Over the long term the processes of rapid economic growth seem to be strongly correlated with improvements in the prosperity and health of a society. Hence derives the commonplace notion that economic growth results in development. This essay argues that contrary to this widely held opinion, economic growth entails critical challenges and threats to the health and welfare of the populations involved and does not, therefore, necessarily produce development.

Since the 1940s economic and demographic historians, social scientists, and policymakers have broadly accepted that each national trajectory of sustained economic growth has always been attended by a “demographic transition,” a process in which a pronounced fall in national mortality levels (and also fertility levels) occurs as a result of the gains to national wealth. In fact the idea of a demographic transition, both as a theory and as a general historical model, has been subjected both to fundamental conceptual criticism and to empirical refutation. Important counter-examples have been uncovered, such as historic France with its fertility decline occurring before either rapid economic growth or mortality decline, and contemporary states, such as Kerala, Costa Rica, Sri Lanka, and China, where mortality has declined in advance of rapid wealth creation. Although there has been significant dissent, a glib post-World War II consensus has remained largely unperturbed: that economic growth causes mortality decline, principally through an epidemiological transition—a decline of infectious and communicable diseases.