Unequal
Causes of Death
Infectious
diseases still kill most in non-industrialized world and kill
1/3 worldwide
Worldwide, one death
in three is from an infectious or communicable disease,
however, almost all these deaths occur in the non-industrialized
world. Health inequality effects not just how people live, but
often dictates how and at what age they die.
The pie graphs (at
right) show the different causes of death between regions of
the world defined by the WHO as high and low mortality
regions. These areas correspond closely with the non-industrialized
and industrialized parts of the world. As the graph shows, the
majority of people in high-mortality countries die of communicable
diseases, while in low-mortality countries deaths are due largely
to non-communicable diseases.
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The
radar graph (below) shows regional differences in causes of death
in 2000. The thick brown line represents the world average for
each category of cause. style='color:black'>Then, regional rates
above and below average are shown with colored lines. For example,
the red line shows that infectious and parasitic diseases, including
measles and malaria, are more frequent causes of death in Sub-Saharan
Africa than elsewhere. Respiratory infection disproportionately effects people living in Southeast
Asia and Sub-Saharan African. These two regions are also particularly
hit by maternal and perinatal conditions
as well. The Asia and the West Pacific
region has a rate of non-communicable respiratory diseases, such
as chronic bronchitis and emphysema, that is nearly 2.5 times
higher than the rest of the world. Western Europe has a greater
proportion of deaths due to heart (cardiovascular) disease and
cancer (malignant and other neoplasms). |
Communicable diseases
kill poor children
Communicable diseases, along with nutritional deficiencies,
and maternal and perinatal diseases, continue to take a heavy
and largely avoidable toll. The Burden of Disease Unit at the
Harvard School of Public Health found that in 1990, 17.3 million
deaths were due to these causes, with
more than 16.5 million in non-industrialized regions, mainly India
and Sub-Saharan African (see table, below). Together diarrhoeal
diseases and lower respiratory infections (including
pneumonia) caused 40% of these deaths. Lower respiratory
infections killed 4.3 million people, with 2.9 million deaths
in the non-industrialized regions. Diarrhoeal diseases caused
2.9 mn deaths, and nearly all were in the non-industrialized
world. Tuberculosis, measles and malaria continue to be major
threats. In 1990, they collectively killed 3.8 million people
in the non-industrialized world -- yet barely registered in
the industrialized world.
Infectious diseases disproportionately affect children
and childhood death rates. A baby girl born in Sub-Saharan Africa
faces a 22 per cent risk of death before age 15. In China the
risk is less than 5 per cent and in Industrialized countries the risk is just 1.1 per cent. The vast
majority of these deaths could have been prevented with existing
interventions.
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Non-communicable Diseases not disease of Affluence
Non-industrialized regions
often have lower life expectancies, even for non-communicable
causes of death. Although these diseases, including heart disease
and stroke, are the largest proportional killers of people in
the industrialized world, they often kill a large population in
non-industrialized world, and at a younger age. For example in
1990, of the 6.3 million people that died of heart disease, 57%
were in the non-industrialized regions; among the 4.4 million
people that died of stroke, 68% were in non-industrialized countries.
When one looks at the probability of dying between the ages of
15 and 60, the industrialized and non-industrialized world have
similar rates for non-communicable diseases. (See Table 9).
For people between the ages of 60 and 70, some non-industrialized
regions have a higher rate of death from non-communicable
diseases than the industrialized regions. This shows that unequal
access to treatment and other factors causes premature mortality
rates in non-industrialized countries.
This refutes the myth that non-communicable diseases, such as stroke and heart
disease, mainly impact the affluent. Instead, it highlights
that communicable diseases kill children
in non-industrialized countries most often, and these
deaths have a significant impact on overall world mortality
rates. Controlling these diseases, through immunization
and other means, can be one large step toward achieving health
equality.
References
Burden of Disease Unit, (2000)."Executive
Summary of The Global Burden of Disease and Injury Series,
Harvard.
New Glossary words (to be completed)
communicable
disease
non-communicable
disease
maternal and perinatal conditions
Maps
Life Expectancy
Infant Morality
Under 5 Mortality
Disease Prevalence
Mortality
Stratum
WHO
aggregates country data by geographic and mortality groups.
More info
Links
International
Burden of Disease Network
http://www.ibdn.net/
Papers
Global
Burden of Disease 2000 (WHO Whitepaper)
http://www3.who.int/whosis/discussion_papers/pdf/paper50.pdf
Data
and Statistics
WHO
Cause of Death
http://www3.who.int/whosis/menu.cfm?path=whosis,whsa&language=english
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