Global Health (AQA A Level Geography)

Spatial variations in patterns of health exist and these patterns change over time

Various measures of health are used

Mortality rates can be measured in different ways

• In less developed countries this is due to poor socio-economic resources leading to lower life expectancy

• In developed countries this is due to higher life expectancies leading to ageing populations

• Infant mortality, case mortality and attack rate tend to be higher in developing countries with the highest rates generally in sub-Saharan Africa

• High crude death rates exist in all regions of the world

World Health Organisation (WHO) uses healthy life expectancy (HALE), which refers to how long a person can be expected to live in good health without significant disease or injury

• 2000 average for Africa was 45.8 years

• 2019 figures for HALE at birth show a global average of 63.7 years with Western Oceania (68.6) and Europe (68.3) having the highest regional average, and Africa (56.0) the lowest

• HALE is increasing in every region of the world

Morbidity patterns vary according to two different types of illness: 

• Non-communicable disease is often more prevalent in HICs due to higher proportions of elderly population. 

• Older people are more likely to suffer from some cancers and heart conditions

• Increasing affluence can lead to unhealthy lifestyles and sugary diets which can lead to a higher risk of developing cancer, diabetes and heart disease

• Non-communicable diseases - medical conditions that are not infectious such as asthma, cancer and heart disease

• Communicable diseases - infectious conditions that can be passed from person-to-person such as malaria, HIV/AIDS and coronavirus

LICs are more likely to see higher rates of communicable disease due to poor quality of water supply, less education around healthy lifestyles, poor quality of sanitation and health care

High rates of morbidity do not always translate into high rates of mortality

• Depends on level and quality of healthcare and medicines

• In Africa 79 out of 100,000 got some form of cancer in 2012. In North America the figure was 510 out of 100,000

• But 55 out of 100,000 died from cancer in Africa, a 70% incidence to death rate In North America 197 died, a 39% incidence to death rate

The Epidemiological Transition model (proposed in 1971 by the Egyptian American epidemiologist Abdel Omran) describes how mortality rates in places change over time

There are close links between this model and the Demographic Transition Model 

Due to economic and social developments the main causes of death in countries shift from infectious diseases to degenerative, non-communicable illnesses

Economic developments over time that impact on health include 

• Investment in food production technology to increase supply of food and quality of diet

• Investment in transport infrastructure to allow more widespread distribution of food and medicine

• Improved sewage and drainage infrastructure in urban areas

• More trade of goods and services allowing importing of more varied food supplies in exchange

Social developments over time that impact on health include

• Increasing supply of clean water

• Sanitation provision improved

• Education about diet, sanitation and disease prevention improved, especially amongst women

• New medicines and vaccines discovered and more people have access to healthcare

• Improved training of medical staff

Stage 1

• High number of deaths from infectious disease; low life expectancy

Stage 2

• Improved socio-economic conditions lead to falling number of deaths from infectious disease and increasing life expectancy

Stage 3

• Non-communicable illness starts to affect more people as they are living longer and increasing affluence leads to less healthy lifestyles

Stage 4

• Better treatment leads to delay and prevention of non-communicable disease despite higher life expectancies

Stage 5

• Re-emergence of infectious diseases as globalisation allows disease to spread more easily and bacterias develop resistance to antibiotics. It is argued this is what happened with the Covid-19 Pandemic