The document discusses various indicators used to measure development, including economic indicators like GDP and social indicators like life expectancy. It explains that composite indicators which combine multiple factors, like the Human Development Index, provide a more comprehensive picture of a country's development level than any single indicator. Reasons for differences in development levels between countries include natural resources, industrialization, political stability, location, and access to trade. Within countries, there are also often disparities between urban and rural areas in terms of access to services.

1. Development & Health

3. Two Main Groups of Indicators Economic (Traditional) Social & Human (Modern) Measure wealth and levels of industrialisation Indicate quality of life: Health, Diet, Education

4. Indicators of development Such indicators have several uses They allow us to compare different countries using standard agreed measurements. They allow us to rank countries They allow us to chart progress over a period of time They give us a “snapshot” of a country, economically, politically & socially

5. Economic indicators Gross National Product (GNP) This is the value of all goods produced, services provided in a country and services earned abroad in one year. Gross Domestic Product (GDP) This is the value of all goods produced, services provided in a country in a year. GNP/GDP $ per capita = Per person % People employed in agriculture A country where most people work in agriculture has very little industry. This means the wealth of the country is limited Energy per person(tonnes of oil equivelent per person) The energy used in a country divided by the number of people in that country. Countries with a higher standard of living and industries will use more energy.

6. The world divided by Gross Domestic product Notice how America and Europe dominate this map, along with Japan (yes – that huge dark-green island on the right really is Japan), while Africa dwindles almost to invisibility.

7. What are social indicators? Social indicators show how a country uses its wealth to improve the lives of its people.

8. Social indicators Death rate The number of people who die for every 1000 people who live in the country. Adult literacy The number of adults who can read in every 1000 of the population Calories per person The average number of calories consumed by each person per day. Life expectancy The number of years on average that people live. Other indicators include: - Protein per person per day - Population per doctor - Infant mortality

9. The world divided by child mortality Notice how the African continent becomes inflated while the USA shrinks.

10. It is important to remember that although a statistic such as GNP/capita or Life expectancy in years will suggest certain things about conditions in a country, the figures are just statistics and do not always give a true representation of standard of living or quality of life within a particular country. The statistics are simply indicators.

11. It is important to remember the following when using indicator statistics:- Statistics are often out of date by the time they are published and characteristics of populations can change very quickly. Statistical data is sometimes collected and processed in different ways by different countries and ideally countries shouldn’t be compared unless you are sure the statistics are reliable sourced e.g. from the UN and that they are from the same date. A statistic for a whole country is an average for the whole country and doesn’t take into account rural/urban differences or regional differences in large countries. Sometimes a statistic e.g. GNP/capita can be hugely skewed by extremes e.g. Oil producing countries GNP/capita can appear very high because of the extreme wealth that is in the hands of a minority of people or companies but when averaged out per capita it gives a very misleading figure. Sometimes a single statistic used for comparison purposes will have very little relevance to a particular country’s way of life. E.g. GNP/capita may not be of particular significance in a very rural subsistence agricultural area but would be a vital figure when looking at an urban area of a developed country.

12. Using your textbook pg 145-147, detail 5 criticisms that might be used against using economic indicators such as GNP per capital (US$)

13. GNP is based on the US dollar and fluctuations in its relative value can adversely affect the data. GNP does not make allowance for the purchasing power of the local currency, which can vary greatly between countries. However it is possible to adjust for this and express the figure in terms of Purchasing Power Parity (PPP). GNP does not take account of the subsistence part of agricultural production or of trade by way of barter. State controlled economies such as China or North Korea may have distorted figures due to state direction of the economy according to long –term planning or ideology, eg China’s ‘one child’ policy. All ELDC’s have difficulty in obtaining data, and the quality of data may vary, especially between urban areas and inaccessible rural areas. Civil unrest, mistrust of central government, localised disruption due to severe weather eg drought, and corruption in Local Government may all conspire to pollute the data.

14. Development Indicators Decisions on levels of development should be based on a number of indicators used together rather than individual indicators such as GNP. The use of single indicators can be misleading since the data is based on averages and these do not reveal the whole situation. For example, average per capita income or GDP per capita for Saudi Arabia may seem high and suggest a high level of development but income distribution is very unequal, varying from extremely high to very low. Similarly GNP may indicate a high level but be based on a single commodity such as oil. Taken together to produce combined indices such as the “Physical Quality of Life Index” (PQLI) or the Human Development Index (HDI), this gives a much more accurate picture of the stage of development of any given country.

15. Good indicators We have already looked at why life expectancy is a “good” indicator, let’s look at Adult Literacy Rates. This is another good indicator because it tells you the proportion of adults who can read or write in a country, but again it suggests a lot of other things:- Where Adult Literacy is high it suggests that schools and teachers are available to the vast majority of the population and that children are encouraged to attend. It also suggests that the education system is a secondary or tertiary system to have trained teachers available. It also suggest that the country has the money to invest in education and if people have high literacy levels then they will be able to work in secondary or tertiary industry which is better paid. If on the other hand literacy levels are low it implies that the country does not have the income to spend on education for everyone or that children do not attend school because they have farm work or household chores to do instead i.e. a subsistence economy. A low level also suggest people will be working mainly in lower paid primary jobs often at subsistence level.

16. Now try some more examples yourself People per doctor % employed in primary jobs Infant Mortality Rate

17. Exemplar Question Suggest one economic and one social/human indicator of development and show how each might illustrate a country’s level of development. (8 marks) Task: Applications pg 149 Q1& 3

18. Composite Indicators It is generally accepted that individual indicators are of limited value. Individual social indicators are “average” figures and conceal large variations within/between countries. A country with an above average calorific intake indicator may have well-fed people, but this does not tell us much about their overall health, education or wealth or social freedom. For that reason it is possible to group together indicators. e.g. Physical Quality of Life Index (PQLI) uses life expectancy, literacy rates & infant mortality rate. (This gives a number from 0- 100 A PQLI of over 77 is consider good) HDI: Wealth, Health & Education: Combined indicators which produce an index between 0-1. A number of 0.8 is considered developed! Composite figures rely on a number of valid indicators. They tend to balance out some wide variations

19. DEVELOPMENT AND HEALTH So what if we develop a complex set of indicators? PHYSICAL QUALITY OF LIFE . (PQLI) It uses three social indicators- Adult literacy Literacy rates Infant mortality HUMAN DEVELOPMENT INDEX . (HDI) It uses three mixed indicators- Wealth- GDP per capita Life expectancy Educational achievement There are two to learn ! Sometimes a different indicator is substituted

20. Human Development Index: This is a combination of social and economic factors: - Life expectancy - Cost of living - Adult literacy - School enrolment - GNP per capita This produces an index from 0 – 1. A number of 0.8 or above is considered developed. See map on following slide illustrating development levels using HDI. (some indicators may be substituted)

21. Human Development Index values.

22. Exemplar Question Describe the link and pattern between GDP or GNP per capita (i.e. economic indicator) and PQLI (i.e. social, cultural, welfare composite indicator)

23. There is a link between economic indicators (e.g. GDP) and the composite indicators (PQLI). Countries such as Canada, Norway, the USA and UK will be highly placed in all lists. Such countries use their wealth to provide high levels of education and health care. The opposite is also generally true. That is countries with a low GDP do not have the money to invest in health/education/ infrastructure and have low PQLIs. Some countries do not follow these patterns, e.g. oil rich Arab states (e.g. Kuwait, Saudi Arabia) with high GDPs (exporting oil) but lower PQLIs. Or Sri Lanka, China or Costa Rica, with lower GDP but have higher PQLI (such money that there is, is spent on education and health)

24. DEVELOPMENT AND HEALTH PQLI is shown at the side. It has only a few differences from the HDI, shown below.

25. Reasons for inequalities in development between countries There are a number of reasons why development is uneven throughout the world. - Trade - Population growth - Industrialisation - Political turmoil - Physical factors

26. 1. Trade Patterns of trade can lead to a trade surplus or deficit depending on goods being traded. E.g. Some countries have more natural resources, such as……….., where the extra income has allowed the country to develop at a faster rate, therefore increasing GNP. Remember that not all countries have resources to trade e.g. It can be complicated by trade barriers and tariffs.

27. 2. Population growth High rates of natural increase can put strain on resources such as fuel, water and food and this can lead to the country struggling to develop . This is because the economy is not strong enough to cope with this change and the vicious cycle may continue as the nation cannot provide jobs, houses nor medical facilities

28. 3. Industrialisation A move to become an industrial society and become an NIC or Newly Industrialised Society (Pg 150-151 of Applications textbook) Greater capital accumulation allows for……….. The role of Multi National Companies (MNC)

29. Countries considered NICs as of 2007 Pg 150 - NICs

30. 4. Political turmoil Unstable governments can lead to civil war which restricts development Corruption in governments puts money into weapons instead of healthcare and education hence the country’s slow development. E.g.

31. 5. Physical factors Every country has a different location eg. Amount of natural resources in a country varies e.g. The climate in every country can vary. E.g …..is prone to drought which would prevent crops being grown and thus decreasing the amount of food produced in the country. Disease presence can put a strain on health care and causing victims to either die or be unable to work therefore negatively impacting the economy. If a country is in debt (e.g. Mali) then it may have to borrow more money to repay these debts and it will not be able to spend this money on improved infrastructure, healthcare and education - money and trained personnel will be needed when a natural disaster occurs. This is money that could be used for further development within the country. E.g.

32. A few reasons for different levels of development between ELDCs NIC’s Exploitable Resources (oil, diamonds, tourism) Political Instability / Civil Wars Land Locked / Lack of resources/ Natural Disasters/Climate/Disease e.g. e.g. e.g. e.g. e.g.

33. Contrasts in Development There are many reasons for differences in levels of Development between ELDCs: Some countries have a very high GNP due to income from oil. These “oil rich” nations include.. Saudi Arabia, Kuwait, UAE, Qatar, Dubai, Libya Some counties may be described as NICs.. Newly Industrialised Countries and although classified as “Developing” they have become more developed due to new industry…referred to also as Tiger Economies they include Hong Kong, South Korea, Taiwan, Singapore, Philippines, Thailand, Indonesia and Malaysia. Other countries are very poor because they have very few or no natural resources and they have experienced climatic disasters..Ethiopia, Bangledesh and Somalia.

34. Ethiopia for example suffers large-scale droughts as a result of its location in the Sahel belt of Africa. Severe and long lasting droughts have affected it in the recent past, leading to failure of crops, death of animals and famine. Starving subsistence farmers were forced off the land due to increasing desertification. Malnutrition and severely reduced working capacity ensued. Lack of investment in agriculture and the difficult climate means that little agricultural produce can be exported to bring income. 4. In other areas civil war and other forms of political instability have prevented development… Sudan, Sierra Leone, Afghanistan 5. In some parts of the developing world land-locked countries are less developed than those with a coastal location where trade is easier.

35. Task: Booklets page 10&11

36. Remember: The indicators are average figures, and there are wealthy groups within both societies as well as poorer groups. The urban areas tend to be better off than the rural areas. Remote areas do not have the same access as the “core” to water supplies, sanitation, education, health, international aid and power

37. Differences in Development Within a country Case Study: Nigeria

42. Polychromatic Rendering Time! Map 2: Secondary Education in Nigeria

43. 2006 Paper : Q6a Answers might include: Countries such as Saudi Arabia with natural resources such as oil or Malaysia which exports primary products such as tropical hardwood, rubber, palm oil and tin tend to be better off than countries such as Burkina Faso which lack resources. Some countries earn a great deal from being NICs e.g. South Korea, Taiwan Some countries such as Brazil have both resources and growing manufacturing industries. Freedom from natural disasters which can restrict development e.g. drought in sub saharan Africa, floods in Bangledesh, Hurricanes in the Caribbean. Political instability – avoiding civil wars such as these in Sudan/Rwanda/Somalia/Liberia/Sierra Leone.

44. 2002 Q6b With reference to countries of the Developing World with which you are familiar, describe and suggest reasons for the differences in the provision of social services (i.e. health, water & sanitation) between urban and rural areas. 10 marks

45. Possible answers Remember to Describe & Explain! Description should identify that rural areas are poorest served for sanitation provision and best served by health service provision. Reasons for the disparity between rural and urban areas can be explained in terms of: Economic savings to be made through the reduced connection and installation costs to serve a concentrated group of people in an urban rather than a more dispersed rural population. The relative ease of attracting staff and the subsequent provision of health services in an urban area with its many attractions compared to a distant rural area. The larger potential labour pool of skilled/educated population in urban areas. The focus of government spending in urban areas to ensure a more politically astute populace are “best served”.

46. Page 6: Measuring Development: use SG geog book Other measures of Development :Core Themes Human p142&143 Page 9: HDI - League Table Applications pg 149 Q1& 3 Pg 150 – NICs Photographs/ make poverty history video/ N/S divide Handouts etc in folder on shared

47. Health

48. Health Levels of health and the incidence of disease are major indicators of development. Many diseases are linked to the environment, whether it be the physical environment, social/human conditions or to the general lifestyle. A summary of the basics The health of an individual is related to hereditary and biological factors, environmental features as well as social and human conditions. There are links between certain diseases and population distribution, density and wealth. Disease (or morbidity as it is known in medical statistics) obviously affects death rates and life expectancy. A country with low health care provision is unlikely to have a firm base for economic growth and development.

49. Vicious Circle of Health Problems Malnutrition results not only from a lack of food but the lack of the necessary vitamins, proteins, carbohydrates which contribute to a balanced and healthy diet. Diets which are based on one basic food source such as rice lack this variety supplied by nutritious foods. This happens in many countries throughout the world, notable south east Asia and the Indian sub-continent. Consequently, a significant proportion of the population is unhealthy due to malnutrition and unable to resist even the most simple of diseases. Many people are debilitated and unable to work for any length of time. Industrial and agricultural output suffers and this eventually has a serious effect on the whole economy of countries in the developing world. Those suffering from malnutrition may not generate enough income for themselves and their families in order to pay for the basic necessities of life: food, accommodation, education and healthcare. Poverty ensues and, without any financial assistance from outside sources, it continues throughout the lifespan of those affected

50. A summary of factors influencing poor health Human & Social Factors Physical factors linked to high death rate and mortality Poverty (unable to afford health care) A climate liable to suffer from drought / flooding, leading to crop failure, leading to famine. Poor living conditions (e.g. shanty towns) Presence of endemic disease Lack of sanitation and access to clean water Remoteness e.g. difficult terrain such as mountains can make health care provision difficult. Insufficient health care support, hospitals, drugs Hot/wet conditions can provide ideal conditions for insects to transmit disease. Low public awareness, poor education, and poor hygiene Famine/War/Crop failure

51. With reference to countries in the ELDCs with which you are familiar, describe and suggest reasons for the differences in the provision of social services between rural and urban areas. (10 marks)

52. Description and explanation of differences in the provision of water and sanitation between urban and rural areas Lack of clean, safe water leads to the contraction of many water-borne diseases such as typhoid, schistosomiasis, cholera, diahorrea. Lack of clean water may be due to physical factors may be due to physical factors such as drought or economic factors such as lack of funding for sanitation and water supply to households in poorer countries. These problems tend to occur more in poorer agricultural areas which rely on local water sources such as rivers and streams which can become contaminated. Urban areas usually have sanitation and water supplies although they may not be available to all residents, particularly those in squatter areas or shanty towns. In addition to pg 23 of booklets

53. Health care must vary accordingly. For example, endogenous disease treatment or prevention can best be tackled by education and by changing lifestyles, as well as by expensive use of drugs, doctors and hospitals. Endogenous diseases can be linked to environmental factors, by poverty and everything that goes with poverty (poor education, health care and unsafe living conditions). Generally speaking, for the vast majority of countries around the world, people are living longer, death rates are dropping and infant mortality is falling. We seem to be doing something right. However there are massive differences between the EMDCs and the ELDCs

54. The fight to combat disease and protect people in the UK 1. Environmental Health Measures (water supplies, sewage, public health inspectors 2. Integrated National Health Service: GPs. Specialists, hospitals, dental service 3. Social Securing Services – To ensure illnesses need not result in poverty. Sickness & disability allowances. 4. General Health Education 5. Protection from national & international infections. Points of entry into country controlled to check that international regulations are not contravened. Describe what you see. Why would this not suit a poorer country such as Somalia or Mozambique? Young Pregnant Elderly Immunisations and vaccination, School health visits Ante and post natal clinics, health visitors, maternity hospitals Home help provision, Health visitors, Geriatric special hospitals General Population Measures

55. Extremely Expensive model Requires large numbers of skilled workers Can support all people in a country regardless of wealth, age or whether they live in dense concentrations or in remoter rural communities. However :It also suffers from the problem that no matter how much money is spent, there is always the demand that more is needed!

56. Nutrition, Health & Development “there is no drug to solve hunger, still less a vaccine to prevent it” (World Health Organisation). The requirements for a healthy lifestyle are very simply: A balanced diet to ensure healthy growth and resistance to infection. Pure water supplies to avoid the dangers of waterborne disease. Good housing for protection from the extremes of the weather. An effective health care service for support from pre birth to old age

57. The Syllabus The higher syllabus asks you to have detailed knowledge about one water related disease. You should be able to cover all of the following issues. Describe the physical (environmental) and human factors that put people at risk of contracting the disease. Describe the methods and strategies used to control the spread of the disease. Evaluate the success/failure of these methods. Describe the benefits to the community or county of controlling the disease. 18 marks i.e. now 36 marks!!! Case Study: Malaria

58. Primary Health Care The provision of basic health care which is non specialised and aims to make good health care available to all the people in a country. Read through page 31 of your booklets where PHC is introduced by looking at some common problems and possible PHC strategies. Eg. Local Health clinics (linked to a referral structure where complex cases can be moved to specialists), Mass vaccination programmes, Sanitation & clean water projects, barefoot doctors, Health Education Projects

59. In general, these schemes have been very successful. They involve local people who are known and can be trusted. They are most effective in rural areas that are often remote and isolated, with limited existing educational and medical support. However too few health workers have been trained to meet the needs of the most troubled communities. There always remains a lack of funding and a lack of volunteers. The early successes have been hit by war, economic depression and natural disasters such as famine or earthquake.