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.

 

 

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. 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.

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. <link title to http://www.hsph.harvard.edu/organizations/bdu/summary.html>

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