Transcript Variations in Health - George Washington High School

Variations in and Measurements
of Health
IB Geography II
Objectives
• By the end of these guided notes, students
will be able to:
– Understand and calculate the different ways of
measuring the health of a population.
– Evaluate the strengths and limitations of
indicators used to measure health.
– Describe variations in health as reflected by
changes in life expectancy national and global
scales since 1950.
– Explain patterns and trends in terms of
differences in income and lifestyle.
What is health?
The World Health Organization defines
health as ‘a state of complete physical,
mental and social well-being’.
Morbidity – The level of sickness, numbers of people
who are sick, prevalence of disease.
Mortality – The level of deaths, numbers of people
dying due to sickness.
Variations in Health: Key Indicators
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Infant Mortality Rate
Child Mortality Rate
Life Expectancy
Calorie Intake
Access to Safe Water
Access to Health Services
Health-Adjusted Life Expectancy (HALE)
Infant Mortality Rate
Total # of deaths of children < 1 year old
________________________________
Total # of Live Births
per 1000
Infant Mortality Rate
• Ranges: 2 per 1,000 in Sweden to 178 per
1,000 in Angola
Child Mortality Rate
Total # of deaths of children and infants < 5 years old
________________________________ X 1000
Total # of Live Births
Infant Mortality Rate/Child
Mortality Rate
• Advantages
– IMR/CMR are good
measures of human
welfare because it
reflects household
income, nutrition,
maternal age and
education, housing
conditions, and
sanitation
• Disadvantages
– Not all data is collected,
some births go
undocumented, so deaths
would go undocumented
as well.
– If it is collected by a
household survey, national
birth and death
registration systems may
be unreliable, AIDS
epidemic, civil war and
migration lead to further
inaccuracy in Africa
Life Expectancy
• The average number of years that a person
can be expected to live if demographic
factors remain unchanged
• Ranges from 45-80 globally
• Males < Female
• Life expectancy globally has increased since
1950 due to greater food production, more
clean water, better living conditions, and
better health care.
Advantages of using Life
Expectancy
• Life expectancy can tell you a lot about a
population/country including:
• Pollution levels, conflict, occupation, shelter, food,
medical facilities, income, literacy… ALL IMPACT
LIFE EXPECTANCY!!!
• You can compare some of these differences within a
population: Rich v poor, urban v rural, male v female,
ethnic groups, age groups.
Limitations to using Life Expectancy
• Considers only length of life, not number of
years spent living in poor health
• YLDs (years lived with a disability)
• DALYs (disability adjusted life expectancy): the
sum of years of potential life lost due to
premature mortality and the years of
productive life lost due to disability
• It is just an average, there can be
regional/urban-rural variations
Calorie Intake
• WHO outlines that the
recommended calorie
intake is:
– Men: 2500 per day
– Women: 2000 per day
• Afghanistan: 1,500 per
day per person
• USA: 3,774 per day per
person
Advantages of Calorie Intake
• Can tell you a lot about the food system in a
given country, and it can be linked to other
health indicators and social indicators like
income.
Limitations to Calorie Intake
• Does not take nutrient consumption into
account
– Example: eating 1,000 calories worth of apples is
very different from eating 1,000 calories worth of
chips
• It is not linked to calorie requirement
– Example: Construction worker who works 12
hours a day in the heat and cold doing manual
labor will need more calories than an accountant
who sits at his desk for 8 hours a day
Chronic v. Acute Food Shortage
Chronic
• Acute
Occurring over a long
period of time
Occurring over a short
period of time
Access to Safe Water
• Access to water that is affordable, in sufficient
quantity and available without excessive effort and
time
• Directly related to poverty
• Often caused by governments failing in the ability to
finance sanitation and water systems
• In 2008, 2.6 billion people had no access to a toilet,
and 1.1 billion were defecating in the open
• Inadequate sewage and water systems spread
infections like cholera and viral hepatitis
Access to Safe Water
• Advantages
• Directly related to poverty- can
tell you a lot about the income of
a person, or economic state of
the country.
• It is also directly related to the
ability of governments to finance
satisfactory sanitation systems.
• It can also be linked to health
because poor access to safe
water can be linked to the spread
of infectious disease like cholera,
diarrhea disease, etc.
• Disadvantages
– Doesn’t account for
differences in rural to
urban or regional
variations.
– It’s an average, so
people with higher
incomes most likely have
better access.
Access to Health Services
• Usually
measured in
the number of
people per
doctor, health
worker or
hospital per
every 10,000 in
the population
Country
Switzerland Brazil
Ethiopia
Physicians
per 10,000
40
17
.5
Hospital
Beds per
10,000
Health
Expenditure
$ per capita
55
24
2
4,417
674
26
Access to Health Services
• Advantages
– Can show you how much
money is being spent per
individual by giving data
on health beds,
medication, physicians
per person in the
population.
• Disadvantages
– Doesn’t account for
differences in rural to
urban or regional
variations.
– It’s an average, so
people with higher
incomes most likely have
better access.
Health Adjusted Life Expectancy
(HALE)
• Combines measures of both age and sex
specific health data and mortality data into a
single statistic
• HALE indicates the number of expected years
of life equivalent to years lived in full health,
based on the average experience in a
population
• Not just quantity of life, but quality of life
Calculating HALE
• The WHO uses life expectancy + Sullivan’s
Method to compute the HALE for countries
• Sullivan’s Method: the number of remaining
years, at a particular age, which an individual
can expect to live in a healthy state
• Method includes weight assigned to each type
of disability, depending on severity
Limitations to HALE
• Major challenge due to lack of reliable data
on mortality and morbidity, especially from
low income countries
• There’s also a lack of comparability of selfreported data from health interviews.
Comparing Life Expectancy/HALE
Region
Life Expectancy
HALE
Europe
76
70
North America
78
69
Oceania
76
68
Sub-Saharan Africa
52
41
Epidemiology – The study of the factors affecting
the health, morbidity and mortality of populations.
Closely linked to Geography as the factors will
vary spatially and will be place specific.
The Epidemiological Transition Model
(Health Transition)
• As health improves, morbidity and mortality fall thus
life expectancy increases.
• This is called epidemiological (health) transition
(Omran 1971).
– This model focuses on both health and morbidity.
– Changes will be apparent through modernization.
– Changes will appear at different times depending on each
country and its developmental processes.
Epidemiological Transition Model
LEDC ____________________________________ MEDC
Infectious diseases ____________ Degenerative diseases
Diseases of Poverty ____________ Diseases of Affluence
Aids, Cholera, Tuberculosis,
Diarrhea, Malaria, Typhoid,
Yellow fever, measles, Polio,
Perinatal deaths (in first week
of life).
Cancer, Heart and
circulatory disease,
Obesity, Type two
diabetes, Alzheimer's
disease.
Demographic Transition Model v.
Epidemiological Transition Model
• Similarities
– Both deal with how countries develop over time.
• Differences
– epidemiological transition model focuses more on
the reasons for development through health and
not solely on births and deaths.
Similarities and Differences
Epidemiological Transition
Model (Health model)
Demographic Transition Model
Disease Categories
Endogenetic (from inside)
Congenital diseases from birth and degenerative
diseases resulting from old age.
Exogenetic (from outside)
Environmental conditions, social habits and
hazards.
Exogenetic Factors LEDCS and
MEDCS compared
LEDC
•Nutrition (being underweight)
•The environment (unsafe water, sanitation and hygiene)
•Poor living standards
•Social norms and disease such as HIV/AIDS (unsafe sex).
MEDC
•Lifestyle causing high blood pressure (stress)
•Physical inactivity (heart disease, diabetes)
•Leisure activities (tobacco, alcohol, and drugs)
•Nutrition (being overweight, high cholesterol levels, low fruit
and vegetable intake).
Global Variations in Health
and Income 1950
Global Variations in
Health and Income 1980
Global Variations in
Health and Income 2009