The characteristics of low-, middle- and high-income countries and the classification of countries by income

What this dot point is asking

This dot point asks you to describe the characteristics that typically distinguish low-, middle- and high-income countries, and to use those characteristics to explain differences in health status and human development. The exam may give you a country or data set and ask you to identify its income classification and the features that go with it.

How countries are classified

The World Bank classifies countries into low-income, lower-middle-income, upper-middle-income and high-income groups based on gross national income per capita - roughly, the average income per person. The study commonly groups these as low-, middle- and high-income countries. Income classification is useful because it correlates strongly with health and human development, though it is not a perfect predictor.

Characteristics of low-income countries

Low-income countries typically show:

• Low average incomes and high rates of extreme poverty.
• Weak or under-resourced health and education systems, with few doctors and hospitals.
• Poor access to safe water, sanitation and reliable electricity.
• High infant, child and maternal mortality and high burden from infectious disease and undernutrition.
• Lower life expectancy and lower HDI.
• A large proportion of people working in subsistence agriculture, often with limited industry.

Characteristics of middle-income countries

Middle-income countries are diverse and sit between the two extremes. They typically show:

• Growing economies with expanding industry and services.
• Improving but still uneven access to healthcare and education.
• A double burden of disease - persisting infectious disease and undernutrition alongside rising chronic disease from changing diets and lifestyles.
• Moderate life expectancy and HDI, with significant inequality between urban and rural areas.

Characteristics of high-income countries

High-income countries typically show:

• High average incomes and low rates of extreme poverty.
• Well-resourced, accessible health and education systems.
• Near-universal access to safe water, sanitation and electricity.
• Low infant and maternal mortality and high life expectancy.
• A burden of disease dominated by chronic and lifestyle conditions such as cardiovascular disease, cancer and mental ill health.
• High HDI and developed infrastructure and industry.

Linking income to health and human development

Higher income at the country level usually means more government revenue for health, education, water and sanitation, which improves health status and human development. But income is not destiny - some middle-income countries achieve strong health outcomes through good policy, while inequality within a country means national averages can hide poor conditions for some groups.

In the exam, name the income group, list the characteristics that fit, and connect them to specific differences in health status indicators such as life expectancy, under-five mortality and burden of disease.