The Kerala Paradox

Today we're going to talk about Kerala,

a state in the southwest of India

By the way here's a picture of a boat trip
in Kerala, a lot of tourists do this.

If you'd like to see where Kerala is on
the map it's right down here,

the light green state.

The so called Kerala paradox is that
Kerala has been a relatively poor state

of India, but it has social indicators
which in some important regards are well

in advance of much of the rest of India.

Some of the social indicators are really
quite good, even compared to

parts of the developed world.

Just to give a few examples, literacy in
Kerala is measured at about 92%, compared

to about 52% for the rest of India, and
of course that's a large gap.

If we look at infant mortality it's about
17 out of 1000 in Kerala, and in the rest

of India it's a much higher 85 out of 1000

Life expectancy for males in Kerala, it's
about 68, and the rest of India it

averages about 63.

It's an even larger gap for females, where
in Kerala it's 74, and the rest of India

it's about 64, a full 10 years less.

Finally, rates of fertility in Kerala are
much lower, measured per woman we have

here about 20 per 1000, compared to the
average for the rest of India being about

31 per 1000.

What are the causes of this, well it's
going to turn out to be a complex story,

but right off the bat one cause is that
social development expenditures in Kerala

are higher in general then in the
rest of India.

For instance in Kerala those expenditures
are about 1/3 higher than a simple model

of per capita income would predict.

It also seems to be the case that people
actually expect reasonable quality of

social services from their government.

Still we shouldn't focus on just public
sector expenditures

For instance in urban parts of Kerala,
about 64% of healthcare expenditures

are private, and in rural parts of Kerala
about 60% of healthcare expenditures

are private.

It's also interesting to look at the ratio
of private to public spending on

healthcare in Kerala.

In Kerala that ratio is about 9x, that is
much more private spending,

for the rest of India that ratio is about
4x, so Kerala is showing an especially

high preponderance of private spending on
healthcare.

This is an estimate taken from a paper by
Arvent Pannecheria.

Another interesting feature of Kerala is
just how many Keralans have migrated to

the gulf region to work, typically at
higher salaries, and often stayed there

for a while and then moved back home with
a fairly high stash of wealth.

In the earlier days of Indian independence
Kerala really was a less wealthy than

average Indian state, but in more recent
times it's actually become more wealthy

than average, in part due to these
remittances and due to labor moving if

only temporarily to the Persian Gulf.

Remittances from abroad account for about
20% of total income in Kerala,

and that's not always counted in the
statistics.

Kerala now actually on average is one of
the more prosperous states in India,

and it's even more prosperous if we
measure wealth by how much people

actually consume, rather than how much
they earn.

We find also in the data that asset
ownership is at about 2x typical Indian

levels, which is again a reflection of
Kerala becoming more prosperous.

So there is still a paradox in Kerala
having to do with the level of social indicators

compared to the wealth, but this older
notion that Kerala even for India is

especially poor hasn't been true for a
while.

If we look at geography and look back at
history we find some features of Kerala

that probably contribute to it's superior
social indicators.

For instance in Kerala there's generally
lots of rainfall, this means that the

harvest is less vulnerable, and it
to economic and social stability.

It's also the case that the populations of
Kerala tend to be quite accessible, this

is because so frequently there is water
everywhere, whether it's the coast or it

is inland waterways, so the notion of
there being people stuck in some distant

interior, which is hard to reach with
healthcare or social services,

well that's less the case in Kerala than
in many other parts of India,

and in general there is so much of the
state on the coast, coastal location,

and there is so much water transport.

Kerala is not a state which has a lot of
major highways, but nonetheless it has an

extensive road system, and has for a while
and this makes it a more unified state,

knit together with close relations of
trade, and again the distribution of

social services tends to be much easier.

In general in Kerala the urban vs, rural
distinction is weaker than in many other

parts of India, so the notion of having
some very backward rural villages, which

are lacking far far behind major cities,
again that's less likely to be the case in

Kerala than in many other parts of India.

Kerala also has a history of linguistic
homogeneity, and significant parts of

Kerala have been a matrilineal society for
centuries, and that may contribute to the

superior record for social indicators when
it comes to caring for women.

Here's a picture of a tea plantation in
Kerala, you can see that it's quite lush,

and this is reflecting the notion that
rainfall is relatively plentiful in Kerala

compared to some other parts of India.

There's a lot of evidence that the
superior social indicators of Kerala are

rooted fairly far back in history.

For instance, if we look at since 1961 in
Kerala life expectancy has barely been

growing at an above average rate compared
to the rest of India, in other words the

superior performance of the state with
regards to life expectancy comes from

factors which were probably present before
1961.

Since 1961, literacy actually has been
growing at a lower rate than in the

rest of India, for Kerala about 45% and
the rest of India it's gone up about 79%.

This isn't saying that Kerala has done
anything wrong since 1961, they had a

higher literacy rate, that makes it harder
to grow, but again if we are looking to

explain that higher literacy rate we
probably should look at some features of

the state which pre-date 1961.

In general Kerala has had superior
literacy indicators from the time of

colonialism or perhaps even earlier.

Part of the paradox of Kerala is that when
it comes to some social indicators the

state appears to have a much worse
performance than many other parts of India

For instance if we look at alcoholism, or
consider rates of suicide, or rates of

joblessness, and also inequality of income
in all of these areas Kerala has subpar

performance.

It's very difficult to come up with a
unified theory that explains these areas,

where Kerala when it comes to other social
indicators simply isn't doing that well.

Just to close, here's another very nice
picture of Kerala, again this is a picture

of a boat trip.

To follow up on Kerala you can do some
simple googling, such as "Kerala social

indicators" and "Kerala paradox", but
here's some pieces which I found

especially useful in trying to make sense
of the history of Kerala.

Most of them are online, except for this 1
book "Social Development in Kerala",

but in any case these are just some
suggestions to get you started.

In any case, it still seems there is
really quite a bit about the Keralan

paradox which we still don't understand.