Health and Illness

Question 1

Health

Answer 1

The state of being free from illness or injury

Question 2

Illness

Answer 2

A disease or period of sickness affecting the body or mind.

Question 3

Introduction

Answer 3

• The greatest barrier to good health remains poverty.
• Huge global health divide
• Rich countries have an average life expectancy of 80; poor countries’ average 57 (2015)

Question 4

Introduction Evidence

Answer 4

• Collier’s ‘bottom billion’ remain vulnerable to diseases like malaria, TB and have a low life expectancy because they live in poor and marginalised conditions. Every year more than 2m children die from diarrhoeal diseases due to not having clean water.
• In 2008 the Global Commission on the Social Determinants of Health asserted that equality in health and social justice should be the most important consideration for all countries.

Question 5

Communicable Diseases

Answer 5

-An infectious disease transmissible (from person to person) by direct contact with an affected individual or the individual’s discharges or by indirect means.
-Affect being 1.5 billion in the LDCs and causes 500,000 deaths (WHO)
=Initiative began to eradicate or control the 17 Neglected Tropical Diseases that impact particularly in the developing world. Occur in rural and poor urban areas. ‘poverty-promoting’ through their stigmatising features and their impact on child health and education, pregnancy and worker productivity.
=Cost of treatment is minimal. For example, the cost of treating a child for soil-transmitted worms is only $0.50 for an entire year which could make a huge difference.

Question 6

Types of Communicable Diseases

Answer 6

1.) Infection Transmitted via Human Faeces (diarrhoea, polio,)
=Over 2m children a year die from diarrhoeal diseases
2.)Air-borne: 1/3 of all deaths (TB, pneumonia, influenza) All are treatable in DCs also includes smallpox which has been eradicated worldwide.
3.) Tropical (insects and animal carriers): Malaria (600,000 children die, mostly in S-S Africa) and Trypanosomiasis (sleeping sickness, 30 to 40m spread by tsetse fly)
4.) Contact: Leprosy, AIDS/HIV and Trachoma (infection of the upper eyelid to blindness affects 600m and 8m blinded)

Question 7

Non-Communicable Diseases

Answer 7

-A disease that is not transmissible directly from one person to another
-A major cause of death in LDCs
-4 main NCDs which are major causes of death are: Cardiovascular disease, Cancers, Diabetes and Chronic lung diseases
-Known as the epidemiological transition, whereby as countries become more affluent a shift occurs from infectious diseases to NCDs.
=80% of deaths from NCDs occur in low and middle-income countries, so an urgent development issue.
-Urbanisation contributed to rise
=WHO estimates that 30% of people dying from NCDs in developing world countries are under 60 years old, the most productive period of life.
=The financial burden of NCDs can be devastating. Expenses from strokes in China pushed 37% of patients and their families below the poverty line.

Question 8

Mental Illness

Answer 8

-WHO states that we are ‘facing a global human rights emergency in mental health’.
-MH is an invisible problem that has a significant impact on LDCs but receives little attention from either governments or NGOs. Lack of interest is because the allocation of funds is correlated with a project’s marketability to the public.
-Doesn’t generate sympathy for NGOs to care as no emotive images that can be used to raise funds
-The stigma around mental health in LDCs. Widespread discrimination and limited or no treatment.
=Sections of Africa, communities still regard MH as a misfortune in the family or divine punishment.
-Treatment by healers over trained doctors. Healers interpret MH in terms of being possessed or cursed.
-Patients in hospitals experience human rights violations. (physically restrained, isolated, denied their basic rights)

Question 9

Causes of Illness

Answer 9

1. ) Water and Sanitation
2. ) Nutrition and Nourishment
3. ) Illiteracy
4. ) Cultural Practises and Sexual Inequality

Question 10

Causes of Illness: Water and Sanitation

Answer 10

• 1/6 of pop lack access to adequate water supplies (1.1b)
• 2/5 lack adequate sanitation (2.4b)
• Washing with, drinking, cooking with infected or contaminated water is commonplace
• 80% of diseases in LDCs are water-related
• Improved hygiene and sanitation has more impact on health outcomes than improved drinking water (WB)

Question 11

Causes of Illness: Nutrition and Nourishment

Answer 11

-Poverty is the main cause of hunger
-12.6 of the worlds pop are ‘undernourished’ (UN)
-Don’t generally die of starvation, but their weakened state makes them vulnerable to infections and medicine less effective
-Deaths where undernourishment is an underlying cause account for about 60% of deaths from diarrhoea and pneumonia
-Loses nearly 2% of GDP is lost in Bangladesh due to the economic impact of malnourishment
=Unreported World reported that 9/10 adults are obese due to fast food as personal and local foods are seen as wrongly inferior

Question 12

Causes of Illness: Illiteracy

Answer 12

• UNICEF: “There is no tool for development more effective than the education of girls”
• Community Health Workers are proving to be very effective in educating populations, Hygiene issues
• Female literacy and education is vital
• More educated woman tend to have fewer children, later. -The effects shouldn’t be underestimated in their significance for the development

Question 13

Causes of Illness: Cultural Practises and Sexual Inequality

Answer 13

• Culture often prevents girls from attending education
• Poor education and lack of access to info about safe sex aids spread of HIV/AIDS
• Women lack power and control over sex and reproduction because of patriarchal norms and values
• Female circumcision, early pregnancies and multiple pregnancies impact on women’s physical and mental health
• HIV is a leading cause of death, 57% of deaths in southern Africa

Question 14

Healthcare in Developing World

Answer 14

• Effective healthcare, vaccinations, maternal healthcare and treatment of common dieases (Malaria) is essential to achieve the MDGs
• Important in rural areas where access to healthcare is limited by utilising things like community health care workers and trained birth attendants in villages
• This improves health much more quickly than Western Style Healthcare

Question 15

Bio-Medical Model

Answer 15

• Inherited from the West
• It is inappropriate and ineffective at improving healthcare in the developing world
• Encourages the ‘medicalisation’ of healthcare and ‘professionalisation’
• Works on Assumptions: Disease is abnormal, have a specific cause, experienced the same way everywhere, and that medicine is ‘scientifically neutral’

Question 16

Criticisms of Bio-Medical Model

Answer 16

-Fails to deal with the wider social issues
-Failure to use indigenous knowledge, practices and social factors in dealing with health issues
-‘curative’ approaches
-Costly system to implement that benefits the wealthy, urban dwelling minority
-Scarcity of trained doctors and nurses
=Malawi there is 1 doctor per 100,000 people while in the UK there is 166 doctors per 100,000 people

Question 17

Brain Drain of Medical Professionals in the Developing World

Answer 17

• There is little economic incentive for medical professionals to work in poor or rural areas. Have transferrable skills so docs and nurses from the developing world are in demand in the developed world.
• WHO predicts that the current global shortage of 7.2m health workers will increase to 12.9m by 2035, with the poorest countries having the highest shortages
• 5 African countries (SL) have expatriation rates of more than 50%, more than half the doctors born in those countries are now working in developed countries. The UK, the NHS consistently trains insufficient doctors and other medical staff and relies on migrants. Causing shortages of medical staff in the poorer areas of the world.

Question 18

Brain Drain Examples

Answer 18

=Menash: estimated that the money saved by the UK through the recruitment of Ghanaian health workers may have exceeded the value of aid it gave to Ghana for healthcare.
=Sharples: calculates that poverty-stricken Sierra Leone has subsidised the NHS by £22.5m. Calculated by the fact 27 docs and 103 nurses trained in SL are working in the UK, saving the NHS £269,527 it costs to train each junior doctor and £70,000 to train a nurse

Question 19

TNCs and Health

Answer 19

• Developing countries have become ‘markets’ for products considered dangerous or undesirable in the West (drugs, pesticides, herbicides)
• Companies have promoted and sold food products that are expensive and low in nutrition (Baby milk powder)
• Pharmaceutical companies TNCs have used people in LDCs to test new drugs as cheaper and quicker than doing trials in DCs

Question 20

TNCs and Health Example

Answer 20

=Nestle was accused of getting Third World mothers hooked on formula. In poverty-stricken cities in Asia, Africa and Latin America

• “babies are dying because their mother’s bottle feed them with Western-style infant milk”
• Nestlé accomplished this in three ways: Creating a need where none existed. Convincing consumers the products were indispensable. Linking products with the most desirable and unattainable concepts and then give sample

Question 21

Modernisation Theory

Answer 21

• Optimistic
• Expect LDCs health patterns to reflect DCs in the past. DCs passed through the epidemiological tradition, so will LDCs as improvements in nutrition and hygiene reduce death rates from infectious diseases.
• Modernists assume that progress through the ‘stages of development’ will promote improved life expectancy and reduce childhood mortality, eventually leading to illnesses of affluence: heart disease and cancers
• The west has improved the life expectancy and morbidity rates in developing countries
• Western education spreads new (scientific) knowledge and awareness of illness and the causes.
• Media can also serve this purpose gov campaigns to educate the pop, reduce birth rates and STIs
• Immunisation programmes from Western organisations have saved countless lives, eradicating some illnesses (smallpox)

Question 22

Neo-Liberalism

Answer 22

• Emphasis on a market approach to health care
• Individuals should provide their own healthcare over-relying on the state
• TNCs must be given the ability to protect themselves from ‘piracy’ in order to continue with R & D but competition will drive prices down
• Privatisation of health services to provide efficiency and best practice

Question 23

Dependency Theory

Answer 23

• Nauaro: LDCs are undeveloped due to Imperialism, Colonialism and Neo-Colonialism and now people in these countries have even worse healthcare
• Equipment imported from the west and the cost of drugs is 2x for LDCs
• Two-tier healthcare health system as Hospitals concentrated in urban areas and serve the wealthy elite instead of housing on basic healthcare and prevention and the Market reinforces
• Macdonald: Structures set up to improve health and reduce inequality have become the main protagonists
in widening them. Given the food shortage, environmental damage and conflict and advocates intervention to combat market failure. Markets are not valid allocators of essentials like health. Markets peddle unhealthy products, particularly if they are profitable tobacco products and foods high in refined.
• Wilkson and Pickett: Health shows no correlation with average income. A country’s health does not improve the richer it gets. There is a strong correlation with income inequality. The wider the income gaps between the rich and poor within a country, the greater the health gap

Question 24

Feminism

Answer 24

• Patriarchy reinforce the health inequalities that women experience. Poverty and low status mean women receive less access to health care.
• They have less power, status, health and experiences
• STEINMAN said high levels of poverty, exploitation and ill health

Question 25

Feminism Examples

Answer 25

=Early and multiple pregnancies mean high rates of maternal mortality in developing countries as limited access to prenatal care or midwives during and after the birth
=Cultural traditions reduce women’s life chances (early marriage, FGM, son preference)
=Employment opportunities limited, with some women being forced into harmful work such as sex or slavery
=Lack of education disadvantages women and their children. Girls being in school lowers the rates of early pregnancy and reduces the number of children a woman has over her lifetime