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Geography of Health


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Geography of Health

  1. 1. Geography of Health By David Mason and       Alec Walmsley
  2. 2. The Geography of Health <ul><li>What is it? </li></ul><ul><li>  </li></ul><ul><li>&quot;The geography of health investigates topics such as </li></ul><ul><li>the pattern and spread of disease.&quot; </li></ul><ul><li>      </li></ul><ul><li>     </li></ul><ul><li>     This takes into account multiple variables and situations on a global scale to find patterns, which would allow for comparison of data between different countries. This could show a countries situation, in terms of both human and physical geography. </li></ul><ul><li>   </li></ul><ul><li>  </li></ul>
  3. 3. The Geography of Health <ul><li>Examples of Patterns </li></ul><ul><li>HIV / AIDS </li></ul><ul><li>    </li></ul>This graph shows, through territory size, the proportion of peole aged 15-49 years who have HIV.           This graph clearly shows the difference that MEDCs have in terms of people suffer in with HIV in comparison with LEDCs.
  4. 4. The Geography of Health <ul><li>Comparison between LEDCs and MEDCs </li></ul><ul><li>LEDC </li></ul><ul><li>     </li></ul>    LEDCs on a whole have a far higher percentage of adults infected with HIV. By far the worst affected area is Africa, with all top ten affected territories in Africa, reaching a high in Swaziland. However, the smaller island nations have negligible numbers of HIV sufferers.
  5. 5. The Geography of Health <ul><li>Comparison between LEDCs and MEDCs </li></ul><ul><li>MEDC </li></ul><ul><li>     </li></ul>    MEDCs on generally have very low numbers of HIV sufferers, for example Australia has one of the lowest rates in the world. There are of course exceptions such as America.
  6. 6. The Geography of Health <ul><li>Comparison with HIV between LEDCs and MEDC </li></ul><ul><li>Genral Pattern </li></ul><ul><li>         </li></ul><ul><li>LEDCs have a higher proportion of people </li></ul><ul><li>  suffering with HIV than in MEDCs. </li></ul><ul><li>But what does this have to do with the geography of health? </li></ul><ul><li>      </li></ul><ul><li>Well....   </li></ul><ul><li>                 </li></ul><ul><li>                 The geography of health then intends to take this general pattern and find more specific reasons to try and explain it. </li></ul><ul><li>         </li></ul>
  7. 7. The Geography of Health <ul><li>Possible Factors for the Pattern. </li></ul><ul><li>Wealth </li></ul>A map to show the relationship between the total GDP of a country with the percentage of adults infected with HIV.$majorMode=map$is;shi=t;ly=2003;lb=f;il=t;fs=11;al=30;stl=f;st=f;nsl=t;se=t$wst;tts=C$ts;sp=6;ti=2005$zpv;v=0$inc_x;mmid=XCOORDS;i
  8. 8. The Geography of Health <ul><li>Possible Factors for the Pattern. </li></ul><ul><li>Wealth </li></ul><ul><li>      The map above showed an obvious relationship between the wealth of a country and the prevalence of HIV. The country's wealth will inevitably have an effect on it's medical development and thus it's ability to help prevent the spread of diseases such as HIV . </li></ul><ul><li>      </li></ul><ul><li>However... </li></ul><ul><li>      The Maldives, which in 2005 only generated 0.8 billion, has one of the lowest rates of HIV sufferers in the world. So there must be other factors. </li></ul>
  9. 9. The Geography of Health <ul><li>Possible Factors for the Pattern. </li></ul><ul><li>Geographical Location </li></ul><ul><li>     This factor is obviously very important  when looking at the geography of health as it gives a rough indication as to the ease of disease transmission. </li></ul><ul><li>  </li></ul><ul><li>    The previous map also showed that there are certain regions of the world where there is obviously a higher risk of being infected with a disease. It would seem that in Southern Africa there is the highest chance of catching the HIV virus and seeing as these places do not generate the lowest total income then it can't just be availablity of wealth that affects this. </li></ul>
  10. 10. The Geography of Health <ul><li>What can be done with this information? </li></ul><ul><li>     These patterns that we see can then be used as a general model, which help to shed light on where a disease is likely to be spread the quickest and so where best in the world to prepare against any possible risks of  epidemics that could potentially affect the whole world if they become pandemics. </li></ul>
  11. 11. Morbidity By Tom Pybus, Anthony Li and Alex Jenkins
  12. 12. Morbidity <ul><li>Definition:  &quot;Also known as  morbidity rate,  the relative incidence of a particular disease in a specific locality &quot; </li></ul>
  13. 13. Morbidity - Influenza Part I <ul><ul><li>Virus attacks upper respiratory system. </li></ul></ul><ul><ul><li>Most suffer for two weeks then recover. </li></ul></ul><ul><ul><li>Most dangerous and can be fatal in the young, elderly and severely ill. </li></ul></ul><ul><ul><li>Seasonal epidemics can occur especially with the elderly causing economic burdens in MEDCs. </li></ul></ul>
  14. 14. Morbidity - Influenza Part II <ul><ul><li>A lot more dangerous in LEDCs.   </li></ul></ul><ul><ul><li>Lack of data collection means less known about symptoms and effects. </li></ul></ul><ul><ul><li>Tropic areas at high risk, due to maintaining optimal transmission conditions all year. </li></ul></ul><ul><li>Case Study - Madagascar 2002 </li></ul><ul><ul><li>Over 27,000 cases were reported and around 800 deaths were confirmed. </li></ul></ul><ul><ul><li>All in the space of 3 months. </li></ul></ul><ul><ul><li>It is clear that these communities with limited nourishment and health care suffer far more. </li></ul></ul>
  15. 15. Morbidity - Influenza Part III <ul><ul><li>Commonly the flu can genetically mutate and reinfect in other forms. </li></ul></ul><ul><ul><li>An example is the 'Spanish Flu' that affected most of the World and killed over 40 Million people. </li></ul></ul><ul><ul><li>However there are other fears with mutations that are transmitted via animals, commonly known the 'Swine' and 'Bird' Flu. </li></ul></ul><ul><ul><li>[right] - tens of thousands of pigs were slaughtered.  </li></ul></ul>
  16. 16. Morbidity - Yellow Fever Part I <ul><ul><li>Yellow Fever is a viral disease that is spread by viruses and there have been widespread outbreaks of it in Africa, North and South America. </li></ul></ul><ul><ul><li>Been recognised in texts stretching back 400 years. </li></ul></ul><ul><ul><li>The “Yellow” comes from the yellowish discoloration of the skin that affects some patients. </li></ul></ul>
  17. 17. Morbidity - Yellow Fever Part II <ul><ul><li>There are constant, but low levels of the virus in some tropical areas of Africa and the Americas; therefore, there is always a risk of it spreading quickly. </li></ul></ul><ul><ul><li>Yellow Fever outbreaks have also occurred in Europe, the Caribbean Islands and Central and North America. </li></ul></ul><ul><ul><li>Bolivia, Brazil, Colombia, Ecuador and Peru are said to be at greatest risk. </li></ul></ul><ul><ul><li>The number of people infected over the last 20 years has actually increased, even though there has been an effective vaccine available in the last 60 years, making yellow fever a serious public health issue again. </li></ul></ul>
  18. 18. Morbidity - Yellow Fever Part III <ul><li>Yellow fever can be fatal. About 5% of people who get yellow fever die from the condition. </li></ul><ul><li>Typical symptoms of yellow fever include: </li></ul><ul><ul><li>headache, </li></ul></ul><ul><ul><li>high temperature (fever), </li></ul></ul><ul><ul><li>nausea and vomiting, </li></ul></ul><ul><ul><li>jaundice, and </li></ul></ul><ul><ul><li>bleeding (haemorrhage). </li></ul></ul>
  19. 19. Morbidity - Yellow Fever Part IV <ul><ul><li>There are approximately 200,000 reports of yellow fever, 30,000 of them resulting in deaths, per year. However, only a small number of the reports are identified due to under-reporting. </li></ul></ul><ul><ul><li>Although yellow fever has never been reported in Asia, the continent is still under threat because of the wildlife (primates) and mosquitoes, which are thought to transmit the disease.  </li></ul></ul>
  20. 20. EPIDEMICS <ul><li>Rupert Cole, Sanjay Sanger and Sam Tedstone </li></ul>
  21. 21. What is an Epidemic? &quot;An epidemic occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected. &quot; - &quot;A disease affecting a large number of individuals within a population, community, or region at the same time.&quot; -     
  22. 22. Classifying an Epidemic <ul><li>Defining an epidemic can be subjective, depending in part on what is &quot;expected&quot;, a few cases of a very rare disease may be classified as an &quot;epidemic,&quot; while many cases of a common disease (such as the common cold) would not. Three common classifications; </li></ul><ul><ul><li>Endemic:  Common diseases that occur at a constant but relatively low rate such as malaria in Africa. </li></ul></ul><ul><ul><li>Syndemics:  Epidemics that are more like social conditions, they  increase the health burden of the population such as poverty. </li></ul></ul><ul><ul><li>Non-Infectious Diseases:  The term is sometimes used in reference to a problem with society such as obesity. </li></ul></ul>
  23. 23. Transmission <ul><li>Most common methods of transmission: </li></ul><ul><ul><li>Droplet Contact (Common cold, Influenza) </li></ul></ul><ul><ul><li>Vertical (Mother to Child, HIV) </li></ul></ul><ul><ul><li>Oral (Herpes) </li></ul></ul><ul><ul><li>Iatrogenic (Medical Procedures, MRSA) </li></ul></ul><ul><ul><li>Sexual (STDs, Chlamydia, Hepatitis C) </li></ul></ul><ul><ul><li>Fecal-Oral (Usually contaminated food, water,  Cholera) </li></ul></ul>
  24. 24. Examples of Worldwide Epidemics 1300s:  The Black Death 1501-87:  Typhus 1816-26:  Cholera 1863-75:  Cholera 1855-1950:  Bubonic Plague 1980-Present:  HIV
  25. 25. Recent Examples of Epidemics MEDCs: 2009: Swine Influenza - Melbourne 2009: Mumps - Ireland 2009 - Present:  Swine Influenza - Britain    LEDCs: 2002-3: SARS - China 2008: Cholera – Chad 2008: Plague – Madagascar 2008-9: Zimbabwean Cholera Outbreak 2009: Swine Influenza - India
  26. 26. Case Study: SARS <ul><ul><li>Severe Acute Respiratory Syndrome A respiratory disease in humans  which is caused by the SARS coronavirus. </li></ul></ul><ul><ul><li>Classed as an epidemic and a &quot;Near Pandemic&quot;. </li></ul></ul><ul><ul><li>Outbreak in Guangdong (Southerm) in China in November 2002. </li></ul></ul><ul><ul><li>The disease spread widely through China and into 17 countries and  across 5 continents. </li></ul></ul><ul><ul><li>Although the disease only proved to have a 9.6% mortality rate, in total 8273 lives were lost in this epidemic. </li></ul></ul>
  27. 29. Reaction to SARS <ul><ul><li>Chineses Government didn't inform the World Health Organisation until Feburary 2003, 3 months after the first case after 305 cases and 5 deaths. This led to criticism of the Chinese Government and delayed efforts to control the outbreak. </li></ul></ul><ul><ul><li>12 March 2003 Global Alert issued by the WHO and an official Health Warning from the USA's Centre for Disease Control and Prevention.  </li></ul></ul><ul><ul><li>Tourism warnings were also placed on China and Honk Kong by the WHO </li></ul></ul><ul><ul><li>Many buildings with great numbers of infected people inside were quarantined such as an apartment in Hong Kong on 30 March due to 200+ cases in that building alone. </li></ul></ul><ul><ul><li>In 19 May 2004, the WHO announces China free of SARS due to no new infections in 3 weeks. </li></ul></ul>
  29. 31. Pandemic By Jacob Hanvey, Sean Miller & Alex Harden
  30. 32. Pandemic ? ? ? ? ? ?
  31. 33. Definition A pandemic is an epidemic of infectious disease that is spreading through human populations across a large region; for instance a continent, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic.     Throughout history there have been a number of pandemics, such as smallpox and tuberculosis. More recent pandemics include the HIV pandemic and the 2009 flu pandemic.
  32. 34. According to the World Health Organization (WHO), a pandemic can start when three conditions have been met: emergence of a disease new to a population; agents infect humans, causing serious illness; and agents spread easily and sustainably among humans.
  33. 35. Spanish Flu <ul><ul><li>The most common Pandemics we have suffered have been Influenza related. The most severe being the “Spanish Flu” influenza pandemic in 1918-1919 and caused an estimated 40 to 50 million deaths world wide. Current epidemiological models project that a pandemic could result in up to 7.4 million deaths globally. </li></ul></ul><ul><li>  </li></ul>
  34. 36. Spanish Flu <ul><li>The pandemic started quickly. </li></ul><ul><li>The second wave hit in late summer in 1918. </li></ul><ul><li>The pandemic started to die out in most places in early 1919 and had disappeared by 1920. </li></ul>
  35. 37. <ul><ul><li>With the increase in global transport, as well as urbanization and overcrowded conditions in some areas, epidemics due to a new influenza virus are likely to take hold around the world, and become a pandemic faster than before. </li></ul></ul><ul><li>  </li></ul><ul><li>  </li></ul><ul><ul><li>Healthcare and sanitation has dramatically improved especially in MEDC’s resulting in the ideology of more infections but fewer deaths </li></ul></ul>HOWEVER
  36. 38. Before a Pandemic <ul><ul><li>Continuous global surveillance of influenza is key to the early detection of a virus with pandemic potential. WHO has a network of more than 120 National Influenza Centres in over 90 countries that monitor influenza activity and isolate influenza viruses in every region of the world. </li></ul></ul>
  37. 39. During a Pandemic Using the current swine flu as an example it is possible to map outbreaks of the disease in question
  38. 40. Mapping
  39. 41. Comparisons <ul><ul><li>As seen in the previous slides relationships can be made between variables surrounding pandemics in this instance it showed how population density affects the rate of infection </li></ul></ul><ul><ul><li>Making relationships be it however simple often help authorities in planning. </li></ul></ul>
  40. 42. In what ways is Health related to Wealth?  
  41. 43. <ul><li>In general, there is a positive relationship between the wealth of a country and the quality of healthcare provided because it is a vital resource for many people, yet costly and therefore access is restricted.  </li></ul><ul><li>With greater wealth often brings greater access, however in some countries there are exceptions, which will be discussed later. </li></ul><ul><li>From the following maps and graphs , it can be seen that the greater the wealth of a country, the greater the amount of money is spent on healthcare. </li></ul>In what ways is Health related to Wealth?
  42. 45. A graph to show Government expenditure on health as a percentage of total expenditure - This shows the contrast between all countries, and backs up the trend. Many of the MEDC countries spend a greater percentage than those that are LEDC.
  43. 46.  
  44. 47. Around the world, there are of course some exceptions In particular I will be briefly looking at the USA , because of the unique situation that the country is in. A Map to Show the Public Health Spending Proportionally In Relation to the Country Location
  45. 48. A Map to Show the Private Health Spending Proportionally In Relation to the Country Location
  46. 49. Inglewood, Los Angeles <ul><li>These pictures are from a drop-in clinic where people who are uninsured and also poorly insured can queue to see medical staff who volunteer their services without pay. </li></ul><ul><li>There is a limit of 1,500 patients per day and the clinic can help as many as 10,000 people before it moves on after eight days.  </li></ul>Example:  Beverly Alessandra, 61.She had a heart attack two years ago and, with no health insurance, cannot afford the medication that stops her veins clogging.The former secretary, who had to queue for five hours to see a cardiologist, said: &quot;I worked hard all my life but was laid off after 20 years. I need medication but can't afford the $150 a month.&quot; The clinic gave Beverly a supply of the life-saving drugs. Source: The Mirror
  47. 50. <ul><li>Work : blood pressure checks, sight tests, mammograms, dental work, pain relief, smear tests, and TB jabs. </li></ul>
  48. 51. USA <ul><li>Although in the USA, there is the world's highest total spending per person per year on healthcare  ($6103 in 2007), many people do not have access to healthcare - 45m people are uninsured (18% of Americans under 65). </li></ul><ul><li>This issue has become very important recently because it is one of the issues that Barack Obama has vowed to resolve. </li></ul>The video above has been produced by an a group who are against a National healthcare insurance plan for the USA.
  49. 52. Barack Obama's Response
  50. 53. An example of an LEDC: Cuba <ul><li>National health service is socialised because it is a communist nation and heathcare is widely available. Despite spending ten times less per person on healthcare, Cuba is only one place behind the USA in WHO rankings. </li></ul><ul><li>Access to doctors per 100,000 people </li></ul><ul><li>Cuba - 627 </li></ul><ul><li>USA - 225 </li></ul><ul><li>  </li></ul><ul><li>There are 21 medical schools providing free training and even state-sponsored classes to improve health. Cuba has the second highest life expectancy in the carribean - 77. </li></ul><ul><li>But now, it is now badly short of medicines, instruments and equipment, while many hospitals existing in a state of disrepair. Doctors can earn more as taxi drivers, and a USA blockade stops the sale of many modern medicines. </li></ul>