Zusammenfassung der Ressource
Geography of Mortality
- key mortality indicators
- Crude death rate
- Number of deaths per 1000
population in a given year
- limitations
- measure distorted by age structure variations
- Australia and Bolivia have similar crude
death rates ~7 but for different reasons
- AUS lowest 40 IMR (4.43) vs Bolivia
57th highest IMR (38.61)
- various other factors e.g. natural disaster
- variations
- by country
- Highest: South Africa (17.49), Ukraine
(15.72), Lesotho (14.91)
- Southern Africa region: HIV epidemic
- Ukraine: weak healthcare system
- non-communicable diseases
account for 82% of deaths
- a third of Ukrainians die prematurely before 65
- Lowest: Kuwait (2.16), UAE
(1.99), Qatar (1.53)
- Qatar
- world's richest country
- best and widely recognized
healthcare systems in the world
- by region
- Largest drop in Africa:
15/1000 to 11/1000 in 2013
- Important to note variations within region
- Algeria: 4.3/1000
- one of the best healthcare systems in Africa
- nationwide electronic healthcare project
- simplifies administrative procedures
and eliminates paperwork
- 0.1% of sexually active population with AIDS/HIV
- Swaziland (14/1000)
- highest HIV prevalence:
26% among sexually
active population
- reforms in health sector has majorly improved
the health status of ppn
- 90% Antiretroviral (ART) coverage
- IMR reduced from 100 to 79
per 1000 live births (2008-14)
- Maternal mortality rate
reduced
- severe tuberculosis infection
- TB/HIV co-infection rate 80%
- 1380 per 100,000 annually
- access to clean water and sanitation
- only 37% of rural population has
access to safe water
- access to healthcare
- (2009) 0.17 physician density
- life expectancy fell from
63 (1990) to 49
- advantages
- indicates level of healthcare
provision, water quality, sanitation
and living conditions
- standardised death rate
- indicates the CDR if population
had same age and sex composition
- useful for comparative studies
- Age-specific mortality rates
- Infant Mortality Ratio
- no. of infants who die within the first year of age per 1000 live births
- reflects level of healthcare
provision, sanitation, water quality, nutrition
and living conditions
- declining trend with improved medical and
health services and better nutrition
- Bolivia's IMR( 38.61)>halved since 1990s
- highest: Afghanistan (117), Mali (104), Somalia
(100), Niger (86)
- Afghanistan
- common causes: infections,
diarrhoea, and dehydration
- most births done at home
- education: 12.6%
female literacy rate -
lack of midwives
- lack of skilled medical personnel
- 0.19 physicians/1000
- lowest: Monaco (1.8), Japan (2.1), Singapore (2.53)
- Singapore
- (2012) 1st for IMR, 2nd for MMR, 9th for life expectancy
- universal health coverage at public hospitals and
government polyclinics
- Monaco: 7.06 physicians/1000
- Child Mortality Ratio
- no. of children who die
before age 5 per 1000
- Maternal Mortality Ratio
- annual no. of pregnancy-related deaths of
women per 100,000 live births
- highest in South Sudan (>2,000)
- early marriage
- most women in rural areas give birth at home
due to lack of knowledge or accessibility to
proper health facilities
- only one midwife per 125, 000 women
- brain drain of skilled midwives
- Life Expectancy at Birth
- average number of years a person is expected to live in his lifetime
- difficult to calculate as it is normally
derived from national life tables
- Highest: Monaco (89), Japan (84), Singapore(84), San Marino (83)
- Lowest: Chad (49), South Africa (49), Swaziland (50)
- Factors affecting Mortality
- Demographics
- mortality higher for infant/child and old population
- gender
- women higher life expectancy
- 82.8 vs 79 for men
- narrowing gap
- men higher risk of heart attack than women
- ageing population higher risk of death
from cardiovascular disease
- Medical Technology
- access to healthcare
- physician density Niger: 0.02, Monaco 7.06
- Niger: 29% of births attended by skilled
health personnel vs Czech Republic 100%
Anmerkungen:
- Czech republic IMR 2.63 lowest 10 in the world
Niger top 10 IMR (86)
- changes in health education
- improvements in medicine and treatment
- breakthroughs in cancer treatment
- cell research - how to block
movement of cancer cells
- Singapore A*STAR scientists discovered early detection
methods and personalized treatment for ovarian cancer
- discovery of drugs made from tree bark by
the Cancer Research Campaign (CRC)
- Public Health Measures
- Water andSanitation
- eliminate conditions favourable to
the spread of diseases
- e.g. cholera and typhoid most easily
controlled by purification of water ss
- Chad: only 6% of rural population and 31% of
urban population use improved sanitation
- dysentery can be controlled
with proper food hygiene
- unclean water and poor sanitation are
the world's second biggest killer of
children
- immunisation
- mid-1990 vaccines to provide 'basic' coverage for TB,
polio, tetanus, pertussis, and measles averted 2 million
deaths in 2002
- e.g. DTP-3 coverage
- e.g. significant progress of MEASLES coverage
- reduced measles mortality in Africa by 60% between 1999-2004
- polio cases decreased by 99% since 1988
- infant immunisation vital for
improving infant and child survival
- African region lagging behind
global immunisation coverage
- e.g. DTP-3 coverage
- coverage in Africa increased from 54% in 2000
to 74% in 2011
- e.g. DTP-3 coverage
- Smallpox
- endemic in Africa and Asia in 1960s
- Immunisation campaign by WHO
eradicated smallpox by 1980
- deadly disease that threatened 60% of the world's
population and killed every fourth victim
- Hepatitis B vaccine
- 1982
- 79% of infants in WHO's member states receive vaccination
- Socio-economic Changes
- inverse r/s between
socio-economic status
and mortality
- High death rates and low life
expectancies improving
- overall life expectancy in Africa increased
from 51 (1990) to 59 (2013)
- reversed trend for countries
affected with AIDS
Anmerkungen:
- Zimbabwe, Swaziland, Lesotho, South Africa, Botswana
- Rising living standards
- healthcare
- (environmental)sanitation
and hygiene
- nutrition
- resistance to disease
- influenza
- pneumonia
- diarrhoea
- TB
- education
- knowledge about
health and medical care
- changing pattern of diseases
characteristic of modernisation
- Pollution
- Political
- Ethnic cleansing
- Darfur in Sudan: 300,000 deaths
- civil war
- Sudan: 2mil deaths since 1983
- congo war: 3.3 million deaths between 1998-2002
- life expectancy ~56
- genocide
- Rwanda genocide 1994: 800 000
Tutsi minorities killed
- 6 million killed in Nazi Holocaust
- Epidemics and Pandemics (morbidity)
- Botswana, Lesotho and Swaziland
- severe AIDS/HIV epidemic
- Romania: free ART
treatment
- polio-endemic: Nigeria, Afghanistan
- affects children under 5
- Nigeria 124/1000 under-5 mortality ratio
- changing pattern of diseases
characteristic of modernisation
- worldwide obesity has doubled since 1980
Anmerkungen:
- increased intake of energy-dense foods high in fat;
increasingly sedentary nature of work, with advancements in xportation and urbanisation
- leads to cardiovascular diseases,
musculoskeletal disorders and cancer
- DCs and low-and-middle
income countries
- vulnerable to inadequate nutrition low in
cost but lower in nutritional quality
- chronic non-communicable
diseases
- 2014 ebola outbreak
- death toll >2000
- Sierra Leone, Liberia and Guinea
- environmental
- droughts
- 10,000 killed from heatwave
in France in 2003
- floods
- natural disasters
- Indian Ocean tsunami
caused >200k deaths
- pollution
- smog in China reduces average LE by 5.5 years