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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
Leading
Causes of Death in 2001
| Developing Countries
|
Number
of Deaths |
Developed Countries |
Number
of Deaths |
|
1. HIV/AIDS |
2 678 000 |
1.
Ischaemic heart disease |
3 512 000 |
| 2.
Lower respiratory infections |
2 643 000 |
2.
Cerebrovascular disease |
3 346 000 |
|
3.
Ischaemic heart disease |
2 484 000 |
3.
Chronic obstructive pulmonary disease |
1 829 000 |
| 4.
Diarrhoeal diseases |
1 793 000 |
4.
Lower respiratory infections |
1 180 000 |
|
5.
Cerebrovascular disease |
1 381 000 |
5.
Trachea/bronchus/lung cancers |
938 000 |
| 6.
Childhood diseases |
1 217 000 |
6.
Road traffic accidents |
669 000 |
|
7.
Malaria |
1 103 000 |
7.
Stomach cancer |
657 000 |
| 8.
Tuberculosis |
1 021 000 |
8.
Hypertensive heart disease |
635 000 |
|
9.
Chronic obstructive
pulmonary disease |
748 000 |
9.
Tuberculosis |
571 000 |
|
10.Measles |
674 000 |
10.Self-inflicted |
499
000 |
Source:
WHO World Health Report 2002. Countries grouped by WHO
Mortality Stratum, with
Developing Countries representing regions with High and
Very High Mortality, and Developed
Countries representing regions with Low and Very Low Mortality
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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
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