face a serious health disadvantage. Americans with less education are—now, more than ever—dying earlier than their peers. Between 1990 and 2008, the life expectancy gap between the most and least educated Americans grew from 13 to 14 years among males and from 8 to 10 years among females (Cutler & Lleras-Muney, 2010). The gap has been widening since the 1960s. Americans with less education are—now, more than ever—more likely to have major diseases, such as heart disease and diabetes. Those with less education are increasingly more likely to have risk factors that predict disease, such as smoking and obesity. By 2011, smoking was reported by 27 percent of people without a high school diploma or GED but by only 8 percent of those with a Bachelor’s degree.

Between 1974 and 2010, smoking rates among adults with a Bachelor’s degree—which were already much lower than for those with less education—decreased proportionately by 69%, whereas smoking among adults without a high school diploma decreased by only 38% (Cutler & Lleras-Muney, 2010). The USA may not be alone in experiencing declines in life expectancy—a recent study documented an increase in the age standardized death rate in England and Wales during 2014-15 (Ho & Preston, 2019). Research has shown that higher unemployment rates are consistently associated with lower life expectancies (Bartley, 1994). In Europe, educational differences in life expectancy have widened in some countries like Russia and Estonia, while improving in others like Finland and the Czech Republic (Mackenbach et al., 2016).

Many of the world’s wealthiest countries have life expectancies surpassing 80 years. In 2019, Spain, Switzerland, Italy, and Australia had life expectancies exceeding 83 years, with Japan leading the rankings at nearly 85 years. Conversely, countries with the poorest health indicators exhibit life expectancies ranging from 50 to 60 years. For instance, the Central African Republic recorded the lowest life expectancy in 2019 at 53 years (World Bank, 2021). Over the past two centuries, remarkable progress has been achieved in global health, resulting in increased life expectancy in all countries. The United Kingdom’s life expectancy has doubled, exceeding 80 years, while Japan rapidly caught up and surpassed the UK in the late 1960s. South Korea, starting its health improvement journey later, achieved even faster progress and now exceeds the UK’s life expectancy (National Research Council, 2011).

In South Korea, increased GNI had a positive impact on life expectancy. The association between life expectancy and education was significant in Sweden, Finland, Denmark, Norway, and other European countries. Similar relationships can also be seen in Brazil (Li et al., 2019). Recent research in Thailand concludes that older people who have higher educational qualifications and better income have greater health satisfaction and better health outcomes (Ngamaba et al., 2017). The inconsistency and equality of life expectancy have serious effects on individual and aggregate human behavior because they affect human capital investment, economic growth, fertility behavior, incentives for pension benefit claims, and intergenerational transfers. COVID-19 has caused an inordinate number of deaths around the world so far, causing life expectancies to plunge. Historically, countries have recovered from other so-called “mortality shocks,” such as the 1918 flu and two world wars, within one to two years. But the shock of the pandemic is enduring in many places (Kontis et al., 2021).

 A study published Oct. 17 in Nature Human Behavior reviewed life-expectancy trends in 29 countries during 2021, building on previous data the scientists had analyzed from 2020, and found that COVID-19 continued to account for most life-expectancy losses in 2021 (Kontis et al., 2021). But those life-expectancy losses from the pandemic are dissipating in some countries with relatively high rates of vaccination and infection-derived immunity, which both contribute to lower COVID-19 deaths. Four countries in western Europe—Belgium, France, Switzerland, and Sweden—have fully restored their population’s life expectancy back to pre-pandemic levels, and four others have nearly done so, while other countries did not experience additional losses in 2020 compared to 2021. But the U.S. and 11 countries, including many in eastern Europe, continue to record excess mortality (Kontis et al., 2021). Despite the high economic growth in Europe and the USA, we still see low levels of life expectancy.

When we take a look at African countries which generally have low economic growth, the situation is worse. Life expectancy has increased in the majority of African countries for the period 1980-2014, with an average increase slightly higher than that of the world average for that period (Kandala et al., 2017). Life expectancy during the 1960s was low but slowly increased during the period of 1960-1980 in many Sub-Saharan countries. In 2014, the life expectancy was 59 years in Sub-Saharan Africa and 71 as the world average. Northern Africa has experienced a very positive evolution reaching the world average in the year 2014. Many African countries have experienced an important increase in life expectancy in the period 1980-2014, but in many of them, the levels are yet very low, in comparison with the world average (Kandala et al., 2017). According to Guisan & Exposito (2015), the educational level of the population and the level of economic development generally have a positive impact on life expectancy, but in some cases, there are country features that have additional positive or negative effects.

  Regarding African countries with low life expectancy, we find that many causes of death have adjusted rates similar to more developed countries, but there are 8 causes with much higher rates in many Sub-Saharan countries in comparison with other areas. Some outstanding differences in adjusted rates correspond to HIV/AIDS with 160 annual deaths, Influenza and Pneumonia with 144, and Diarrheal diseases with 67 (Guisan & Exposito, 2015). According to the World Bank, Africa has the highest youth unemployment rate globally, with approximately 30% of young people unemployed (World Bank, 2021). Moreover, the education sector in Africa faces several challenges, such as inadequate infrastructure, insufficient funding, low-quality education, and inadequate teacher training, among others.

The access to quality education remains a significant challenge in Africa, particularly in sub-Saharan Africa. UNESCO reports that approximately 64 million children of primary school age in Africa are not enrolled in school, and the dropout rate among those enrolled is high (UNESCO, 2021). Moreover, there is a shortage of qualified teachers, and many schools lack adequate infrastructure, such as classrooms, libraries, and laboratories. In Africa, life expectancy rates are low, with some countries recording rates as low as 40 years. According to the World Bank, Africa has the highest maternal mortality rate globally, with approximately 532 deaths per 100,000 live births (World Bank, 2021). The low life expectancy in Africa is a significant challenge that affects economic growth and development. Furthermore, unemployment leads to low income and poverty, which, in turn, affects access to healthcare and education, leading to low life expectancy rates.

In Cameroon, the education sector is also a major challenge. The country faces several challenges, such as inadequate infrastructure, insufficient funding, low-quality education, and inadequate teacher training, among others. According to UNESCO, approximately 3.3 million children in Cameroon are out of school, and the dropout rate among those enrolled is high (UNESCO, 2021). Moreover, there is a shortage of qualified teachers, and many schools lack adequate infrastructure, such as classrooms, libraries, and laboratories.  One of the consequences of unemployment and low education levels is low life expectancy. According to the World Bank, Cameroon has a high maternal mortality rate, with approximately 596 deaths per 100,000 live births (World Bank, 2021).  The estimated life expectancy at birth in Cameroon is around 61 years for both males and females. Life expectancy in Cameroon has experienced gradual improvement over the past few decades.

From 1990 to 2020, there has been an increase of approximately 9 years in overall life expectancy. This positive trend reflects advancements in healthcare, disease prevention, and socioeconomic development. There are regional disparities in life expectancy within Cameroon. Generally, urban areas tend to have higher life expectancies compared to rural areas. Urban centers usually have better access to healthcare facilities, infrastructure, and social services, which can positively impact health outcomes. Cameroon faces several health challenges that can impact life expectancy. These include infectious diseases such as malaria, HIV/AIDS, respiratory infections, and diarrheal diseases. Maternal and child mortality rates also contribute to lower life expectancy. Addressing these health challenges is crucial for further improvements in life expectancy.

1.2 Statement of the Problem

   The unemployment rate in Cameroon has been persistently high, with a rate of 4.3% in 2019 and it has been on the rise since 2017, where it was at 3.6% (WDI 2021). Despite the government’s efforts to promote education, access to education in Cameroon remains limited, particularly in rural areas. According to the Jahoda Latent Deprivation Model of unemployment and mental well-being, unemployment can lead to a sense of deprivation, affecting individuals’ mental well-being and self-esteem (Jahoda, 1981). The theory suggests that prolonged exposure to stress and mental health challenges is associated with an increased risk of developing chronic conditions, such as cardiovascular diseases, immune disorders, and metabolic disorders, which in turn can impact life expectancy.

In Cameroon, life expectancy has been increasing over the years but remains relatively low compared to other developing countries. According to the World Bank, life expectancy in Cameroon was 60.4 years in 2019, up from 58.4 years in 2015. There is large congestion in schools in the unaffected area making the process of acquiring quality education very difficult. All these have bearing effect on life expectancy. According to the Human Capital theory, education and training have a positive effect on individual productivity and earnings, leading to better health outcomes (Becker, 1962). It suggests that investing in education improves an individual’s human capital, including their knowledge, skills, and abilities, which in turn can result in higher earnings and improved access to healthcare.

The problem statement of this research topic is to investigate the effect of education and unemployment on life expectancy in Cameroon. Cameroon’s high unemployment rates and limited access to education could have adverse effects on the health and wellbeing of the population. This study is therefore tailored to answer the following research questions.

1.3 Research Questions

1.3.1 Main Research Question

What is the effect of education and unemployment on life expectancy in Cameroon?

1.3.2 Specific Research Questions

1.What is the effect of education on life expectancy in Cameroon?

2.What is the effect of unemployment on life expectancy in Cameroon?

1.4 Objectives of the Study

1.4.1 Main Objective

To investigate the effect education and unemployment on life expectancy in Cameroon

1.4.2 Specific Objectives

1. To analyse the effect of education on life expectancy in Cameroon
2. To analyse the effect of unemployment on life expectancy in Cameroon