AS Level Geography - Health

AQA Specification, AS Level Geography - Health

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Key Words

Must Know Key Words:

  • Pallative
  • Health
  • Public Health
  • Morbidity
  • Mortality
  • Antiretroviral Drugs
  • Opportunistic Infection
  • Patented Drugs
  • Lobbying
  • Disease Of Affluence
  • Obesity
  • Balanced Diet
  • Attack Rate
  • Infant Mortality
  • Malnutrition
  • Undernorishment
  • World Health Organisation
  • Life Expectancy
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Key Words Continued

  • Pandemic
  • Epidemic
  • Obesity
  • Globesity
  • Drought
  • Famine
  • Globalisation
  • TNC's - Transnational Coporation
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Explaining Global Patterns in morbidity and mortal

Morbidity and Mortality is affected by:

  • The amount of money residents of an area/country have
  • Acces to healthcare
  • War/Conflict
  • Development level of a country (Whether its a MEDC, LEDC OR NIC(newly industrialised country))
  • How the goverment spends money
  • Political Stability
  • Resources a county have
  • Population age structure
  • Religion
  • Natural Disasters
  • Surrounding Countries and conflict within them countries (etc)

High Mortality isn't always just in LEDCs due to aging populations in MEDCs

Developing countries often have young populations and therefore low death rates

Africa has highest death rate containing 17 of the worst 20 countries

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Explaining Global Patterns in morbidity and mortal

In MEDCs 23% of all deaths are caused by infectious diseases but in LEDCs its 55%

Top 3 Causes of death in MEDCs are:

  • Cancer
  • Type 2 Diabetes
  • Alzheimers Disease

Top 3 Causes of death in LEDCs are:

  • HIV/AIDs
  • Parential Diseases
  • infectious diseases
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Explaining Global Patterns in morbidity and mortal

In MEDCs diseases are normally diseases of affluence (caused by wealth and often non-infectious)

On average 1 in 5 deaths are under the age of 5 in LEDCs

IMR (Infant Mortality rate) = Number of deaths/1000 under the age of 1 ranging from 3 to 170

200 million are under-nourished in the world today

Most infectious diseases are caused by a lack of clean water.

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Main causes of becoming overweight:

  • Cars
  • Cheap Fast food
  • More High fat and Sugary products on the market
  • More Processed Foods
  • More Alcohol and Tobacco users
  • Technology reducing the need for physical movement


Popkin argued in 2006:

"There are more overweight people across the world than hungry ones ... the number of overweight has topped 1 billion comparred to 800 million under-nourished people"

Obesity Global Distribution:

Worlds health organisation predict by 2015 there will be 2.3 billion overweight people. 700 million of which will be obese

(in 2005 there was 1.6bn overweigh and 400mn where obese)

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Singapore Trim and Fit Clubs - MINI CASE STUDY

Residents were given calorie vouchers

The amount of vouchers you got depended upon your weight

People who were overweight were segregated in certain areas of the country (for example in schools, resturants etc).

The more overweight you were the less vouchers you got

School children who were over weight were forced to stay behing in school and do exercise

The vouchers where designed to be swapped for food restricting the amount of food people could eat

This caused a mini black-market for vouchers and many argued against the vouchers as it was unfair how people were segregated and  breach of human rights.

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How Obesity Can Lead To Other Illnesses.

Arithritis - People with arithritis struggling to carry their own weight making joints and muscles stiff

Circulatory Disease - Fat from products containg saturated fats, building up on veins and arterys going in and out of the heart, restricting blood flow.

Heart Attacks and Stroke

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  • There is enough food in the world for everyone to have 2,700 calories a day.
  • 30 million die of starvation per year
  • 800 million suffer from malnutrition

Causes of Famine:

  • Crop Failure
  • Food shortages
  • War/Conflict
  • Overpopulation


  • Death
  • Disease
  • Malnutrition
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Hunger In Ethiopia - CASE STUDY


  • Boys given food before girls due to gender inequality
  • Political/Govermental Corruption
  • Low income of only 280US$ per capita
  • Low Life Expectance (Male 54, Women 56)
  • Droughts are very common
  • Poverty (MAIN FACTOR)
  • Families have to send children out to work
  • Mainly primary industry, in particular agricultare and this has a very low selling price (eg coffee, rice etc)
  • Land is assigned by family size, so individuals dont own any land
  • Everytime land is redistributed a farmer will get less (due to an increasing population)
  • War/Conflict
  • In 1990, 60% of the countries budget was spent on weapons
  • Poor Infrastructure
  • Goverment refuse/restrict the aid it gets in
  • Aid doesnt get to where it is needed
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Hunger In Ethiopia - CASE STUDY

Social Effects:

  • 35,000 die per day dur to hunger related diseases
  • Not enough food aid per family
  • Lack of jobs
  • 95% rely on farming
  • No electricity
  • Most families in rural areas have to beg to gain enough money to survive
  • Easily prevented skin infections are very common
  • Diahorrea
  • 75% share sleeping quatres with livestock
  • 42% of under 5s are underweight
  • Only 65% of rural households get the recommend 2,200 calories from the world health organisation
  • 40% of children sleep on the floor
  • Average family live in a of area 30square meters made out of mud with a thatched roof
  • 55% of people live in slums and shanty towns in the capital Addis Ababa
  • Population is growing quicker than food production
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Hunger In Ethiopia - CASE STUDY

Political Effects:

  • Corrupted Goverments
  • Not enough food to give out as food aid
  • Land distribitution isn't controlled very well
  • Dept burden
  • Unfair aid distribution
  • 60% of budget goes on war and weapons so there is less money so less is spent on human needs like food and clean water, even though there is a lack of food and and safe drinking water
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Hunger In Ethiopia - CASE STUDY

Enviromental Effects:

  • Very little suitable farmland
  • 1.1 hectares of land per familty (4.6 people)
  • Land degration means the land isn't suitable for farming
  • 50-100 tonnes of soil erosion per hectare per year
  • Dung and Crop residue is used instead of fuel
  • 75% of livestock sleep in families sleeping quatres
  • Average cold season night temperature is 5*C
  • Soil can't be improved with fertiliser as they can't afford it
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Hunger In Ethiopia - CASE STUDY

Economic Effects:

  • Only 13.5miles of road in the whole country
  • No transport systems
  • No postal service
  • No telephone service
  • Large Debtr Burden
  • 80% of population rely on agricultural farming
  • Unfair Trade Systems
  • 2008, 16% of people live on just 1US$ per day (use to be 50%)
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Main Triggers:

-- Ground water and soil water levels are declining so are unable to meet agricultural needs for water

--Rapid rise in the cost of raw food supplys/livestock

--Population growth being greater than food supply growth

The Millenium Goals to be achieved by 2015:

-1- Eradicate extreme proverty and hunger

-2- Achieve universal primary education

-3- Promote gender equality and empower women

-4- Reduce child mortality

-5- Improved maternal health

-6- Combat HIV/AIDs, Malaria etc

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Highest levels of HIV/AIDs = Southern Africa (Of The Continent)

More than 15% of people are infected here (eg South Africa)

Higher levels are found here due to the condom gap so men and women are not protected from the transmission of AIDs via sex, so the virus will spread quicker.


  • Diahorrea
  • Wasting (extreme waist loss)
  • Adominial Pain
  • Infections of the mouth and Esophagus

Associated  Respiratory Problems:

  • Bronchitus
  • Tuberculosis
  • Lung cancer
  • Sinusitus
  • Pneumonitis
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HIV/AIDs - Introduction

HIV = Human Immunodeficiency Virus

Attacks the immune system

The HIV retrovirus attatches to a cell in the immune system

From Here it uses the enzymes in the cell to convert the RNA strands inside the DNA of the cell

Once the DNA contained with the retrovirus are in the body they become dormant and inactive OR multiply at a very high rate

The outcome is the distruction of the immune system

This increases the risk of OPPORTUNISTIC INFECTIONS.

Once HIV has turned to AIDs the average survival time with treatment is 5yrs

Without treatment the survival time is usually under a year

Without treatment 9 out of 10 people with aids will progress to AIDs within 10 to 15 years

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HIV/AIDs Timeline

1950 - First blood samples in AFRICA have HIV anti-bodies

1976 - First known AIDs patient dies

1980 - First human retrovirus isolated

1981 - First reports of HIV in L.A.

1983 - Virus first isolated in France

1984 - Virus isolated in U.S.

1985 - Development and implementation of anti-body test to screen blood doners

1986 - Related virus to HIV found (HIV-2)

1992 - AIDs become leading cause of death in US of ages 25-44

1997 - Mortality rates of AIDs decline due to introduction of new drug cocktails

2001 - World Health Organisation says 40mn are infected and 22mn have allready died (AIDs ONLY)

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HIV/AIDs Impacts

  • Lack of sex and hygiene education in most commen prevailing countries
  • Condems to expensive in many places
  • People dont want to be tested
  • Vunerable of getting other diseases
  • High risk if a mother has it so will her children from birth
  • Average man only gets 3 condoms a year
  • More children become orphans from parents dying
  • Inadequate care for children
  • Child Labour
  • Traditions of older men initiating young girls into sex (tribes, culture)
  • Children have to work instead of getting an education
  • People dont want to know when there going to die
  • Traditional Taboos disgussing sex
  • 32% of people with AIDs live in South Africa so less people are able to work causing a negative economic and political effect
  • Not enough antiretroviral drugs at affordable prices
  • Treatment costs are too high for many poorer people so they dont get treated, hence passing the virus on
  • Affects the 25-30 age group most and this is also when people are most valuable to the economy.
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HIV/AIDs - Introduction

68% of all people with AIDs live in sub-saharn Africa

In total 33.2mn people have HIV accross the world

HIV is considered a reflection of Hetrosexual sex

Top 4 Countries with Highest Rates Are:

  • Botswana
  • Zimbabwe
  • Swaizland
  • Lesothio

Migrant men are 26.3 times more likely to get HIV/AIDs

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Population = 1.6million

24% infected

In NE Botswana 50% of expectant mothers have the virus

Anti-Retroviral drugs given to the goverment in 2002

2006 the life expectancy was 34

2010 the life expectancy was 28!!

By 2021 the economy will be a third smaller than it would be if HIV didn't exist!

Reasons why its hard to figure out how many people are infected:

  • People dont get tested
  • People often get affected with other diseases after getting it
  • People dont want to know they've got it
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Role of TransNational Countries - GSK and BAT

-- Pharmaceutical TNCs often bring benefits but also cause problems for the worlds health.

-- They are often described by HERO's by some people or VILLIAN's by others

-- Branded Medcines:

- 3 to 30 times more expensive than non-branded medcines

- Normally strongle advertised

- Branded Medicines (dont use the medical name) eg CALPOL etc

-- Generic Medcines:

- Named after the chemical description of the drug

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World Health Organisations Vision

"Our Vision is that people everywhere have access to the

essential medicines they need; that the medcines are safe, 

effective and ofassured quality; and that they are perscribed

and used rationally"

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Glaxosmithkline (GSK)

Income = 27 billion, Profit = 7.8 billion

Employs 110,000 workers and 40,000 in sales and marketing

2nd biggest pharmaceutical company in the world

Provides 45% of the US revenue

Operates in almost 70 Countries

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GSK Posotives (HERO's)

¬ Their mission is to improve the quality of human life

¬ Only pharmaceutical company to tackle the top 3 priority diseases (Malaria, HIV/AIDS, and tuberculosis)

¬ Employs vasts amounts of people in 117 countries

¬ 15,000 people work in research and development for new medicines

¬ Supply's 25% of the world vaccines and several clinical trials

¬ Many of their brands are household brands (eg Lucozade, Aquafresh, Ribena)

¬ Donate several tablets to developing countries

¬ Donated 155 million albendazole tablets to eliminate lymphatic filariasis in 2006 (1,600 treatments)

¬ Shipped 206 million HIV treatments to developing countries (2006)

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GSK Negatives (VILLIAN's)

¬ Tax avation

Only care about profit so developing countries miss out on drugs

¬ Animal Testing

¬ Often hold back treatments to maximise profits

¬ Testing on people in LEDCs because its cheaper and often these people don't know they are being tested on

¬ Over-Charging

¬ Using patents to stop cheap drugs which do the same job from being developed

¬ Release high levels of Pollutants

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British American Tobacco (BAT)

In china there are 300 million smokers

70% of men smoke and 4% of women do

In India 55,000 children use tobacco with an additional 5 million U15s addicted

(INDIA) Only 20% of all smokers use cigarettes)

BAT is engaged in campaigns targeting more young people to use cigarettes

Significance of BAT in the developing world:

  • Targets the expanding market in INDIA
  • Involved in campaigns to get 250 million tobacco users to convert to cigarette smoking (cigarettes are better for them, so this is actually a good thing)
  • Indian government relaxed rules so that TNCs could have 100% ownership of their manufacturing plants (use to have to be jointly owned/ventures
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Cuban Healthcare System


  • Example of socialised healthcare
  • State provided service
  • Doctors are state employed
  • All facilities are publicly owned
  • FREE


  • Get a better medical status then america
  • Train vasts amounts of new doctors
  • be better than the US as the US wont trade or help them
  • Have loads of doctors
  • Have a doctor on every corner

Other Info:

  • Spent 1 billion USD on science plants.
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Cuban Healthcare


  • 2nd highest life Expectancy in the Caribbean (77, average is 69)
  • 21 medical schools
  • Free medical training
  • 30,000 doctors, 10,000 dentists
  • Population is 11 million
  • 10 times less spending per person when compared to the US BUT:
    • Infant Mortality rates are LOWER (5.6 instead of 7.0)
    • Life expectancy almost identical
  • In 1970 the Doctor Patient ratio was 1:1393
  • In 2005 the doctor patient ratio was 1:159 (BETTER THAN THE US)
  • 12,000 Cuban doctors working in Africa
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Cuban Healthcare PROs and CONs


  • Very well run
  • IMR is lower than what it is in the US
  • More than 1 doctor per 200 people (one of the best in the world)
  • Train doctors from all over the world
  • Hepatitis B vaccine produced making 2 billion USD from 44 countries
  • Becoming self-efficient training medical students from outside countries for oil


  • Some patients have to stay in hotels
  • Medical classes are very large so students don't get individual training, unlike in MEDCs
  • Distinct Lack of Technology
  • Don't charge their own citizens but do charge most foreigners.
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UK Health Service Vs Cuban Healthcare Service

-- State supported services

-- Physicians are sole entrepreneurs and are members of professional associations

-- Facilities are publically owned

-- State role in health is Central and direct

Similarities to the CUBAN Healthcare system:

  • Free
  • Child mortality rates are very low
  • Life expectancies in both countries are rising
  • Both believe everybody should be entilited to a good healthcare service
  • Both send numerous amounts doctors abroad
  • Both set up over 50 years ago
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UK Healtcare Vs Cuban Healthcare DIFFERENCES:

  • Cuba = FREE training (have to par in the UK)
  • Lots of technology in the UK but very little technology in Cuba
  • Home visits are only kept for emergencies and exceptional cases in the UK but used much more widly in Cuba
  • In the UK, 60% of NHS budget is spent on wages
  • Have to pay for drugs in UK (Drugs are free in Cuba)
  • Spend 10 times more than Cuba
  • UK = 120,000 doctors, 40,000 GP's, 25,000 Ambulance staff and 400,000 Nurses
  • Cuba = 30,000 Doctors and 10,000 Dentists
  • Cuba has 1 doctor per 159
  • Cuba only spend £229 per person, UK spends around £2,500 per person
  • Everyone paid the same in Cuba, in the UK everyone is paid a different amount.
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Regional Health Variations - Does a North South Di


The Black Report (1980):

  • Health in all classes across the world has improved
  • Access to health services has worsened
  • Poorer classes have higher infant mortality rates and lower life expectancies

Frank Dobson, Secretary of State for Health:

"Inequality in health is the worse inequality of all. There is no more serious inequality than knowing that you'll die sooner because you're badly off"

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Glascow (Calton) - MINI CASE STUDY

  • 26% of Calton area say there health is not good
  • Calton is the inner city area of glascow, with a life expectancy of 53.9 (worse than iraq)
  • 52% in Calton smoke, the scottish average is 25%
  • Alcohol abuse admissions to hospital are way above the national average
  • Life expectancy is mainly brought down be cancer, heart attacks, drugs and suicide.
  • Many households are "Illiterate about health"
  • 44% of people are on incapacity benefits
  • 37% live in a workless household
  • 30% of households are occupied by lone parents
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Female Life Expectancy and the INVERSE CARE LAW

-- Female LE is increasing accross the country but increasing faster in the south

-- Life expectancy across all is higher in the south

-- Possible reasons for this is that the average income is worse in the north so people have to buy cheaper processed foods which contain high amounts of salt and saturated fats so are, therefore, more unhealty; this then leads to obesity and possibly death

-- Health problems are recognised sooner in the south

-- Doctors prefer to live in the south

Inverse Care Law:

"The availability of good medical care tends to vary inversly with the need for it in the population served" (Hart, 1971)

This basically the most likely to need good healthcare are the least likely to recieve it.

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ACCESS to Healthcare - The Statistics

  • Mortality rates are higher in Scotland than anywhere else in the United Kingdom
  • Scotlands death rate is 1.3/1000, once again higher than the national UK average
  • In 2004 the average UK health spending was £1249 per person but in scotland the average was £1533 per person
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