Chapter 8 Notes

Developed and Developing Countries Developed country: a country that has progressed adequately with regard to economic, demographic and mortality indicators Developing country: a country that has not progressed adequately with regard to economic, demographic and mortality indicators Classifying Countries WHO Mortality Strata WHO classifies countries according to mortality strata Other countries experiencing similar health outcomes Human Development and Sustainability Provides another way at looking at the differences and similarities between countries around the world and classifying countries as either developed or developing Human development: creating an environment in which people can develop to their full potential and lead productive, creative lives according to their needs and interests Expanding choices and enhancing capabilities Having access to knowledge and health Decent standard of living Participating in the life of their community and decisions affecting their lives Level of wellbeing of people and promoting an environment where people can lead long, healthy and fulfilling lives Gross National Income (GNI) or average income = gauge wellbeing and level of development being experienced To improve human development --> build certain capabilities Lead long and healthy lives Have access to knowledge Have access to the resources needed for a decent standard of living Participate in the life of the community Participate in the decisions that affect their lives Ability to sustain and maintain these in the long term Human Development Index (HDI) Measurement system that attempts to reflect the level of human development experienced in different countries and region Four indicators to create index estimating level of human development Life expectancy - an indication of how long a person can expect to live, if death rates do not change Mean years of schooling - average number of years of education achieved by those aged 25 and over Expected years of schooling - number of years od education expected for a child of school entrance age GNI per capita - overall income of a country after expenses owing to other countries have been paid, divided by the population of the country Allow comparisons to be made Four quartiles Very high human development High human development Medium human development Low human development Sustainability 'Meeting the needs of the present without compromising the ability of future generations to meet their own needs' (UN, 1992) Three dimensions of sustainability Economic sustainability - capacity of future generations to earn an income and efficient use of resources to allow economic growth over time Social sustainability - future generations having the same or improved access to social resources (human rights, political stability, education) Environmental sustainability - ensuring the natural environment is utilised in a way that will preserve resources into the future Dimensions = interrelated SUSTAINABILITY OF PROGRAMS AND STRATEGIES Appropriateness: implemented program must address the specific needs of the targeted community or population Consider available data to ensure proposed programs clearly address the priority concerns of the community Strategies must take into account social, cultural and political aspects = implemented programs must be culturally sensitive if they are to be sustainable Key elements for consideration Involve the people Empower people and increases likelihood of people taking ownership of the project Program more likely to meet the needs of the community --> long term sustainability Develop skills that can be used to ensure program continues once outside assistance ceases Social sustainability Choose the right aid to reach poor people Basic necessities (clean water and sanitation) --> develop foundation for positive health outcomes Economic and environmental sustainability Focus on involving and educating women Women generally have lower social status, lower levels of education, less access to health services and less opportunity for higher-paid employment Empowering women --> empowered families and communities Social and economic sustainability Focus on education Keys to good health and human development More likely to be employed --> income to access resources required for decent standard of living Understanding health issues and how and where to access services Social and economic sustainability Ensure programs are culturally appropriate Consider cultural values Ensures programs are accepted and supported by the community Social sustainability Affordability: ensuring the affordability of programs is important at the individual, community and national level and helps ensure economic sustainability People living in poverty do not have money to access programs and resources People with little or no money = unlikely to access health-related programs if a cost is involved Improving health --> achievement of human development and sustainability as individuals who are able to work and participate in society are more able to lead productive and creative lives in accordance with their needs and interests Equity: implemented programs must provide opportunities and meet the needs of all individuals and community groups Creating policies that act to improve and protect the environments in which vulnerable groups live Urban slums, rural and remote areas Funding the most urgent needs of vulnerable groups Providing education for vulnerable groups Developing programs in urban slums and in rural remote areas Ensuring health care is provided based on clinical need as opposed to the ability to pay Health Status Life Expectancy Has increased in most countries over time Occasionally fluctuations occur Developing countries are more susceptible to health issues --> generally experience more severe fluctuations than developed countries The lower the strata of the country, the lower the life expectance and health life expectancy Mortality and Morbidity Give valuable information not only about causes of death and illness, but about the resources that might be employed to close the gap between developed and developing countries CHILD MORTALITY AND MORBIDITY U5MR = important indicator of the level of development of a country Number of deaths that occur is a reflection of: Nutritional health of mothers Health knowledge of mothers Level of immunisation available Availability of maternal and child health services Income and food availability in the family Availability of clean water and safe sanitation Overall safety of the child's environment Higher in developing countries Malnutrition = underlying factor --> high rates of mortality and morbidity Undernourished --> underdeveloped immune system --> struggle to fight off diseases as adequately as those who are well nourished Communicable diseases = huge impact on mortality figures Australian children are more likely to experience mortality and morbidity due to accidental causes such as injuries and poisoning and congenital malformations Childhood deaths in developing countries make up around 99% of global deaths among children Communicable disease - spread through blood, water or air Diarrhoeal, infectious and parasitic diseases Non communicable disease - commonly associated with lifestyle behaviours or a genetic predisposition CVD, obesity, diabetes, cancer ADULT MORTALITY AND MORBIDITY Some countries experience low child mortality but high levels of adult mortality (e.g. Russia) Impact of lifestyle factors (tobacco smoking and excessive alcohol consumption) Mortality rates increase as level of development increases Burden of Disease Mortality rates for non-communicable diseases are often higher in developing countries Human Development Index (HDI) Health is influenced by factors such as income and education = key components of HDI Comparing HDI provides another way to examine the similarities and differences that exist between countries Illustrates close relationship between health and human development Lower HDI = poorer outcomes with regards to life expectance, access to education and income