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Life Expectancy in Montenegro

Montenegro is a Balkan country that obtained independence from Yugoslavia on June 3, 2006. The data regarding life expectancy in Montenegro attests to its modernization and the continuing integration of the country into the global market system. With the fall of communism and the dissolution of Yugoslavia, improvements in life expectancy outcomes have accompanied the increased prevalence of ills more characteristic of developed countries. Below are the top 10 facts concerning life expectancy in Montenegro.

Top 10 Facts About Life Expectancy in Montenegro

  1. Overall life expectancy has improved slightly. As of 2016, life expectancy in Montenegro reached 76.6 years, an increase from 75.28 in 2010. Women on average live 79.2 years, while men on average live 73.9 years.
  2. Some age groups have undergone mortality rate declines, while others have experienced increases. Males under 1-year-old experienced the largest decline in mortality in 2010, down 65 percent from 1990. In contrast, the most significantly increased mortality rate between 1990 and 2010 shows up among females between ages 35 and 39, constituting an 8 percent increase.
  3. The infant mortality rate has declined significantly since 1969. Infant mortality in Montenegro has been subject to a regular and substantial rate of decrease from 1969 to the present. While in 1969 there were 43.3 deaths per 1,000 live births, this rate has declined to merely 2.55 deaths per 1,000 live births as of 2018.
  4. Efforts are being made to target the leading causes of death and their risk factors. As of 2010, ischemic heart disease, cerebrovascular disease and cardiomyopathy constituted the leading causes of death in Montenegro.
    • Between 1990 and 2010, lower respiratory infections declined by 7 percent.
    • High blood pressure remains the principal risk factor for premature death, followed by dietary habits and tobacco consumption.
    • Montenegro’s Law on Food Safety of 21 December 2007 places restrictions on the marketing of such unhealthy foods as play a role in poor health outcomes.
    • The Law on Protection of Consumers of 16 May 2007 prohibits food advertisements that target minors or use minors in promoting products.
  5. In Montenegro, suicides outnumber homicides. The suicide rate remained consistent from the years 2013 to 2015, experiencing only a slight decrease between 2011 and 2012. With 11.07 suicides per 100,000 people in 2015, Montenegro exceeded the global suicide rate average of 9.55 suicides per 100,000 people. When distinguishing by sex, the suicide rate for males numbered 15.03 per 100,000 and for females numbered 7.19 per 100,000, with 4.1 suicides for every homicide. Prior to independence from Serbia, a government initiative successfully reduced the annual suicide rate of the Yugoslav Army (Serb and Montenegrin soldiers) from 13 per 100,000 between 1999 and 2003 down to 5 per 100,000 in 2004. This program, involving the efforts of physicians and psychologists as well as officers, entailed informing soldiers about substance abuse and suicide risk factors, as well as the dismissal of recruits with severe psychological problems.
  6. Obesity is a significant issue. Moderate obesity may reduce one’s life expectancy by three years, while severe obesity may reduce one’s life expectancy by 10 years. Statistics demonstrate that as of 2008, 55.6 percent of the adult Montenegrin population were overweight while 22.5 percent were obese. Men are more likely to be overweight (62 percent) or obese (23.3 percent) than women (49.9 percent and 21.7 percent respectively). In 2015, the European Association for the Study of Obesity (EASO) issued the 2015 Milan Declaration, of which the Montenegrin chapter of the EASO was a signatory. This declaration proposes treating obesity as a crisis requiring the development of educational, research and clinical care strategies for its reduction at the national level.
  7. HIV is rare in Montenegro. The HIV epidemic has had little impact on Montenegro compared to other countries as only 0.01 percent of the population is infected with the virus as of 2011. Data collected in that year established 128 total HIV cases, 62 total AIDS cases and 32 AIDS-related deaths. Of these, 2011 saw nine new HIV cases, three new AIDS cases, and only one AIDS-linked death. Eight out of nine diagnoses in 2011 were male. No mother-to-infant transmission cases were reported in 2011.
  8. Most Montenegrins have access to an improved water source. Access to potable water sources plays a major role in increasing life expectancy, particularly in reducing the incidence of potentially fatal water-borne diseases. By 2015, 99.7 percent of the Montenegrin population could access an improved water source.
  9. Health care staffing suffers a deficit. Health care comprises 6.8 percent of Montenegro’s GDP, totaling $177 in expenditures per capita. However, as Montenegrin health care services usage exceeds the European average, Montenegro faces an understaffing crisis. This chronic understaffing poses a continued risk of increased patient mortality in medical treatment centers.
  10. Life expectancy in Montenegro may respond to the country’s continuing urbanization. Studies show that residents of urban centers may have longer life expectancies than those in more rural, less developed or remote regions. The rural population of Montenegro declined to 35.78 percent by 2016 compared to 81.21 percent in 1960.

Although centuries of isolation and scarcity have left their legacy, these facts about life expectancy in Montenegro indicate that the country continues along the path of modernization. Overall, these top 10 facts about life expectancy in Montenegro give good cause for optimism regarding the country’s future.

– Philip Daniel Glass
Photo: Flickr

Hunger and Nutrition in Austria
After decades of making strides in the fight against hunger and food insecurity, hunger is on the rise. The Food and Agriculture Organization of the United Nations (FAO) reported that the number of undernourished people has risen. Around 821 million people were undernourished around the world in 2017, up from 804 million in 2016.

This article will address the top 10 most interesting facts about hunger and nutrition in Austria. Austria, like many other European nations, is lucky to have the socioeconomic ability to provide basic needs to most of their citizens, but Austria is not without flaws. These flaws will be addressed, as well as the progress Austria has made in its fight against hunger and malnutrition.

Top 10 Facts About Hunger and Nutrition in Austria

  1. Agricultural Land
    Austria has a very low amount of agricultural land. This land, defined by the OECD as “land area that is either arable, under permanent crops, or under permanent pastures” is necessary for a country to grow its own food. Because Austria does not have a large amount of agricultural land, the nation relies on imports. Best Food Importers names Austria as one of the most important food importers, with a constant need for imports of fruits and vegetables.
  2. Buying Local Food
    Not only does Austria have a comparably small amount of agricultural land, but it also faces more problems in the fight for food security for its local populations. Due to land-grabbing, local populations find it more difficult to buy locally, hence Austria’s aforementioned need to import food. However, Austria’s government is taking steps to fix parts of the problem. The Austrian Development Agency (ADA) has shown support for sustainable and fair land-use policies by supporting land rights for local populations and inclusion of disadvantaged populations in decision-making.
  3. Dietary Choices
    Austrians consume more saturated fatty acids and salt than the Food and Agriculture Organization of the United Nations (FAO) recommends. Austrians consumed 12.7 percent of their total calorie intake from saturated fatty acids; the FAO recommends 10 percent. The FAO recommends 5 grams of salt intake a day. Austrian men, by average, consumed 9 grams of salt a day, and Austrian women consumed 8 grams per day.
  4. Obesity Rates
    In 2008 estimates, approximately 60 percent of Austrian men were found to be overweight, compared to the 48.5 percent of Austrian women being overweight. However, in terms of obesity, men and women seem to be nearly equal with 21 percent of Austrian men being considered obese, and 20.9 percent of Austrian women being obese. By 2020, the World Health Organization (WHO) predicts that obesity numbers should rise to 25% for both men and women, and is predicted to steadily rise after that as well. This is a very important nutritional fact that needs to be corrected by the Austrian government.
  5. Stacking Up Against Other Nations
    Even though those numbers seem exceptionally high, when comparing these numbers to other Organization for Economic Co-Operation and Development (OCED) member countries, Austria ranks very well. Austria self-reported that in 2014, 46.7 percent of its population over 16 years of age were overweight or obese. How does this compare to the other OECD countries? The United Kingdom’s overweight and obese population stands at 61.4 percent of its population over the age of 16, while the U.S. self-reported numbers of 65.1 percent of its 16+ population as obese or overweight, but it’s been measured to actually be 70 percent. Italy and Norway were the only European countries that measured better than Austria.
  6. Good Nourishment Rates
    Austria’s undernourishment percentages are low compared to the world average. In both 2000 and 2016, Austria’s prevalence of undernourishment was measured at 3 percent of its population. Currently, 10.6 percent of the world’s population is undernourished. This is once again, a place where nutritionally speaking, Austria is doing very well compared to other nations, but progress can continue to be made.
  7. 7. Food Security
    According to the Global Food Security Index, Austria ranks 14th in the index of the most food-secure countries in the world. Though in 2014 it was ranked as second, 14th still shows that Austria is still very food secure in comparison to most of the world. Affordability of food is Austria’s highest score, ranking 8th in affordability.
  8. Food Quality
    According to Oxfam, Austria ranks 4th overall on their list of 125 countries and their performance in the realm of supplying enough well quality food for its people. Austria was only ranked lower than France, Switzerland and the Netherlands. Providing enough to eat, as well as providing high-quality food boosted Austria into the 4th place ranking.
  9. Water Quality
    Water in Austria is perfect. Austria provides 100 percent safe drinking water to 100 percent of its people. The water quality in Austria is superb as Austria has very strict environmental protection laws. Clean water is necessary for a healthy diet for many reasons, one of them being that the quality of food that can be provided to a population is dependent on the quality of water that went into the process of growing that food.
  10. ADA Efforts
    The ADA is doing its part in aiding countries that struggle with doing the same for their own populations. The ADA aids in water sanitation projects in countries such as Albania and Uganda. Not only are Austrian’s governmental agencies aiding in the fight for universal clean water, but NGOs such as CAREAustria are aiding in the fight as well. For example, CAREAustria has helped bring sanitation technology to parts of Ethiopia that have been damaged by violence and turmoil.

Hunger and Nutrition in Conclusion

As represented by the facts above, Austria does have some flaws within its fight against poor nutrition and hunger. High import rates and less sustainability is a problem, as is consuming too many unhealthy nutrients. All of these problems can be fixed by including both rural and urban populations in decision-making processes, as well as educating the populations on what a healthy diet looks like. And with the progress Austria has already made in providing high-quality food and water, as well as very affordable food prices, there does not seem to be a reason the progress Austria has made in the fight against hunger and poor nutrition won’t continue.

Kurt Thiele
Photo: Flickr

Top 10 Facts About Hunger in Slovakia

Slovakia is a country located in Central Europe. It shares its borders with Poland to the north, Hungary to the south, Austria and the Czech Republic to the west and Ukraine to the east. In July 1993, Czechoslovakia split into two independent states: Slovakia and the Czech Republic. From the beginning of its time as an independent state, Slovakia has taken steps to eliminate hunger even though the country suffers from high rates of poverty. In the article below, the top 10 facts about hunger in Slovakia are presented.

Top 10 Facts About Hunger in Slovakia

  1. In 2018, Slovakia ranked 16 out of 119 countries on the Global Hunger Index scale. It has a score of 5.0 which means that its hunger level is very low. In fact, hunger levels in Slovakia are better than in Russia, which has a score of 6.1.
  2. Less than 10 percent of the population in Slovakia are considered malnourished. According to the Global Hunger Index (GHI), about 5 percent of Slovakians are lacking adequate food. The graph shows that hunger levels have been consistently dropping since the year 2000.
  3. The number of people who are considered undernourished in Slovakia is at 2.7 percent. Undernourishment has been declining since 2001 when it hit its peak at 6.7 percent. Even though Slovakia does not suffer from a hunger crisis, they still have to deal with other issues relating to food security and malnutrition. Changes in economic life have led to increased food prices, less spending money for the general population and groups of nutritionally-vulnerable people. Furthermore, changes in the economy have led to difficulties in food distribution. This is a very unique problem regarding the Top 10 Facts About Hunger in Slovakia.
  4. In Slovakia in 2011,  61.8 percent of adults were overweight. Men have higher rates of being overweight in Slovakia in comparison to women. Just under 69.6 percent of males are overweight in Slovakia while 56 percent of women are overweight. By the year 2030, it is estimated that the obesity rate for men will be around 28 percent and, for women,  18 percent.
  5. Agriculture is dominated by large scale corporations in Slovakia, so small, local farms are rare. One major problem is that the youth of Slovakia are uninterested in the farming industry. The Slovak Agency of Environment holds out-of-school environmental programs to increase education and training in agrobiodiversity.
  6. In 2005, there were about 81,500 people working agricultural jobs and more than 59,000 people working in the food industry. A decade later the numbers dropped to 51,000 and 50,200.  In 2016, only one-fifth of companies in the agriculture industry expected growth in their market share. Most of the agricultural companies revenue declined that same year.
  7. Between 2007-2014, milk production in Slovakia fell by 10.7 percent; although milk consumption increased by 17.5 percent. Meat production also fell, beef by 25.4 percent and poultry by 12.1 percent, as the result of a decrease in livestock. However, the consumption of beef, poultry and pork fell as well. The inconsistencies are due to constant changes in EU subsidy programs. “Sanctions against Russia leading to an excess of pork, record-breaking grain harvests, and unresolved problem of milk prices are all factors,” said Jiri Vacek director of CEEC research. This may directly affect some of the most important details about understanding the 10 Ten Facts About Hunger in Slovakia.
  8. In 2016, dairy producers experienced a crisis due to overproduction and low retail prices of milk. As an answer to the problem, the Agricultural Ministry stabilized the industry by supporting employment in dairy farming regions and focusing on a long-term solution. This plan included $33 million of support for milk products. Later that year, 1,760 dairy farmers had joined the project, giving financial support to farmers and providing important information.
  9.  In 2013-2014, subsistence farmers made up slightly less than 50 percent of the total number of vegetables produced. The biggest share of subsistence farmers per vegetable was cabbage at around 24 percent, tomatoes were just below 14 percent and carrots at just below 12 percent. Some of the other vegetables include peppers, onions and cucumbers.
  10. Slovakians do not eat enough fruits and vegetables per capita on a daily basis. The WHO/FAO recommends an intake of 600 grams of fruits and vegetables every day. Slovakians fall short of this number by more than 100 grams per day. Slovakians eat an average of 493 grams of fruits and vegetables per capita per day. This may be a factor in why Slovakians life expectancy falls shorter than the EU average.

Slovakia is considered one of Europe’s biggest success stories. When Slovakia originally separated from Czechoslovakia in 1993, the newly independent nation had an uphill battle to climb. However, a decade later Slovakia has taken major strides in becoming a successful, independent democracy. The country is not perfect, however, as Slovakia’s Romany population still suffers from high levels of poverty and social isolation. These top 10 facts about hunger in Slovakia show that hunger is not seen as a major problem.

Nicholas Bartlett
Photo: Flickr

Obesity in Resource-Poor NationsThe state of physical activity – or perhaps inactivity – is presenting researchers with a new problem in an age of widespread poverty. Over two billion people are currently obese or overweight, globally. Subsequently, one in 10 deaths are the direct result of health issues stemming from inactivity and obesity.

Inactivity in high-income countries is not a novel concept. When there are means of automatic transportation, a market or grocer nearby and a population that has access to vast white-collar work opportunities, inactivity – and its resulting obesity – existing at an elevated rate is not suspect. However, obesity in resource-poor nations is now concerning global leaders. When a country cannot afford basic needs without help, how will it deal with increased healthcare costs associated with poor health?

Brazilian researcher, Dr. Pedro C. Hallal, recently sought out to answer just how inactive the world is becoming. In 2012, Hallal compiled answers to 155 population surveys from 122 different countries, with the purpose of collecting data about people’s general health and lifestyle choices. What Hallal discovered was that severely impoverished countries, like Swaziland and Dominican Republic, ranked at the top of the list of the most inactive countries, alongside some of the most affluent countries.

According to Hallal’s research, Malta ranked at the very top, with nearly 72 percent of the population reporting high levels of inactivity. However, the Pacific Islands, Middle East and Americas lead the way, generally. For comparison, the U.S. had an inactivity rate of 41 percent. The countries with the most commendable numbers were well under 10 percent; these include Bangladesh, Mozambique, Benin and Cambodia.

Sub-Saharan Africa demonstrates, though, why physical activity is so essential, even when wages and higher living standards cannot be guaranteed. Noncommunicable diseases, such as diabetes and cancer, thrive in resource-poor countries such as Kenya. While these resource-poor nations are having a tough time ensuring a balanced diet, the rapid urbanization of these same countries is compounding the negative health effects and increasing the number of health-related deaths.

A healthy lifestyle ultimately depends on an active one. This does not mean that gyms need to be constructed immediately, nor does foreign aid need to fund exercise equipment before meeting basic needs. Rather, one important thing that can be done is simply encouraging people to be more active. The U.N. has intervened, with its Sustainable Development Goals placing a focus on poor eating choices combined with physical inactivity, and the need to improve the rates of obesity that result from these choices.

However, the solution must be a societal one. Frank Hu, professor of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health, noted that “different countries have different issues… You need to mobilize (their) whole society to tackle the problem… it’s not just a medical problem.”

The benefits of a healthier nation are also not a novel concept. When people are physically active, the heart and lungs experience increased efficiency, cholesterol levels go down, muscles strengthen, blood pressure problems decline and, overall, individuals makes themselves less susceptible to major illnesses. There are no inherent risks in encouraging people to walk a little more and have their kids play outside for 30 minutes, aside from a possible scraped knee or other minor accident.

The rising level of obesity in resource-poor nations should concern the countries experiencing it, along with the countries that are providing foreign aid. While not every nation can adjust the foods available, individuals in resource-poor nations can still make choices about their physical activity in order to prevent obesity. Neglecting to address this issue will only open the door to more medical expenses for countries that cannot afford to run themselves financially. Obesity is preventable, but it takes societal motivation and accountability to help prevent it.

Taylor Elkins

Photo: Flickr

Hunger in Guadeloupe

Guadeloupe is an island and French territory located in the Caribbean. Hunger in Guadeloupe has long been an issue, and that problem has evolved over the past decade.

In 2008, a food crisis struck the Caribbean. Many countries, such as Haiti, had trouble feeding their entire populations. Thousands of citizens from these countries began to riot and protest in the streets, and the Guadeloupean government was worried the same would happen in the island nation.

However, Guadeloupe has an advantage: France. Guadeloupe receives nearly 80 percent of its food as imports. This means that despite tropical issues that affect the Caribbean, the island doesn’t have to worry about feeding its people.

Just a few years after this crisis in 2011, Guadeloupe had an undernourishment level below 5 percent, which is on par with America and many other developed nations. Solving the problem of hunger in Guadeloupe with imports seems like a wonderful answer; however, it doesn’t come without some problems as well.

Guadeloupean people now rely on these imports, urged by the French government to export most of their domestic goods, and their preferences have become based on Western tastes. The problem with a lot of westernized food is that it is full of preservatives and has higher calorie counts than are necessary. Hunger in Guadeloupe no longer refers to undernourishment in the sense of too little food, but instead too little nutrients.

The scientific journal Diabetes and Metabolism found that depending on the particular part of Guadeloupe, rates of obesity vary between 17.9 to 33.1 percent. Another study by Women Health shows that there is an association between low education and low income with obesity. Imports are more expensive than healthy, locally grown fruit. This often causes families to resort to the unhealthy options simply due to cheaper prices.

To help stop this growing obesity rate, the Guadeloupean government must reduce the nation’s dependency on imports by using this rich, tropical farmland to grow fruits and vegetables. The only way they can do this is to work with the French government to encourage them to stop pushing for such great quantities of exports. Not only would this help provide healthier options, but it would help the local economy. More agriculture would provide more jobs to reduce the poverty rate, which is around 12.5 percent.

Scott Kesselring

Photo: Flickr

 Hunger in Dominica
With a GDP of nearly $5.2 million and a population of 72,680 people, the Commonwealth of Dominica is considered an upper-middle income country, according to the World Bank.

While the average citizen does not regularly face hunger in Dominica, many still face malnutrition through the introduction of the Western diet. Approximately 55 percent of all foods consumed in Dominica are imported, which contributes to a calorically dense, yet nutritionally weak diet and increases in diet-related non-communicable diseases like obesity.

The World Health Organization (WHO) and local clinicians alike have identified obesity to be a persistent issue for the island country, with clinical data estimating 24.8 percent of adolescents to be overweight and 9.1 percent obese in 2016. The WHO has enlisted a series of nutritional initiatives and campaigns to reduce obesity through nutrition counseling and promotion of unprocessed foods. Domestic agriculture and fisheries production contribute significant food culture and nutrition value for the population.

Dominica is also especially susceptible to natural disasters due to its location in the Caribbean. Hurricanes and tropical storms can severely stunt the island nation’s food production, as seen in the aftermath of Tropical Storm Erika in 2015. The Agriculture Minister at the time, Johnson Drigo, reported over $200 million in damages to Dominica’s agricultural sector months after the tropical storm had passed.

The Food and Agriculture Organization (FAO) has contributed much to the literature surrounding nutrition security in Dominica, as well as measures to improve it. The FAO and the government of Dominica have agreed to collaborate over the 2016 to 2019 timeframe in three primary categories: food and nutrition security, agricultural health and food safety; risk management, building resilience to climate change; and sustainable rural agricultural development.

For instance, the FAO aids Dominica’s National School Feeding Program in connecting school lunch programs to local farms and in improving nutrition education among students. The FAO also recognizes that domestic agriculture and fisheries production contributes significant food culture and nutrition value for the population.

When it comes to natural disaster relief, the FAO invests in the short-term, emergency recovery efforts of small farmers and supports long-term, emergency relief planning and agriculture disaster risk management.

While hunger in Dominica may not be the most pertinent issue in the country’s food security, the key to minimizing hunger, obesity and malnutrition alike may lie in improving sustainable nutrition development and in preserving and protecting local agriculture in light of natural disasters.

Casie Wilson

Photo: Flickr

Poor Health in the Pacific Has Hope
The World Health Organization has identified nine out of the top 10 most obese nations as being located in the Pacific. Within these nine nations, rates of obesity range from 35 percent all the way up to 50 percent.

Obesity measurements are calculated by looking at an individual’s BMI, or body mass index. Pacific islanders naturally have a larger build than people of other ethnicities. This is the case because, at one time, people from this region were forced to endure long and difficult journeys at sea. People able to store enough energy in the form of fat were more likely to survive, and evolution selected for these genes. However, this genetic component still does not explain all of the obesity rates.

What does help to explain this epidemic is the increasing number of foods that are being imported to the islands. Traditional tropical diets included an abundance of fresh produce and fish, but these foods are now replaced with more processed foods, which provide a cheaper alternative. One World Health Organization worker and Fijian native even noted that “it’s cheaper to buy a bottle of coke than a bottle of water.”

Additionally, urbanization and increasing numbers of office jobs contribute to poor health in the Pacific. Historically, many jobs such as fishing and farming included a great deal of physical activity. However, as more people begin to drive to work in offices, physical activity is greatly reduced.

This obesity academic is exhibited in children as well. Roughly one in five Pacific children are obese, and diabetes is a constant concern for children as well as health services who struggle to meet increasing demands.

Despite these unfortunate circumstances, there is still much hope for improving health in the Pacific. Members of the World Health Organization are confident that higher taxes on soft drinks, controlled marketing of products aimed at children and general promotions of a healthy lifestyle can help to turn things around.

Additionally, Australian researchers recently found an issue with the way that the rates of Type 2 diabetes were being measured in the Pacific. Essentially, blood glucose levels measured in the first phase of the survey were mistakenly compared to plasma levels in the follow-up portion of the survey. This caused rates to become inflated to nearly twice their actual value.

It was originally believed that Samoa experienced a 24.3 percent increase in diabetes from 2002 to 2013 when the actual increase was less than 3 percent. Tonga was thought to have experienced a 12 percent increase when diabetes rates actually decreased by three percent. Clearly, a recalculation may be required.

Although this inflation certainly does not mitigate the entire health crisis occurring in the Pacific islands, it does mean that at least rates of diabetes may be lower than was previously thought. Further steps to improve health in the Pacific will need to include conscious efforts on behalf of national governments, health organizations and citizens to strongly promote healthy living.

Nathaniel Siegel

Photo: Flickr

Top Diseases in Kiribati
Kiribati is stricken with a hefty mix of diseases that are communicable and non-communicable. The top diseases in Kiribati resulting in death are circulatory, parasitic, nutritional and metabolic disorders. The leading causes of health complications are fungal, respiratory and diarrheal infections.

Life expectancy in Kiribati is the second lowest in the Pacific, with females at 69 years and males at 64 years. Factors contributing to Kiribati’s increased burden of disease are overcrowding, poor hygiene, inadequate sanitation, insufficient immunization coverage, as well as a lack of care and supplies for maternal/neonatal health.

Water-borne illnesses are among the top diseases in Kiribati. The primary infections being diarrhea, dysentery, conjunctivitis, rotavirus, giardia and fungal. These diseases are most threatening to children, causing 60 deaths per 1,000 live births in children under five.

The prevalence of water-borne illness plagues Kiribati mostly due to sanitation issues. Unfortunately, unsafe water is only part of the problem, improper food handling and the continued sale and consumption of expired foods only adds to the cycle of parasitic diseases.

Once a contagious disease has planted itself on the island, it becomes hard to contain because of the high density living arrangements of most communities. For example, Kiribati is one of only four countries in the world that still has leprosy, the number of contraction reaching 180 last year in 2015.

Tuberculosis (TB) is another top disease in Kiribati. TB remains rampant in Kiribati because it is easily spread and can remain dormant for long periods of time. However, disease begets disease. A burdened immune system makes it harder to prevent and treat other diseases. Not surprisingly, the magnitude of diabetes in Kiribati contributes largely to the continued occurrence of TB.

Lifestyle choices, or ignorance of health, feeds the expansion of diabetes, making it one of the top diseases in Kiribati. The majority of I-Kiribati fit into a profile at high risk for diabetes: high blood pressure, obesity, lack of exercise, poor nutrition and smoking. Already, 25 percent of the adult population is receiving treatment for diabetes or pre-diabetes, with numbers growing each year.

Smoking and diabetes are a deadly combination progressing towards a failing circulatory system, resulting in limb amputation and other disabilities. The rate of amputation in Kiribati is increasing at an alarming rate. In 2014, there were 136 amputations, nearly doubling that of the previous year.

Tobacco consumption is a risk factor for diabetes, but smoking also carries its own army of diseases such as respiratory infections, stroke, cancers and circulatory problems. Kiribati’s tobacco consumption is the highest in the South Pacific as 61.5 percent of its population smoke.

Like with combating most diseases, the key to success in ending the cycle of disease in Kiribati is awareness and prevention. The government of Kiribati, along with support from the World Health Organization have implemented plans to heighten the awareness of communicable and non-communicable diseases.

The goals for these programs are to reinforce good hygiene, improve water sanitation services, increase standard immunizations, educate citizens on the harmful effects of smoking, as well as informing them on the benefits of exercise and good nutrition. As awareness spreads and prevention occurs, there will be a decline in top diseases in Kiribati.

Amy Whitman

Photo: Flickr

Public Health Challenge: Combating the Top Diseases in Estonia
A member of the European Union since 2004, Estonia is among the wealthiest nations in the Baltic region. Likewise, the country has a modern health system that can reasonably support its population of 1.3 million.

Almost all Estonians are covered by health insurance, and the greatest menaces to public health, like heart disease and cancer, are characteristic of a developed country.

Nonetheless, more than one in five Estonians lives below the poverty line and are especially at risk for certain health problems that are prevalent in the country. Here are some of the top diseases in Estonia and what is being done to combat them.

HIV/AIDS

While the death toll from AIDS is dwarfed by that of heart disease and cancer in Estonia, the country has the highest prevalence of HIV in all of Europe. Around 1.3 percent of the population carries HIV, comparable to rates in Sierra Leone or Mali.

The first case of HIV was diagnosed in 1988, and the rate of incidence remained minuscule until the turn of the century. According to a report by the World Health Organization (WHO), the disease exploded in 2000, mostly among drug users.

Since then, the incidence rate has declined, but still more cases are reported each year. Epidemiologists have found that heterosexual transmission has increased in recent years, adding to the more than 9 thousand Estonians who have been infected.

Estonia has seriously grappled with HIV/AIDS for decades. All treatment for HIV-positive patients is free, and education about the disease is standard in Estonian classrooms. Some trends have epidemiologists in the country hopeful: according to UN AIDS, both safe sex practices and HIV testing are on the rise among Estonians.

Tuberculosis

Like AIDS, tuberculosis is not one of the major killers in Estonia, but the disease poses complex challenges for the country’s health system. Estonia has one of the highest multi-drug resistant tuberculosis burdens in the world. In many ways, tuberculosis in the country is tied to the issue of HIV: the prevalence of TB/HIV co-infection in Estonia is one of the highest in Europe at 15 percent.

Beyond people who suffer from AIDS, tuberculosis also particularly threatens Estonians who use intravenous drugs or drink heavily — a population that reports from WHO suggest could be large.

The rate of tuberculosis incidence is decreasing, indicating that Estonia is winning its battle against the disease. But according to WHO, as the incidence decreases, new challenges will arise. As the issue shrinks in magnitude, political and financial commitment may also dwindle — something that Estonia’s government must avoid if the disease is to be defeated in the country.

Obesity

There is still controversy over whether obesity is actually a “disease,” but reports and data on public health in Estonia have outlined it as a clear issue. Sources disagree, but 2014 research from the University of Tartu found that as many as one in three Estonians are clinically obese (a body mass index of over 30).

Obesity can greatly increase the risk of a myriad of health issues, including diabetes, heart disease and stroke. Heart disease and stroke accounted for nearly half of all deaths in Estonia in 2012 (48 percent), so many physicians believe the issue should be taken seriously as one of the top diseases in Estonia.

The issue may be correlated to modernization. WHO estimates that nearly half of Estonian adults are insufficiently active, while salt intake is growing.

Obesity is not an easy issue to tackle, but growing scholarship and research on obesity has helped Estonia assess its magnitude and effects. In recent years the government has implemented some policies to promote consumer awareness and healthy eating habits in schools.

Estonia faces unique but surmountable public health challenges. The government likely has the means to solve such issues, and the nation, therefore, serves as a good example of how funding is not the only weapon fights like these; there must be political attention, commitment and patience. Coming years will tell the extent Estonia’s diligence in the realm of health, and likely provide valuable lessons for nations facing similar issues.

Charlie Tomb

Photo: Flickr

Obesity and Malnutrition
In 2014, more than 1.9 billion adults were overweight, and more than 600 million of these adults were obese. While we may often associate the epidemic of obesity with the developed countries, it has spread to the developing world as well.

There is a “double burden” of obesity and malnutrition in developing countries. Food that lacks important nutrients but is high in carbohydrates and sugars has become widely available in the developing world for a very low cost. Families that may not have a lot of money often resort to these food options.

This burden of both obesity and malnutrition is particularly evident in urban areas of poverty-stricken countries. The subsidization of agriculture in combination with multinational companies has made the production of foods with refined fats, oils, and carbohydrates cheap and widely accessible. Furthermore, more than 50 percent of low-income countries lack recommendations for food and beverage consumption.

In March 2015, the World Health Organization (WHO) released a guideline for sugar intake. While this is a step in the right direction, there is still more work to be done.

Potential solutions include taxations of high sugar content products, restrictions in marketing these products, and food industry regulations.

It is essential that the developing world does not repeat our mistakes. More importantly, it is not acceptable for developed countries to supply cheap, low-quality food simply for profit. There is a global accountability and responsibility that accompanies the rise in globalization.

Iliana Lang

Sources: NIH, The Lancet, Oxford Journals, Food Navigator

Photo: Flickr