Archive for category: Health

Information and stories on health topics.

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Obesity Growing in the Developing World

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The number of overweight and obese people has grown drastically in the past 30 years, going from 23% of the world’s population in 1980 to over a third today.  Surprisingly to some, the majority of overweight and obese people live in developing countries.  As globalization spreads and countries go from low-income to middle-income, people have more money to buy food.  At the same time the access to cheap junk food full of fat, carbohydrates, sugar and salt is becoming readily available.  As food gets tastier and cheaper, families in the developing world are consuming these products and steadily gaining weight.

Sharada Keats and Steven Wiggins from the Overseas Development Institute in London released a report on January 3rd called, “Future Diets.”  This report summarizes research that shows that diets are changing.  As incomes rise in the developing world people are moving from a diet that consists of cereals and tubers to diets that include meat, fat and sugar.

The portion sizes that people are eating are also going up.

These changes mean that the price of animal products will go up all over the world while prices for grains will go down.  The agricultural crisis of not having enough grains to feed the poor may be replaced by a public health crisis as more people move to eating unhealthy diets.

Obesity is increasing throughout the developing world.  Further, reports have noted that obesity has tripled in the developing world in the past 30 years.

Mexico is a good example of how globalization and higher incomes are impacting diets and waistlines of middle-income countries. In 1980, fewer than 40% of Mexicans were overweight or obese. Today that figure is more than 70%.  In 1980 there were 250 million overweight and obese adults in the developing world. In 2008 those numbers have grown to 904 million.

This is a global health concern as unhealthy diets and weight gain put people at a large risk for a wide range of health conditions including cancer, cardiovascular disease, and diabetes. This is going to place an increased burden on low and middle-income countries with already struggling health care systems.  It will also cause economic difficulties and increased health care costs.

At the moment there seems to be little interest among the public and leaders to take action against the growing obesity problem.  Keats and Wiggins suggest that as countries begin to face the serious health implications and economic problems associated with obesity they may consider investing in public education and policy changes as well.  Conclusively, Keats and Wiggins suggest for a resolution that is a moderate combination of education, prices and regulation measures.

– Elizabeth Brown

Sources: NPR, Overseas Development Institute (ODI), BBC

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Bangladesh Healthcare Improves Despite Poverty

Despite widespread poverty and low governmental spending on health, Bangladesh – particularly, its healthcare system – has made significant improvements in life expectancy, vaccination rates and decreased infant mortality rates. In a special report by The Lancet, it has been shown that the remarkable strides made by the country are due to programs that focus on gender equality, family planning and immunizations.

Professor Mushtaque Chowdhury from BRAC, a Bangladeshi NGO, has said, “Over the past 40 years, Bangladesh has outperformed its Asian neighbors, convincingly defying the expert view that reducing poverty and increasing health resources are the key drivers of better population health. Since 1980 maternal mortality has dropped by 75%, infant mortality has more than halved since 1990, and life expectancy has increased to 68.3 years—surpassing neighboring India and Pakistan.”

Women have played a large role in these advancements. Door-to-door female health workers delivered family planning services over the last 40 years, resulting in a drop from 7 births per woman in 1971 to 2.3 in 2010. During that time, contraceptive use has increased from 10% to 62%. Education for girls was also noted as a key factor in these improvements.

The success achieved has been attributed to the involvement of NGOs, such as BRAC, in poor rural areas. “NGOs as a group have innovated to address issues of poverty, unemployment, health, education and the environment, and in many cases the government and NGOs have worked together to achieve a common goal,” The Lacent report continues to reveal.

While Bangladesh is succeeding in many areas, there are still many more that are not so positive such as child malnutrition. In the poorest families, 50% of children are still underweight. Even in the wealthiest quintile, 21% of children do not receive enough food.

“The Bangladesh health system has been shaped to address the first generation of poverty-linked infections, and nutritional and maternity-related diseases,” the Lancet goes on to say. “But given the epidemiological transition, the health system will have to be adjusted to grapple with chronic non-communicable diseases. For the fragile and evolving Bangladesh health system, the global attention on universal health coverage has not been translated into substantive action.”

– David Smith

Sources: TheLancet, TheGuardian, The Conversation

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Poverty, Poor Health and Access to Healthcare

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It is an obvious fact that living in poverty makes one more vulnerable, less secure and more likely to need assistance. When combating poverty issues of health and accessibility to health care providers in a crucial factor in creating the stability that helps people leave poverty and with appropriate polices to prevent future poverty crisis.

In the United States, it is clear that many have fallen into poverty. The U.S. Census Bureau’s annual report on poverty provides clear evidence that more Americans are struggling financially. Nearly 46 million people, which would be 14.6 percent of the population, are living in poverty. Of that, hundreds of thousands of these people were once counted among the middle class. Something beyond employment and GDP has effected security in the U.S. and made it difficult to not be impoverished.

When comparing the U.S. with other wealthy countries, the U.S. has one of the highest reported numbers of people living in poverty. Additionally, Americans also face a high risk of becoming poor. The disparity begs for answers.

When countries do not protect rights and basic securities it often leads to a poorly functioning economy and a poor standard of living.  States that do not have affordable health care have high rates of poverty. High rates of economic growth or their level of wealth cannot circumvent the absence of human rights protections and the statistics reflect that.

With such high costs of coverage and access, it is not surprising that the new census report also shows that 16.7 percent of Americans are without health insurance. The passage of the Affordable Care Act has brought this discussion of the value of human health to the forefront, and is the first major piece of anti-poverty legislation in decades.

The ACA mandates that quality healthcare must be provided to all Americans no matter what their income level is. In addition to accessible healthcare for those in need, the bill also reaffirms the belief that health care is a human right.

The health insecurity of the poor puts everyone at risk and the lack of care is trapping people in systemic poverty and risking lives that could otherwise be saved. When people live in extreme poverty they a more frequently and severely ill and face greater complications with more demands on an already over-burdened healthcare system.

Unless we can contain this spiral out of the cycle of poverty it will only continue. Job creation offers security through employment; however it cannot make a sick individual a healthy worker, and cannot always cover the high costs of health treatments and coverage.

The causes of poverty are varied and not always identified. Unless poverty is fought simultaneously from multiple points of vulnerability, it is not a winnable fight. With affordable accessible healthcare is provided along with increased social services, benefits and job creation, there are enough steps for individuals to finally leave poverty and find the security to participate economically and thrive.

– Nina Verfaillie
Feature Writer

Sources: Huffington Post, The Atlanta Journal-Constitution, CNN
Photo: The Economist

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Cancer Cases at All Time High

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According to the World Health Organization, Cancer cases are soaring each year. Data indicates an upward trend from 12.7 million cases in 2008 to 14 million in 2012. Cancer related deaths have also increased from 7.6 million to 8.3 million since 2008. With these growing rates, there is a desperate need for advances in diagnosis and detection of cancer.

An IARC report has shown a connection between increased smoking, obesity and cancer rates. This report also predicts a rise in cancer cases to 19.3 million by 2025. Several types of cancer kill every year but the most common cancer affecting thousands of women worldwide and is a leading cause of deaths in developing countries is attributed to breast cancer.

Developed countries do not have the clinical advances required to stop the disease at an early stage. Several people living below the poverty level don’t even know they have breast cancer since clinics are scarce. The Word Health Organization has also claimed this urgency for treatment of breast cancer in developing countries as thousands die from late detection. In 2012, around 522,000 women from around the globe died of this disease. Lung cancer is also among the top most common cancers worldwide, about 13% of total cancer cases. The large amount of lung cancer rates has been linked to both increased smoking from adults and young adults alike. Longer lifespans also contributes to these spiking rates according to the BBC.

Several health leaders from IARC believe that these growing cancer rates can be changed through preemptive action seen before with cervical cancer and access to the HPV vaccination. They hope that national programs for screening can produce similar excellent results and by giving easy access to treatment or detection centers, several will be able to beat other forms of cancer.

– Maybelline Martez

Sources: BBC, NY Daily News, Global Post
Photo: Giphy.com

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Overpopulation and Public Health

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There is much debate whether overpopulation poses public health risks. Some believe it is the cause of hunger and poverty throughout the world while others feel that it has never been a problem.  It is important to shed light on this fear of overpopulation as its consequences are said to be evident in all developing countries.

Several reports about Africa’s growing population has been connected to the starvation of millions of people. Every year 32.5 percent of children in developing countries suffer from malnutrition. Sustainable population advocates have pointed to the approximate 200 million hunger-related deaths in the past twenty years. Deterioration in global biodiversity has also been linked to overpopulation. Substantial data of species loss has been presented by countries such as China, Brazil and Mexico. Human settlements that are gradually increasing according to the rate of population is said to ruin the benefits of nature and destroy habitats. The consequences of overpopulation is also suggested in access to education, primarily in Africa. In African classrooms, children are unable to learn due to overcrowding.  Access to water, medical care and housing are all diminished when there are more people that require aid. Data from the United Nations further suggests that by 2050, 10 percent to 15 percent of land that is farmed today will not be available. This could potentially lead to a food crisis as the current population increases at a faster rate.

Those supporting a sustainable population see hope in public policies being employed in countries such as Bangladesh, Iran and Thailand. Results from securing social services to women and families indicate a large decrease in undernourished people in Asia, from 23.7 percent to 13.9 percent. This downward trend from simply giving access to birth control and adopting policies that give aid to small families suggests that overpopulation is an issue that can be solved.  Policies that provide family planning to those in remote, rural areas in Asia has led to stability in undernourishment over time. By merely shifting the focus on public policy these countries quickly witnessed better health standards, quality of education and housing availability, all of which offer hope to the remaining developing nations.

– Maybelline Martez

Sources: Scientific American, Huffington Post, World Hunger

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Ethnic Tension Within Inner Mongolia

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It is no secret that the concerns and rights of ethnic minorities in China fall to the wayside in favor of the Han, the ethnicity with the majority in the country. Inner Mongolia serves as an example of the cultural and economic strife caused by marginalizing one group over another. The result is what the Mongol minority believes is outright economic exclusion and the watering down of their culture.

One of the key issues within the region is the migration of the indigenous nomads from their native grasslands to the cities. The Chinese government waves off the migration as a move into modernity for the nomads. A removal from what Chinese authorities refer to as a “backward” culture, but as Nick Holdstock of the U.K. Independent points out, the natives have no say whatsoever when it comes to moving to the cities. This outflow of ethnic Mongolians to urban centers has raised fears among Mongolians that their culture, language and lifestyle are being threatened.

Another point of tension lies in the regional mining of rare-earth metals. Various mining companies have entered the region to take advantage of the lucrative prospects, especially since the value of these metals is demonstrated in their ubiquity among high-tech electronics. However, the mining has been accompanied by a degradation of the surrounding environment as well as the health of the nomads.

For example, the town of Baotou, a major mining hub, has seen its groundwater polluted to toxic levels, their crops ruined and much of their livestock destroyed. Moreover, the use of underground water sources, essential to the removal of impurities from the coal, has lessened the water available to crops and livestock. Many farmers, unable to deal with destruction of their livelihood, have moved away. The Guardian points out that the population within the surrounding villages of the Baotou plants has decreased dramatically. Those that have remained in the area are plagued by severe illness.

All of these factors have coalesced, creating serious economic problems for the ethnic minority. Environmental devastation of their grasslands has degraded some of the main forms of their economic livelihood; the mining industry in the region tends to hire workers from other provinces, excluding the nomads from many of the economic benefits the industry might bring.  Furthermore, those who have migrated to urban areas have discovered cultural barriers to finding gainful employment, namely an inability to speak passable Mandarin.

Tensions have, moreover, reached the point of violence in some instances. In 2011, a herder was killed by a passing coal truck when he attempted to prevent coal trucks from crossing into his land during his protest against the mining industry. Several days later another protester was killed by a forklift driver. Tensions finally boiled over and several thousand Mongolians went out to voice their opposition toward the mining activities.

Unfortunately, the case of Inner Mongolia is a harsh reminder among ethnic minorities in China of their second-class citizen status. Perhaps in time, the Chinese government will listen to the voices of protest among the disenfranchised minority groups that populate many rural areas throughout China. Until then, Mongolians and other ethnicities face major economic and cultural challenges.

– Zack Lindberg

Sources: The Independent, The Guardian
Fabio Ghioni

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Food Aid in Puntland, Somalia

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On November 10, a deadly cyclone raged through the region of Puntland, located in Somalia’s northeastern coast. Though the cyclone has reportedly killed up to 300 people, the death toll has not yet been verified. Many of these victims were children and elderly, both of which are more vulnerable to hypothermia and exposure. Moreover, the United Nations says as many as 30,000 people are in need of food aid.

Whole villages have been washed away by the storm, thus forcing local aid workers to struggle to reach the stranded victims due to the damaged infrastructure. Furthermore, large portions of roads have been damaged, driving aid workers to deliver food aid on foot. Many people are also missing, especially in coastal towns where fisherman and their boats have been lost at sea.

Pastoralists have been hit the hardest since their livestock and poorly built homes and barns have been washed away. The region does not normally experience rain so the area’s infrastructure has not been built to withstand this sort of storm. In fact, some of the worst hit villages have lost 90 percent of their livestock to icy rain and flooding.

Moreover, areas infamous for pirates such as the port of Ely are some of the worst affected. This is worrisome as the 2004 Tsunami was considered one of the major triggers of the pirate attacks off the coast of Somalia where 736 people and 32 ships were held hostage.

The World Food Programme (WFP) recently arrived in Puntland and transported 340 metric tons of food including cereal and vegetable seeds to the worst affected areas of Bossaso, Banderbayla, Dongoroyo and Eyl. In total 27, 000 people have been given a month’s worth of food rations. In addition Puntland’s government sent 32 trucks of emergency supplies throughout the needed areas.

Once emergency aid has been distributed and the region is no longer in a state of disaster the WFP will begin recovery work to rebuild the infrastructure of the area. The Food-for-Assets initiative is a recovery program run by the WFP that assists communities in rebuilding their infrastructure in a way that would better withstand a future natural disaster. Moreover, community workers are paid in food rations for assisting with the development.

Further south in Middle Shabelle, flooding has devastated the town of Jowhar and surrounding areas, pushing over 10,000 people to flee their homes. Their water supplies have, furthermore, been contaminated increasing the risk of waterborne diseases, while all standing crops and livestock in the area have been destroyed or lost. The International Committee of the Red Cross has provided 25,800 people with emergency essentials such as kitchen sets, clothes and sleeping mats.  They have also been able to stop flooding and repair riverbanks in five locations and distributed emergency food aid and water.

– Lisa Toole

Sources: AllAfrica: Food Aid, AllAfrica: Twin Natural Disasters, Yahoo, World Food Programme, Aljazeera

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Social Determinants of Health

Medical Tourism
When most people think about the health of individuals, communities, and populations they think of access to healthcare. People in developing countries have a definite lack of access to doctors, nurses, drugs, and the latest medical technologies.  It is important to remember that the conditions people are born into also have a significant and lasting affect on their health. These circumstances are shaped by the distribution of power and resources both globally and locally. These factors are known as the “Social Determinants of Health”

The social determinants of health are the social, economic, and political factors that shape the health of individuals, communities, and nations. Social determinants of health include both environmental resources such as housing, income and income distribution, unemployment, early life, education, and food insecurity.  They also include gender, ethnicity, class, and race.

The social determinants of health are responsible for health inequities. Health inequities are the large discrepancies in health status seen between countries and within countries. Wealthier countries in the developed world have much lower rates of infant mortality. The infant mortality rate is the number of infants who die before they reach age one, per 1000 births in any year.

The World Bank reports that Sweden, Norway, and Japan have an infant mortality rate of only two in 2012. The US is three times higher at six deaths per 1000 live births. Unfortunately, in many countries in sub Saharan Africa approximately 10% of children die before their first birthday. The infant mortality rate in Sierra Leone was 117 in 2012.

Another factor used to measure the health of nations that is largely impacted by the social determinants of health is life expectancy at birth. Countries in sub Saharan Africa fare the worst; Sierra Leone has a life expectancy of 45 years and Mozambique has a life expectancy of 49 years. High-income countries fare much better; Japan and Switzerland have average life expectancies of 83. The United States has an average life expectancy of 79 years.  Inequality within a country also has a large impact on the overall health of a nation. The U.S. has one of the highest rates of inequality in the world. This is why the US does not fare as well as other developed countries in infant mortality rates and life expectancy.

Health inequities are considered to be unfair and avoidable. It is widely considered that health inequities could be abolished with improved social policies and programs and great income iquality. At the World Conference on the Social Determinants of Health in 2011 the WHO developed five action areas for improving health equity:

1.    Adopt improved governance for health and development

2.    Promote participation in policy making and implantation

3.   Further reorient the health sector towards promoting health and reducing health inequities

4.   Strengthen global governance and collaboration

5.   Monitor progress and increase accountability

– Lisa Toole 

Sources: The World Bank, WHO, CDC, NCBI

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Drones Impact on Mental Health in Pakistan

The United States has waged a drone campaign in Pakistan since the early 2000’s. The Waziristan region in northern Pakistan has been a specific target due to the major presence of the Taliban in the area. The Bureau of Investigative Journalism in London released a report indicating that drone strikes carried out by the U.S. have killed 3,581 people since 2004. That number includes 884 civilians and 197 children. Unsurprisingly, this has led to a rise in mental health issues.

The Huffington Post reported a story of a man who lost nine friends and relatives in one attack in 2009. While Mohammed Fahim was in another room, a drone hit his house, killing everyone else instantly. Fahim insists that his family had no ties to Islamist militancy, but instead that this was an attack that went astray.

Residents in Waziristan complain of living in a constant fear of drones, specifically citing the buzzing sound they emit when they fly overhead. This fear is leading to a rise in depression, anxiety, and in some cases psychotic episodes. Doctor Muktar ul-Haq is the head of psychiatry at a government hospital in the city of Peshawar. He told a story of a man who had a full blown psychotic episode after he found a SIM card outside of his house. A common rumor in Pakistan is that SIM cards emit signals to drones, guiding their attack. Haq said when the man was admitted he was “aggressive and paranoid.”

The social problems that plague Pakistan, such as poverty, Taliban violence, and unemployment, contribute to the rise in depression and anxiety. With all of these other problems, mental health falls to the bottom of the list. There are no official statistics about the rise in mental health issues, but some psychiatrists treating people in the region estimate that rates psychological illnesses have risen three fold.

– Colleen Eckvahl

Sources: Huffington Post, The Atlantic
Photo: CS Monitor

HIV Infection Rises in China’s Youth Population

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The HIV rate appears to be rising among Chinese people aged 15-24, according to HIV/AIDS specialists at the Chinese Center for Disease Control and Prevention. Between 2011 and 2012 the rate of new infection in youths increased 29% from 1,074 to 1,387. The overall new infection rate has quadrupled since 2007.

Another change in the demographics of China’s HIV infections is that transmission through sex, as opposed to intravenous drugs or infections in medical settings, accounts for 87.1% of new cases.

Between 2008 and 2012, the proportion of youth infected with HIV/AIDS almost doubled, and inconsistent use of condoms among men who have sex with men (MSM) in urban areas is considered to be a major factor, according to UNAIDS.

Of newly infected youth, 95% are men.

“The kinds of people suffering from AIDS have grown more varied and complex,” states Dr. Wang Ning, AIDS specialist at the Chinese Center for Disease Control and Prevention. “The direction of the development of the disease is from high-risk groups to groups that have traditionally been understood as low-risk groups,” including university students.

Homosexuality remains taboo in China, as well as frank conversations concerning sex, especially in rural areas.

China Radio International reports that there is a lack of sex education in Chinese schools and where sex education is taught, it is generally sex-segregated, with boys and girls only learning about their own gender.

During the 1990s, hundreds of thousands of people reportedly were infected with HIV from receiving contaminated blood and plasma. In what is widely considered a cover-up by officials in the Henan province, “blood-dealers” purchased poor farmers’ untested blood, pooled it, and returned the plasma to the farmers, causing a quick spread of HIV. The blood then entered hospitals and continued to infect people.

The black market economy was reportedly encouraged by local officials, including current Chinese Premier Li Keqiang who was a senior Communist Party official in the province at the time.

Li forbid NGOs and medical professionals from reaching those infected with HIV in Henan.

“It was because of Li’s cover-up of the AIDS epidemic that a large number of patients did not receive attention and died,” states HIV/AIDS advocate Hu Jia.

Contrary to China’s recent trends, HIV infections in the developing world have decreased over 50% since 2001, according to the Joint United Nations Program on HIV/AIDS.

The majority of this improvement has occurred in Sub-Saharan Africa, with Malawi, Namibia and Botswana seeing a roughly 70% decrease in new infections in the last 10 years.

However, infections in the Middle East and North Africa have increased 35% in the same timeframe, and rates in Eastern Europe and Central Asia appear to be rising as well.

Though there are serious concerns about rising rates among young people in China, rates of HIV remain relatively low. As a point of comparison, in 2010 there were 12,200 new cases of HIV for youths age 13-24 in the United States, a rate 12 times higher than that of China in a country with a quarter of China’s population.

Dr. Bernard Schwartlander, director at UNAIDS, reports that China is focused on getting HIV-positive people on antiretroviral drugs, which treat those infected as well as reduce the risks of infecting others. He also says that China’s HIV response has improved dramatically, with the country having one of the biggest harm-reduction initiatives, including needle exchanges and methadone clinics.

Such programs do not, however, directly address the spread of the infection through sex, and many in the country still believe that the government does not care about people with HIV/AIDS.

Hu Jia claims that the government merely pays lip-service to HIV/AIDS issues. She asserts, “Every year around December 1, the Communist Party[-led] administration appears very concerned [with HIV/AIDS issues]. But the media has never reported all the demonstrations and petitions or the suffering of the people with AIDS.”

– Kaylie Cordingley

Sources: New York Times, Al Jazeera, NPR, China Daily, CDC