Summary
Background Human capital is recognised as the level of education and health in a population and is considered an
important determinant of economic growth. The World Bank has called for measurement and annual reporting of
human capital to track and motivate investments in health and education and enhance productivity. We aim to provide
a new comprehensive measure of human capital across countries globally.
Methods We generated a period measure of expected human capital, defined for each birth cohort as the expected
years lived from age 20 to 64 years and adjusted for educational attainment, learning or education quality, and
functional health status using rates specific to each time period, age, and sex for 195 countries from 1990 to 2016. We
estimated educational attainment using 2522 censuses and household surveys; we based learning estimates on
1894 tests among school-aged children; and we based functional health status on the prevalence of seven health
conditions, which were taken from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016).
Mortality rates specific to location, age, and sex were also taken from GBD 2016.
Findings In 2016, Finland had the highest level of expected human capital of 28·4 health, education, and learningadjusted
expected years lived between age 20 and 64 years (95% uncertainty interval 27·5–29·2); Niger had the lowest
expected human capital of less than 1·6 years (0·98–2·6). In 2016, 44 countries had already achieved more than
20 years of expected human capital; 68 countries had expected human capital of less than 10 years. Of 195 countries,
the ten most populous countries in 2016 for expected human capital were ranked: China at 44, India at 158, USA at
27, Indonesia at 131, Brazil at 71, Pakistan at 164, Nigeria at 171, Bangladesh at 161, Russia at 49, and Mexico at 104.
Assessment of change in expected human capital from 1990 to 2016 shows marked variation from less than 2 years of
progress in 18 countries to more than 5 years of progress in 35 countries. Larger improvements in expected human
capital appear to be associated with faster economic growth. The top quartile of countries in terms of absolute change
in human capital from 1990 to 2016 had a median annualised growth in gross domestic product of 2·60%
(IQR 1·85–3·69) compared with 1·45% (0·18–2·19) for countries in the bottom quartile.
Interpretation Countries vary widely in the rate of human capital formation. Monitoring the production of human
capital can facilitate a mechanism to hold governments and donors accountable for investments in health and
education.
Stephen S Lim, Rachel L Updike, Alexander S Kaldjian, Ryan M Barber, Krycia Cowling, Hunter York, Joseph Friedman, R Xu, Joanna L Whisnant,
Heather J Taylor, Andrew T Leever, Yesenia Roman, Miranda F Bryant, Joseph Dieleman, Emmanuela Gakidou, Christopher J L Murray
Funding Institute for Health Metrics and Evaluation.
Lancet 2018; 392: 1217–34
Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0
license.
