Chapter 79 Health
a global perspective
The world has become a much smaller place as more people travel. Hence diseases spread much faster across national boundaries, as travellers are accompanied by bugs, bacteria and viruses. There were nearly 200 million international migrants (3% of the world’s population) in 2006. Health scares about bird flu and severe acute respiratory syndrome (SARS) have highlighted this global mobility. Patterns in the prevalence of diseases vary by geographical location, for example, the prevalence of HIV is significantly higher in sub-Saharan Africa than in most other regions of the world.
Some use the term ‘international health’ others ‘global health’. The word ‘international’ is defined in terms of crossing national borders, whereas the word ‘global’ encompasses the entire world. We can study different patterns of disease, but also ways of providing health care (see pp. 150–151), and health policy-making. Therefore, it is not just health problems that cross borders or are common to countries around the world; solutions can also cross borders, countries can both learn from each other and also share their own experiences and information.
A developing country tends to have the following features:
The level of development in countries has a direct effect on its population. For example, one of the characteristics of developing countries is their relatively young population; in Europe 20% is under the age of 15, in North America 22%, in Asia 34% and in Africa 45%. They represent the next generation to become sexually active (see pp. 30–31), and will affect the birth rate and population growth.
Current international health issues
There are different patterns of disease between developing and developed countries (Table 1). In high-income countries two-thirds of people live beyond the age of 70 and the main causes of mortality are chronic and non-infectious diseases. In low-income countries less than a quarter of people reach 70 and, although the causes of mortality included coronary heart disease, infectious diseases (e.g. HIV) and complications of pregnancy and childbirth continue to be major causes of death. Governments will need to prioritize (see pp. 154–155) differently to provide the health services needed to combat these different causes of death.
