*HUNGER effects of POVERTY

*CRIME effects of POVERTY

DEATH AS THE EFFECTS OF POVERTY

The World Health Organisation produces a report every year on the health of the world population, based on statistics compiled from the 193 member states that form the United Nations. The latest report shows that, in the developing world, life expectancy is shorter than in OECD countries, women are more prone to die in childbirth and babies are more likely to die before the age of five.

The report illustrates that global inequalities in healthcare are much greater than they were 30 years ago. While people in the West can expect to live until their late 70s, people living in poor countries, such as Burkina Faso or Chad, are unlikely to live beyond 46 or 47 years of age. In Africa, half the population lives on less than US$1.25 a day with little or no access to safe water. According to the UN, 12 million people die of preventable diseases every year, often caused by water-born parasitic diseases like dysentery, insect-born parasitic diseases such as malaria, or from other factors related to wider economic and social problems such as malnutrition and lack of medical care.

Today, around 21,000 children died around the world

That is equivalent to:
-1 child dying every 4 seconds
-14 children dying every minute
-A 2011 Libya conflict-scale death toll every day
-A 2010 Haiti earthquake occurring every 10 days
-A 2004 Asian Tsunami occurring every 11 days
-An Iraq-scale death toll every 19-46 days
-Just under 7.6 million children dying every year
-Some 92 million children dying between 2000 and 2010

The silent killers are poverty, easily preventable diseases and illnesses, and other related causes. Despite the scale of this daily/ongoing catastrophe, it rarely manages to achieve, much less sustain, prime-time, headline coverage.

The Major Causes of Death and Disease in Developing Countries

In comparison with the United States and other developed countries, the developing world is an area of high birth rates and high mortality, especially infant and juvenile mortality. Let us contrast some basic public health statistics of the developing world with those of the United States. Fertility rates in many developing countries are in the range 5.5 to 7.0 in recent years. The current rate in the U.S. is 2.0. (The fertility rate is the number of children a woman would give birth to in a lifetime if she experienced the birth rate for her country in a specified year.)The infant mortality rate in the U.S. is less than 10 per 1,000 live births; in many of the world's poorest countries this rate is between 100 and 150.

Even more striking is the discrepancy between mortality rates for children aged 1 to 4. In the U.S. it is about 2 per 1,000 live births; in many developing countries it is 50 to 75 times greater. To summarize, in the most wretched countries for every 1,000 births, there are 100 to 150 deaths in the first year and an additional 100 to 150 deaths before age 5. Many international health experts regard the combination of these two rates, i.e. the mortality of children under 5 per 1,000 live births, as the best single statistic for evaluating the overall health status of a developing country. Because of the extremely high death rates for infants and young children, 50% to 60% of all deaths in the poorest developing countries occur before the age of 5, as compared to about 3% in the U.S., where about 90% of deaths occur after age 45.

Although mortality rates for young children and infants are still extremely high in most developing countries, it should be noted that these rates decreased substantially in many regions between 1975 and 1990. In Latin America and the Caribbean, the rate for children under 5 went from 104 per 1,000 live births to 60; in China, from 85 to 43; in India, from 195 to 127. In sub-Saharan Africa, however, decreases were more modest - from 212 to 175. Despite the high death rates for young children, population is increasing in most developing countries. The relationship between population growth and economic development is complex, but most authorities agree that , for most developing countries, population is growing at a rate that hinders economic growth and perpetuates poverty. (Table 1a gives the population, per capita income, fertility rate, life expectancy at birth, and mortality rate for children < 5 in selected developing countries and the United States.)

The major causes of death in the developing world

Severe poverty is the root cause of the high mortality rates in the developing world. Poverty results in malnutrition, overcrowded living conditions, inadequate sanitation, and contaminated water. Routine vaccination is often unavailable for both children and adults, and basic clinical care for the acutely ill is in short supply. Thus, poverty creates a fertile environment for infectious and parasitic diseases. Poverty also leads to illiteracy and inadequate education. Deficient education, especially of females, is closely correlated with poor health in developing countries.

POOR HEALTH RELATION TO DEATH

Attribution of deaths to specific diseases is difficult for several reasons. Most developing countries have only rudimentary national health statistics, or none at all. In addition, protein-energy malnutrition and micronutrient deficiencies, by lowering resistance to infection, are contributing factors to many deaths. Finally many children have multiple infections simultaneously, e.g. measles plus malaria. The best data on mortality in the developing world comes from a large on-going study sponsored by the World Health Organization (WHO) and the World Bank - the Global Burden of Disease study. Table 1 summarizes the mortality data from this study for 1990. The developing countries covered by this table are Mexico, and all the countries of the Caribbean region, Central and South America, Africa and Asia except Japan. This group is far from homogenous. It contains several countries with transitional economies, e.g. Mexico, Brazil, Argentina, Chile, South Korea, Thailand, whose health problems are in some ways closer to those of the industrialized countries than to those of the poorest developing countries. It also contains China, with 29% of the total population of the developing world. Although China is among the very poorest nations in terms of per capita income, it has made the public health system and birth control top priorities. Consequently it has a low birth rate and a mortality rate of about 40 per 1,000 for children under 5 - a rate comparable to that of many transitional nations. Not only are there important differences between individual countries in this group, but also within countries there are usually significant differences in health statistics between urban and rural areas, and often between regions of the country.

Source: World Bank, Disease Control Priorities in Developing Countries, 1993

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