Pushing beyond GDP in Development: Birth Outcomes in São Paulo, Brazil

Discussions of development have increasingly paid attention to standards of living. The United Nations, for example, uses years schooling and life expectancy alongside gross domestic product per capita to create a human development index. Connecting those metrics to daily life experiences, however, still requires considerable imagination. Latin American historians face an additional hurdle: consistent and reliable measures related to health and education can be fleeting, particularly for the years prior to the founding of the United Nation’s Economic Commission for Latin America (ECLA/CEPAL) in 1949. This paper contributes to development debates in two ways. First, it explores alternative data sources to fill in the historical gaps. Second, it uses a capabilities approach to deepen our understanding of development and the constraints preventing individuals from improving their standards of living. Data-wise, this paper utilizes records from the São Paulo maternity hospital to analyze a critical period in São Paulo’s history in the 1920s and 1930s. The rhetoric of “progress” and “modernity” saw considerable investment in public works projects at both the state and federal level, but access to health services was not equally available to all, particularly for newly arriving migrants from the interior and northeast. Neonatal birth outcomes (the first seven days post-partem) can provide insight into a mother’s life during the gestation period. The results demonstrate significant racial disparities among women of childbearing age. This more nuanced health metric can provide a localized understanding of the development experience during the early twentieth century.