households of the basket of goods and services needed for a healthy life or just
the opportunity to acquire them regardless of whether individuals actually
exercise that choice? Frequently people make choices to consume foodstuffs
high in saturated fats and sugar or alcohol and so even with enough dispos-
able income to purchase sufficient healthy and nutritious food, people do not
fulfil their basic needs. Are then people exercising genuine choices or acting
out of ignorance? We may tend towards ‘choice’ in the case of adults making a
decision for themselves but perhaps not so in the case of a girl-child who is
being deprived of nutrition and health care by a household who prefer to ensure
the survival of her brother. What about the rational adult who is suffering
malnutrition because he is ‘choosing’ to be an alcoholic or is heavily influ-
enced by advertising, so consuming Coca-Cola rather than more nutritious food
and drink? The ‘basic’ of basic needs may ensure a person survives but with a
miserable and austere sense of existence. What about luxuries and pleasures?
There is no indication of how or whether progress continues once basic needs
have been fulfilled. Should basic needs include non-material aspects such as
free speech, equality before the law and participation in democratic elections?
Are basic needs universal or context specific? Differences in cultural norms
are likely to imply the latter, for example the possession of chopsticks may be
considered a basic need in China but not so in other countries where food is
eaten by hand. If basic needs differ between countries/cultures, any sort of
comparative work becomes much more difficult. Basic needs may also change
over time with rising incomes, urbanization and industrialization. Literacy
may not be necessary in a traditional rural economy but becomes increasingly
essential to work and interact socially in an urban industrial setting. A recent
initiative in the spirit of the basic needs approach are the Millennium
Development Goals (MDGs) discussed in Box 1.2.
A second ideal end-state is the achievement of universal adequate nutrition.
Nutrition is usually considered part of the basket of basic needs but is often
focused on as a distinct issue. There is also a fascinating and somewhat
perverse link between nutrition and economic growth.
Nutrition can be measured in terms of physical intake. Calorie availability
is computed by converting food quantities (purchases and consumption from
own production) into nutrient intakes, using special conversion tables. There
are problems with this method. First, it assumes no food is wasted. Second,
consumption and production surveys tend not to take into account meals that
are given to guests or employees. A more direct method to estimate nutrient
intake is to ask respondents to recall patterns of consumption over a defined
prior time period. The shorter the recall period the more atypical consumption
is likely to be, the longer the recall period the more problems there will be with
errors in recall. Trying to relate nutritional intake to need is also difficult and
has to consider the demands placed on nutrition through illness, pregnancy and
labour. Dysentery, for example, can quickly counteract the effect of a diet with
otherwise ample nutrition. A more accurate but time-consuming and expensive
method is through anthropometric measurements, that is, measuring people’s
Thinking about Growth 33