Posted: March 10th, 2024

Leading Health Risks in High-, Middle-, and Low-Income Countries

Leading Health Risks in High-, Middle-, and Low-Income Countries
1. Introduction
Given the wide disparities in economic conditions and human health that exist around the world, studying leading health risks in different income countries has become very crucial. The type and level of health risks vary widely between high-income countries (HIC), middle-income countries (MIC), and low-income countries (LIC). It is also a well-known fact that HIC, MIC, and LIC face different types of health risks. The higher income countries deal primarily with non-communicable diseases. On the other hand, low-income countries have been facing the burden of communicable diseases for a long time. However, with globalization over the past few decades and increasing incorporation of less-developed countries into the world economy, it is now recognized that even the high-income countries are not immune to diseases that traditionally have been found in the low-income countries. On the other hand, there are some diseases that have not been traditionally found in the lower income countries but due to globalization and increasing integration of economies with one another, the hazards of such diseases spreading to these countries are becoming real, posing real threats to human health and destroying the economies and the quality of life. In the past, most of the public health research and strategies focused on national and local health challenges. This was mainly because the long distances and the practical difficulties of global health research and intervention were a major obstacle to overseas collaboration. However, with technological advancements and a significant reduction in air travel costs, global health research and intervention has become much more practical and affordable. Also, the fact that the world has become a global village and more and more people are traveling and coming as visitors to the higher income countries, researchers and policymakers can no longer afford to ignore problems that face the poorer countries that have been mentioned above. In fact, now it has been realized that addressing global health challenges is very important to protect the health of the people in the higher income and lower income countries.
1.1. Definition of high-, middle-, and low-income countries
Overall, it is crucial to study the leading health risks in different income countries because solutions and remedies need to complement the entire socioeconomic structure of a country. Caused by and causing a myriad of problems – some relating to societal issues while others result from genetic, environmental, and lifestyle factors – it is necessary to investigate each problem in specific income countries to aid the proposal and implementation of effective policies and interventions. By doing so, better equalizing the standard of healthcare throughout the world is just a measure away.
Lastly, low-income countries are those with a GNI per capita of $1,025 or less. Such nations are commonly in Africa and Asia, and are faced with a high burden of communicable diseases and poor maternal and child health. In these countries, health services are often insufficient and access to clean water and proper sanitation is limited. Examples are Bangladesh, Uganda, and Niger.
Middle-income countries, on the other hand, are nations with a GNI per capita between $1,026 and $12,475. These countries are faced with a dual burden of disease – the variety of non-communicable diseases that come with increased industrialization and urbanization, as well as persistent communicable diseases. India, Indonesia, and Egypt are some of the countries that fall into this category.
High-income countries are those with a gross national income (GNI) per capita of $12,476 or more. It is important to note that high-income countries are generally well-equipped with healthcare infrastructure and resources for the diagnosis and treatment of various diseases. Examples of countries in this category include the United States, Canada, Germany, and Australia.
1.2. Importance of studying leading health risks in different income countries
Studying leading health risks in different income countries is crucial because it provides a clearer understanding of the global burden of diseases and how various healthcare systems are coping with different health issues. Such studies will also provide insight into the varying levels of healthcare facilities and expertise in different countries and can help to formulate effective strategies for healthcare provision. Knowing the different health problems across the world will guide the international efforts in tackling major health issues and work towards reducing disparities, which will finally help to improve health for everyone and promote international development. Also, it can be seen that there is a trend of increased percentage of deaths from non-communicable diseases in people of low and middle-income countries, as a result of urbanization and changes in lifestyles. By understanding different levels of health problems and how they change, it will make it much easier for professionals to identify patients’ needs and give them effective support. Regular checks for health risks specific to the income country in which the patient is residing can be implemented, which can diagnose illnesses in early stages, save resources, and more importantly, save lives. Moreover, as the progress of technology, the world is becoming increasingly interconnected than ever before. It will be easier for different income countries to share information on health issues and successes in medical science. This international approach in understanding health risks and research will not only increase our global knowledge but also provide the opportunity to learn from others’ work and lessen the unnecessary repetition of mistakes. By recognizing the different economic and social factors, paying attention to the specific conditions in each income country, and reviewing them systematically, global health can be improved efficiently and underpin the further social and economic advances in the world.
2. Leading Health Risks in High-Income Countries
While the life expectancy at birth is lower in low-income countries relative to high-income countries, the variation in the risks of dying is higher for high-income countries than for other countries. In terms of the leading health risks in high-income countries, cardiovascular diseases is at the top of the ranks. Over the period of many years, the rate is extremely high, like 26% to 31% for women and 27% to 32% for men. The main type of cardiovascular diseases is blood vessel diseases. This kind of disease can lead to even more serious diseases, including heart disease, stroke, and high blood pressure. Cancer holds the second rank of the leading health risks. There are over 100 different types of cancer, and each is classified by the type of cell that is initially affected. Mental health disorders are the health risk of great concern in high-income countries. According to this work, about 35% to 40% with a mental disorder do not receive proper treatment. Substance abuse might seem to be less common in high-income countries. However, according to the statistical data, the problems of substance abuse are just as severe as the other diseases. Every year, an estimation of thousands of people are killed as a result of drunken driving or accidents related to substance abuse. Substance abuse not only affects the performance and behavior of the patients, but also can cost the country a great deal of money every year in terms of medical expenses. This kind of disease can lead to even more serious diseases, including heart disease, stroke, and high blood pressure. Cancer holds the second rank of the leading health risks. There are over 100 different types of cancer, and each is classified by the type of cell that is initially affected. Mental health disorders are the health risk of great concern in high-income countries. According to this work, about 35% to 40% with a mental disorder do not receive proper treatment. Substance abuse might seem to be less common in high-income countries. However, according to the statistical data, the problems of substance abuse are just as severe as the other diseases. Every year, an estimation of thousands of people are killed as a result of drunken driving or accidents related to substance abuse. Substance abuse not only affects the performance and behavior of the patients, but also can cost the country a great deal of money every year in terms of medical expenses.
2.1. Cardiovascular diseases
Cardiovascular diseases, encompassing heart diseases and stroke, are the leading cause of death in high-income countries. According to the World Health Organization, an estimated 80% of all global cardiovascular disease deaths occur in low- and middle-income countries, but there is still a need to keep these diseases in check in high-income countries. The high prevalence has been attributed to the rich, western dietary habits and low levels of physical activity. Population-based preventative strategies such as reducing salt intake in the population and promoting physical activity can help lower the risk factors. Legislation efforts have also been made to encourage healthy living. For example, in the UK, the government began the ‘Responsibility Deal’ in 2011 which is a programme aimed at reducing the burden of chronic diseases. Initiatives on food such as reducing salt and encouraging companies to offer more healthier options became part of the deal. High cholesterol, raised blood pressure, and smoking are key risk factors in suffer in high-income countries, although research has shown that the number of heart attacks and stroke in the UK are continuing to fall. This may be because of improved treatments with help from the British Heart Foundation. An estimated 42,000 lives have been saved over a decade, but the foundation emphasizes that more people need to survive. The concept of risk transition involves shifts in the population in terms of what the main health problems are due to changes in the risk factors over time. For example, in high-income countries, increasing life expectancy as a result of social and economic development will cause a rise in age-related diseases like heart diseases. Such a rise in cardiovascular diseases is also seen in middle and low-income countries where there is fast and cruel change caused by urbanization, sedentary lifestyles, and the nutrition transition to high-calorie foods. Health policies in high-income countries tend to focus on primary prevention, that is preventing diseases before they start in order to reduce the number of people getting sick. This is because the countries tend to have developed health systems so there are resources set aside for preventative activities. For example, on the 6th of July in 2018, the National Health Service in the UK launched the ‘We Are The NHS’ campaign aiming to recruit a range of primary care staff such as nurses and pharmacists. This campaign highlights the duty for communities.
2.2. Cancer
Cancer is caused by a combination of genetic, environmental, and lifestyle factors that can cause cells in the body to grow and reproduce in an uncontrollable way. There are over 200 different types of cancer, and each is diagnosed and treated in a particular way. However, the common factors for the most lifestyle-caused cancers – such as lung, bowel, breast, and prostate cancer – are well known. These are high alcohol intake, a bad diet, and smoking or chewing tobacco. In the United States, up to 30% of all cancer deaths are attributed to tobacco. In addition to this, obesity is thought to be responsible for the development of at least five other types of cancer – these include cancer of the breast and liver. This is particularly relevant today as in recent years the number of people who are obese has increased rapidly, leading to warnings from Cancer Research UK that obesity will soon overtake smoking as the most common cause of cancer in the UK. Infection is another significant cause of cancer worldwide, responsible for around 22% of cancer deaths in the lowest income countries. This can be contributed to factors such as the absence of information, vaccines, and screening programs. One of the global health targets of the United Nations is to reduce the deaths caused by cancer by a third. However, researchers are still being faced with the dilemma of balancing the improvement of diagnosis and treatment in high-income countries with the funding of preventative measures in low-income countries. This is because the majority of cancer cases are diagnosed in higher-income settings, where it is easier to provide support and treatment and therefore more likely that funding for further research and care will be donated. However, the prevalence of risk factors in less wealthy countries and the lack of access to information, vaccination, and screening programs almost guarantees an increase in the number of people diagnosed and dying from cancer in the future.
2.3. Mental health disorders
In high-income countries, mental health disorders are one of the leading health risks. They are characterized by alterations in thinking, mood, or behavior associated with significant distress and impaired functioning. Mental health disorders are a diverse group of diseases, including depression, bipolar disorder, dementia, schizophrenia, and anxiety disorders. High levels of stress from any cause, be it family or job-related or from a traumatic event, can trigger a mental disorder. The risk for the disorders is particularly high in certain age groups. For example, depression affects a large proportion of the younger population in high-income countries. This can directly decrease the ability of young people to acquire an education and pursue a career. Besides, mental health disorders can also result in economic consequences. Not only do mental disorders cause suffering, but irrational and often dangerous behavior coming from the disease can lead to chronic physical illnesses. It can also decrease an individual’s ability to stay employed. For a said country like the United States, the total spending on mental health services reaches about 80 billion dollars a year. This includes various mental procedures as well as over 20 million prescribed doctor visits every year. However, many of those suffering from mental disorders do not actively seek professional help so the real numbers of those needing medical attention may be even higher. The stigma around mental health-related diseases in high-income countries can prevent those who truly need medical and social attention from seeking help. The reason for having so many mental health services and such high spending in many post-industrial nations has to do with many factors. Treatment usually requires regular contact with a doctor and prescriptive drug and often both psychotherapy and medication will be utilized. Work in the neurosciences and the development of new drugs have helped wet a positive shift in the growing field of evidence-based mental healthcare. I believe as time goes on and society becomes more informed, mental health will be looked upon with a more serious attitude and receive the proper attention necessary for the managing and ultimately the treating of the disorders.
2.4. Substance abuse
Countries generally classify drugs and alcohol into different categories according to their potential for abuse. The Substance Abuse and Mental Health Services Administration (SAMHSA) in the United States, for example, makes a distinction between illicit drugs, alcohol, and the misuse of legally manufactured substances. According to a brief by the SAMHSA, the term ‘substance abuse’ is frequently used to refer to the use of illicit drugs, however it can also relate to the misuse of alcohol or prescription medication. This is why ‘substance abuse’ is currently referred to in the new DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) as ‘substance related and addictive disorders’. This new definition not only presents a shift in the way that the medical profession views substance abuse but it also manages to broaden the concept itself. According to the DSM-5, in order for a behaviour to be classified as ‘addictive’, it must be compulsive and lead to an adverse effect. Random drug testing is often an integral aspect of an individual’s restraining order or probation conditions. Many attorneys advise their clients to regularly document themselves taking the drug test, to prevent false claims of skipped testing. Many courts have regulations as to what type of drug tests may be used; some will permit hair follicle drug testing while others may not. Such measures are common for those serving in certain capacities of the law, be it parole officers, judges, or police personnel. Alcohol and some drug addiction behavior can prompt the bringing forward of ‘involuntary commitment’ forms. These forms vary from state to state, but the overall concept is that concerned individuals close to the patient can apply to have them admitted into a facility where they can receive help, evaluation and the proper treatment. The level of impairment that a person may suffer could very much determine whether or not the application is successful.
3. Leading Health Risks in Middle-Income Countries
In middle-income countries, the leading health risks are infectious diseases, maternal and child health issues, non-communicable diseases, and environmental health risks. These countries often struggle with a combination of infectious diseases and emerging non-communicable diseases, along with health risks associated with their environments. Middle-income countries are also known as emerging economies and have a gross national income per capita between $1,036 and $12,475. Some examples of middle-income countries include China, Brazil, Colombia, and South Africa. These countries are going through a process called epidemiological transition, where the disease burden shifts from infectious diseases to chronic diseases, usually due to changes in lifestyle and socioeconomic factors. However, this transition is not always smooth and many middle-income countries face what is known as a “double burden” in the area of public health. On the one hand, they continue to grapple with the challenges posed by infectious diseases and, on the other hand, have to deal with an increasing prevalence of non-communicable diseases. Some examples of middle-income countries include China, Brazil, Colombia, and South Africa. These countries are going through a process called epidemiological transition, where the disease burden shifts from infectious diseases to chronic diseases, usually due to changes in lifestyle and socioeconomic factors. However, this transition is not always smooth and many middle-income countries face what is known as a “double burden” in the area of public health. On the one hand, they continue to grapple with the challenges posed by infectious diseases and, on the other hand, have to deal with an increasing prevalence of non-communicable diseases. Some non-communicable diseases are caused by lifestyle factors such as smoking, consuming food and drink with high sugar levels, and a lack of physical activity. It is tempting to think that as soon as a country reaches high-income status, the focus of public health should shift towards addressing non-communicable diseases. However, this assumes that the policies and interventions necessary to reduce rates of these diseases are already in place and that the serious inequalities in terms of economic and healthcare resources have been, in some way, resolved. This is far from reality at the moment and it would be dangerous and misguided to ignore the issue of infectious diseases purely in anticipation of future health challenges. So, in contrast to high-income countries, middle-income countries face a more complex landscape of health risks and it is essential that these are taken into account when developing public health policies and interventions that are tailored to their specific circumstances.
3.1. Infectious diseases
Infectious diseases are the leading health risk in middle-income countries. With a growing, more mobile population and greater interaction between the three income groupings, their potential to cause global health problems is becoming more pronounced. New infectious diseases are emerging and old ones are appearing in new locations around the world. For 500 years, the fastest-growing disease family and have resulted in widespread political regional disparities in public safety and human health, fueling a demand for new initiatives, research, and information. In more affluent countries, the rise of non-communicable diseases, such as cancer and heart disease, means that cancer deaths and new cancer cases are more prevalent in upper middle-income countries. Non-communicable diseases like diabetes and heart disease are so common now that they are no longer regarded as a lethality. Middle-income countries are experiencing a transition, where non-communicable diseases are rising due to an epidemiological transition. This is when the population’s health structure shifts from a focus on managing infectious diseases to non-communicable diseases, due to the population advancing and general health services improving. The rates of infectious diseases in middle-income countries have dropped. Middle-income countries are those with higher numbers of people infected and those that can fund control strategies, such as South Africa. However, those often neglected in research and control strategies are most affected; lower middle-income countries. Such countries have the second highest number of infectious cases in the world but have fewer resources allocated for research and healthcare. In lower-income countries, healthcare has to be made affordable for the large majority living in poverty. High technology healthcare is often overlooked in favor of basic public health needs. This may reflect an emphasis on healthcare as only a solution when diseases have reached an incurable stage. As a result, infectious diseases continue to persist due to poor housing, inadequate quality or supply of food, lack of sustainable, clean water, pollution, and so on.
3.2. Maternal and child health issues
Middle-income countries continue to struggle with high maternal mortality rates and under-five mortality rates compared to high-income countries. The leading causes of maternal mortality include postpartum hemorrhage, complications from delivery, and hypertensive disorders in pregnancy. These issues are likely linked to various barriers that women face in accessing and utilizing maternal healthcare services. For example, a study on 18 middle-income countries found that two-fifths of pregnant women did not complete the recommended four antenatal care visits. In addition, about 73% of births in the households of the poorest 20% of the population were not attended by skilled health personnel, compared with 10% of births in the households of the richest 20% of the population. This discrepancy in care for different groups of women can contribute to negative birth outcomes and maternal mortality. In a similar manner, under-five mortality is often associated with preventable and treatable conditions such as pneumonia, diarrhea, and malnutrition. It is suggested that limited access to primary healthcare services and the lack of skilled birth attendants may contribute to mortality among young children. The evidence shows that international funding for maternal and child health has increased over the past few decades, and, as in the case with vaccinations to prevent infectious diseases, the implementation of community-based health interventions in some middle-income countries has led to substantial improvements in reducing high maternal mortality rates. However, it remains a challenge to ensure that these countries allocate resources effectively and sustainably to improve maternal and child health, as the leading health risks are complex and solutions demand long-term investment and appropriate, evidence-based interventions.
3.3. Non-communicable diseases
Non-communicable diseases (NCDs), also known as chronic diseases, are not passed from person to person. They are of long duration and generally slow progression. The four main types of non-communicable diseases are cardiovascular diseases (like heart attacks and stroke), cancer, chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma) and diabetes. Causes of non-communicable diseases are the interactions among genetic, behavioural, metabolic and environmental factors. The main underlying cause for the increasing prevalence of NCDs in middle-income countries is changes in risk factors. Lifestyle choices and behaviours can have a large impact on people’s health. In an increasingly urbanised and globalised world, middle-income populations are more frequently consuming unhealthy and highly processed food that has replaced traditional diets. High in added sugars, fats and salt such as fast foods and carbonated drinks are leading to an increase in conditions like obesity, hypertension and heart disease. Furthermore, NCDs are placing a heavy burden on the middle-income countries from a financial perspective. It is estimated that over 80% of deaths due to NCDs occur in middle-income countries. Most notably, NCDs pose social and economic challenges, especially in the poorest and most vulnerable communities where the diseases are more frequently associated with the elderly. These individuals may face long-term disability, reduced capacity to work and require costly medical treatment which can easily push them further into poverty. In a world that is rapidly evolving and adapting to new technology and ways of living, it is essential that public health policy also adapts to take into account the growing burden of NCDs in middle-income countries. Such challenges bring about the need for a vigilant assessment of our healthcare workforce and infrastructure, understanding risk factors of living longer and the effects an increasingly globalised world can have on the health of middle-income populations.
3.4. Environmental health risks
But environmental health risks in middle-income countries, such as China, are very different in nature. This is because environmental health risks’ main focus is on how the environment affects the risks of disease and death in a community, particularly in the developing world. Soil and water pollution, inadequate sanitation and poor air quality are responsible for millions of deaths each year. In Bangladesh, air pollution caused 37,000 deaths in 2004. High population pressure leads to unplanned housing, deforestation, urbanization, and overuse of agricultural and industrial chemicals that in turn give rise to a wide range of environmental health problems. In MEDCs, however, environmental health risks tend to be more about lifestyles. For example, thanks to increasing prosperity in countries such as Britain, people are more likely to eat foods that are high in fats and sugars. This, in turn, leads to problems such as obesity and heart disease. Also, men and women are having fewer children and having them when they are older. Again in the UK, the average age of a woman when she has her first child is now over 30. However, the negative side of this trend is that older pregnancies are more likely to result in complications both for the mother and the child. And studies have shown that if ‘mum’ smokes during pregnancy, the child is more likely to have ADHD. On a local level, environmental health risks in MEDCs often revolve around the impact of planning, decision making, and scientific research. For example, the way in which towns and cities are developed can raise issues about how best to use space. Industrial letting rights are an important issue, as is the impact that pollution from traffic has on housing and how best to tackle illnesses caused by the environment such as radiation sickness. Environmental health, apart from the term being so wide and diverse, is considered as an evolving and dynamic science, which is at the forefront in the investigation of new clues on the global issues that surround world health and unnatural situations. It is considered as a very important tool in taking a precautionary, preventive approach to any health risks that might be caused in this world by humans and the environment.
4. Leading Health Risks in Low-Income Countries
Pose and define what you are studying and make a coherent series of points to discuss a group of interrelated issues. Well-structured and fluent writing and the use of paragraphing help you to put forward and develop your ideas. Writing may be rather too complex for your level: this is fine as long as it is clearly written. Well-argued response in a formal, academic style, using sentences of varying length with some grammatical structures and language appropriate to the task. Use technical language and introduce terms and concepts. Use technical language and introduce terms and concepts specific to the focus, such as barriers, stigma, and preventative health strategies.
A UN report revealed that in low-income countries, an average of 6.7 people has access to one doctor. This dramatically falls short of the 2.5 healthcare professionals including doctors, nurses, and midwives per 1000 people recommended by the WHO in order to achieve key health targets as laid out in the Millennium Development Goals for 2015. More than half of the global burden of disease caused by water and sanitation-related diseases is borne by these countries, even though they only account for 12 percent of the global population. This highlights both the vital necessity of access to safe, clean drinking water and effective sanitation and global disparities in access to these utilities. Water and sanitation-related diseases include waterborne diseases such as cholera and dysentery, and other diseases including malaria. It also includes sanitation-related diseases, that is, conditions resulting from a failure in sanitation services, such as soil transmitted helminthiases and schistosomiasis. These two diseases make it into the top 10 leading health risks in these countries with the highest disease burden. However, progress has been made through international programs such as WaterAid, which aims to enable the world’s poorest and most marginalized to achieve access to clean water and sanitation.
The lack of access to healthcare is interlinked with many of the other leading health risks in low-income countries, such as high infant and maternal mortality rates, and shorter life spans. With the highest global burden of disease due to the inability to prevent and treat infectious and parasitic diseases, the pattern of health in low-income countries reflects the inability of governments to provide adequate preventative and curative primary health care services for the whole population.
Malnutrition is another leading health risk in low-income countries and one that affects about 23 percent of their populations. This is because poverty leads to inadequate nutrition and poor sanitation, which in turn exposes people to a cycle of illness. The World Health Organization, WHO, describes malnutrition as the cellular imbalance between the supply of nutrients and energy and the body’s demand for them in order to ensure growth, maintenance, and specific functions. However, while malnutrition includes both undernutrition and overnutrition, the former is a key social determinant of health in these countries. It can lead to other health problems, including low birth weight, rickets, and stunted growth, which often has both short-term and long-term health implications.
Not only low-income countries have a high prevalence of diseases like malaria, tuberculosis, and HIV, but they are also much more likely to be dealing with large-scale outbreaks of emerging and re-emerging infections such as yellow fever and the plague, and even potential global health security risks like avian influenza. Communicable diseases are a major concern in this category of countries due to factors such as poor nutrition, inadequate living conditions, and a lack of access to education. Babies often acquire these diseases from their mothers, often causing premature death among newborns or mothers, resulting in more than half of the global maternal and child mortality being concentrated in these countries.
4.1. Communicable diseases
In low-income countries, communicable diseases are the leading health risk. Communicable diseases, also known as infectious diseases, are illnesses that are caused by infectious agents and can be spread from one person to another. Malaria, tuberculosis, and HIV/AIDS are the most common communicable diseases in low-income countries. These illnesses often require long-term treatment and medication, which can be difficult for people in low-income countries to access due to financial and social barriers. In addition, many of these diseases can be prevented by addressing the environmental and living conditions factors that put people at risk, such as poor housing and sanitation. However, low-income countries often lack the infrastructure and resources needed to implement effective prevention measures and the situations become worse. According to the World Health Organisation, over 36% of global deaths are due to communicable diseases, and 90% of these deaths occur in low-income countries. This statistics reveals the devastating impact that communicable diseases can have within these countries. From a theoretical standpoint, a range of different sociological and environmental theories can explain the prevalence of communicable diseases in low-income countries. However, they are primarily due to the nature of capitalist social systems, such as world-system theory; globalisation and development; and ecology and urbanisation. Capitalist social systems fundamentally discourage the steps to maintain and even improve health and thus, it is those in low-income countries that suffer as their health is not profitable under the current world system. Moreover, globalisation results in free market policies and transnational corporations, leading to more wealth and activities in higher income countries and leaving economically marginalised groups in low-income countries to suffer from having lack of access to health knowledge and amenities. Ecological and urbanisation theories suggest that increases in populations and changes to natural landscapes result in people living in closer proximity to potential disease vectors and reservoirs, meaning that infection can spread rapidly through a population. Modern day and contemporary approaches to disease control within low-income countries often place emphasis on the transmission dynamics of such infections, such as the role of vectors. This knowledge can be utilised to inform interventions that aim to disrupt the chain of transmission and break the cycle of infection within the population. Public health interventions have been successful in using this theoretical framework to tackle diseases. A notable example is the use of indoor residual spraying and the distribution of insecticide-treated bed nets in sub-Saharan Africa to control and prevent the spread of malaria. Malaria is primarily spread by the female Anopheles mosquito, which are known to bite between the periods of dusk and dawn. Through the targeting of mosquito reservoirs and with knowledge on their life cycle, there has been a reduction in disease prevalence and incidence over the past few years and many thousands of deaths avoided. Such strategies are essential as they focus on prevention of the disease rather than just treating it – in low-income countries, prevention is far more effective than treatment, especially in hard to reach communities.
4.2. Malnutrition
According to the World Health Organization, malnutrition is by far the biggest contributor to child mortality and is estimated to be associated with 54% of all child deaths worldwide. Three quarters of these deaths are attributable to severe malnutrition, which is a significant public health problem in developing countries in Africa, Asia, and Latin America. The term ‘malnutrition’ applies to deficiencies, excesses, or imbalances in a person’s intake of energy and/or nutrients. Overall, it is used to refer to both under-nutrition and over-nutrition, but in the context of low-income countries, malnutrition almost always refers to under-nutrition. This, however, can lead to obesity, particularly in populations undergoing a process of nutrition transition, in which a country is changing from a traditional diet to a more western, high-fat and sugar option. Rises in income and urbanization are increasing, and it’s a huge problem in transitioning countries such as Guatemala and Indonesia, where underlying malnutrition in 5% of children is being exacerbated by the intake of cheaper, energy-dense food. Also, since people with obesity can often be malnourished in terms of vitamin and mineral quantity (even though they are eating too much energy), increases in obesity can be considered an increase in malnutrition rates. Very low food security is a term used in the United States to describe a home with such limited access to food that it has been forced to eat foods that they do not want. This is in a country that has an estimated obesity prevalence of 39%, and yet the Center for American Progress reports that 1.5 million households suffer from very low food security. The problem is not just one of food availability but of poverty, with 21% of all children living in poverty. This demonstrates how malnutrition is not just a problem for low-income countries; although the main burden appears to be focused on low-income countries, countries often described as ‘transitional economies’ or ’emerging economies’, some low-income families in high-income countries face considerable malnutrition problems. This is because they suffer from social inequities and health inequalities, which means that often the poorest suffer the most. The effects of under-nutrition in early life can include impaired physical and cognitive development, and such effects are mostly irreversible, affecting those individuals into adulthood. Also, malnutrition is a significant factor in a large number of deaths in children under the age of 5 years old. In 2011, South Sudan reported that 45% of children under 5 suffer from malnutrition, and the country had one of the highest under-5 mortality rates in the world at more than 100 in every 1000 live births. It is also worth mentioning that malnutrition has immediate and long-term effects on health. For example, iron deficiency anaemia – a consequence of malnutrition – is associated with an increased chance of pre-term delivery and a higher risk of foetal mortality and low-birth weight. This highlights the importance of government attempts to try and reduce malnutrition – improving the quality of healthcare and general standard of living as well as the education about food and nutrition. The focus of such a unit would be to provide structured care and work to reduce rates of malnutrition in what is a public health issue in the developing world.
4.3. Lack of access to healthcare
In the absence of easily accessible medical services, the health concerns and complications within any given population will be exacerbated. With no immediate access to medication and medical treatment, non-life threatening diseases, minor illnesses, and mental health issues are left to deteriorate to a critical state – growing into larger, life-threatening conditions and sometimes becoming terminal. For example, in a remote area of a low-income country, people may have to walk over 20 miles to seek medical attention, with the potential need for anti-venom or quick medical intervention for something such as snake bites – this distance and primitive means of transporting a patient could very easily end in the loss of a life. It is well established and factual that in higher income, well-developed countries, with accessible healthcare systems, people on average live longer in good health – in part due to the ability to prevent ill health through screening programs and healthcare management. Furthermore, minimal intervention when a problem arises such as physiotherapy or a simple course of antibiotics effectively prevents the issue from developing into a serious problem down the line. This proactive way of managing health issues is simply not a possibility when people do not have immediate access to appropriate medical procedures or medications. Another issue associated with inaccessible healthcare is that patients with infectious or contagious diseases are left with no other option than to simply “crack on” without any sort of medical isolation or medical guidance. This creates a cycle of prolonged national health issues, as potential epidemics have the freedom to spread rapidly. It also creates unnecessary stigma and personal difficulties for those suffering from contagious conditions; when a course of antibiotics could swiftly return that person back to good health, meaning that they pose no risk to others around them. Finally, in regions without sufficient local medical help, the workload for international aid projects and medical charities can sometimes become overwhelming. This then has the knock-on negative effect of reducing these services in other badly affected areas across the globe, simply because a large importation of the program’s funding and resources has to be plowed into maintaining the people in one region of the world. Coherent with this idea, in low-income countries, aid resources and local medical infrastructure are not sufficient for the size of the population and the number of differing health concerns.
4.4. Water and sanitation-related diseases
Waterborne diseases are the second leading cause of death for low-income countries, after respiratory infections. These diseases, such as cholera, dysentery, typhoid, and polio, are caused by a variety of microorganisms and are spread through contaminated water and poor sanitation. They lead to a large number of deaths, especially among children under the age of five. For example, 900 children die every day from diarrheal diseases linked to poor water and sanitation. Sanitation-related diseases, on the other hand, are contracted due to contact with human feces. Skin, eye, and respiratory infections are among the common types of sanitation-related diseases. Inadequate sanitation can lead to the contamination of water sources, the environment, and food, compounding the health problems due to lack of hygiene and safe water. Populations most at risk of dying from water and sanitation-related diseases are spread out in over 20 countries around the world. These are mainly countries in Sub-Saharan Africa and South Asia, except for Afghanistan. It is really sad to see that those regions of the world with some of the highest rates of maternal, neonatal, child, and adolescent mortality are also the ones that are affected by the biggest inequality in accessing health facilities as a result of diseases associated with inadequate water and sanitation. Although simple preventive measures such as good hygiene, access to clean water, and better sanitation could alleviate a lot of the daily suffering, the inequality gap cannot be tackled without a massive scaling up of investments. Improvements in water and sanitation could lead to economic expansion, increase school attendance, and reduce poverty. Such improvements are more likely to be sustainable if people living in the communities have more choice and ownership in how the facilities are installed and maintained over the long term.