Making Health Work

Carl Mosk shows how population quality-specifically, the population quality of schoolchildren in Japan, as measured with extensive figures on height, weight, chest girth, and body weight index-provides a key to understanding eco- nomic growth and social change in that greatly changed and expanded society. Japan, perhaps more than any other country in the twentieth century, exemplifies the capacity to industrialize rapidly and raise income levels despite severe natural resource constraints.
The quality of a population determines its capability and work capacity, physically and mentally, and is determined by the net nutritional intake. Not surprisingly, Mosk's figures show that the net nutritional intake (gross intake less the nutrients burned in fueling physical work effort and combating disease) increased in Japan during the period 1900-1985. He finds, however, that gross food intake played a minor role. The main reasons for the increase in net nutrition are a decline in the rate of physical work extracted from children and greater medical and public health efficacy in fighting infection.
Mosk demonstrates the crucial importance of social and political factors in the distribution of population quality across social and economic levels. The question of entitlements to food and to public health and medical services is central because, Mosk says, during the pre-industrial period entitlements were politically balkanized and strongly market oriented, and this legacy of balkanization slowed the development of new institutions governing entitlements, which might be suitable to an era of industrialization. Changes came about through the voicing of demand for entitlements through markets and through political and social protest movements.
Making Health Work offers a rigorous, eclectic approach to the investigation of Japan's increasing population quality, which is clearly reflected in the increasing size