Geography- Health

• Virus that attacks immune system.
• Spreads by sexual intercourse, contaminated needles, contaminated blood transfusions and in pregnancy from mother to baby.
• Pattern 1: 1960s Western Europe- homosexual communities, high risk through drug users and prostitutes.
• Pattern 2: Sub-saharan Africa- hetrosexuals, spread between men and women or mother to baby.
• Pattern 3: 1980s Eastern areas/Asia- travelling and contaminated blood transfusions. 

Impacts

• E- negative impacts on DNP.
• E- AIDS destroying workforce- reduction of working class, subsistance farmers struggle to feed themselves.
• H- increasing strain of health services.
• H- 3 million children HIV+ in Africa, 2.4 million Africans died from HIV/AIDS.
• H- life expectancy in Bostwana decrease to below 40 years.
• L- 13 million orphans in Africa.
• L- rely on young for income- have to sacrifice education, no future or opportunites.

Treatment:

• Palliative care.
• HIV treatment should be free.

Prevention:

• Family planning, and increase contraceptive use.
• Provide clean needles and syringes.
• Avoid unintended pregnancies.

Education and advertising:

• Effective prevention programs, eg abstaining form sex and being faithful.
• National AIDS Committee in Thailand- gave 60 million free condoms.

Botswana:

• 24% of adults infected with HIW.
• Government managing spread of disease by prevention.
• Life expectancy lower that 40.
• AIDS destroying workforce, economy effected- by 2021 will be 1/3 smaller.

Thailand:

• First case in 1980s.
• Rapid increase in infection rates in vulnerable groups with sex workers and prostitutes.
• Spread to hetrosexual due to decrease in condom use and increase of premarital and extra-marital male conduct with sex workers.
• 1999 1 million infected with HIV.
• Thai government launched '100% condom' program in 1991.
• Freee condoms given out, meaning more people use them.
• National AIDS committee set up campaigns via TV, radio and posters.
• HIV infection rates decrease.

• Gender- 6.5% in males, 4% in females.
• Age- 1 in 3 men and 1 in 4 women over 75 have CHD.
• Ethnicity- Indian, Pakistani, Black Caribbean and Chinese men much lower than general pop.
• Socio economic- differences between deprivation categories.

How is it managed?

• Effective and relatively inexpensive medication available.
• Effective devices like pacemakers and prosthetic valves.
• Educate the publime- improve quality of live and decrease amount of deaths.
• Advising on healthy lifestyles.
• World Heart Day; medical activities, public do exercise, promote healthy diet.
• Healthy lifestyle- 5 a day, Jamie Oliver healthy school meals.

Where?

• Highest death rate from CHD is in India. 60% of CHD is in developing countries.

Impacts:

• H- symptoms= chest, shoulder, arm and neck pain, shortness of breath.
• L- lifestyle changes ege exercise, stop smoking. Visit doctors to check blood pressure, sugars and cholesterol levels, restrict freedom.
• E- patient stops work so no income. Employers have to get new employee, money on business, taxpayer in NHS.

Socail Impacts:

• 2500 Haitians died from cholera. 
• Cholera is spreading- people have to make precautions eg disease control officers at airports.
• Cholera needs to be prevented.

Agriculture and Trade:

• Some of Haiti's rice harvest lost due to contamination.
• Farmers lose money, people won't want to buy rice from Haiti due to cholera risk, decreasing trade.

Foreign Aid:

• UK sends aid to Haiti to prevent disease spreading. Going to improve health and water supply for 231,000 people.

Morbidity

• Means illness.
• Infections diseases(HIV/AIDS) more common in LEDCs, non-communicable diseases(CHD, cancer) more common in MEDCs.
• DALY- the disability-adjusted life year is a measure of overall disease burden, expressed as the number of years lost due to ill-health

Mortality:

• Means death- high morbidity= high mortality.
• Mortality rate- how many people die in a population over a period of time.

Causes:

• Energy imbalance between calories consumed and expended.
• Decrease in exercise, energy dense foods high in fat, sugar.

Health consequences:

• Diabetes, cancer, cardiovascular disease, premature death.

Reducing obesity:

• Exercise and good diet, less saturated fats.
• More fruit and veg, limit sugar. Reduce portion size, review marketing practices (eg calories)
• Compulsory PE, healthy school meals, surgery.

Global distribution:

• More obesity in MEDCs- fatty foods more available, can afford it.
• More than 1/3 US adults are obese.
• Alabama and Mississippi are fatest states.

Causes:

• Drought, harvests falied.
• Population doubled.
• Inhospitable environment- 50+, increasing food costs.
• Government stops some aid groups. War.

Impacts:

• Death by hunger. Beri Beri (blind), aneamia, rickets (vit D deficiency)
• Starvation- 50% people become malnourished (lack of nutrition). 

Short-Term Solutions:

• Donations to help people affected. Adverts, medical aid.
• Distrubuting food that is rich in energy, eg oats, porridge, granola bars.

Long-Term Solutions:

• Education. HPVs (High Yielding Varieties)- make more money. Manage food prices.
• Helping to develop more productive farming system to prevent future famines.
• Donating farm animals, eg cows- providing milk and meat.

USA- Pluralistic

• Health system provided by thousands of independent doctors and hospitals.
• Consumer has to pay for treatment, doctor fees, hospitalisation, surgery, equipment, etc.
• Most people have insurance but 44 million don't.
• Is a consumer product.

France- Insurance/Social Security:

• Judged by WHO as most effective in the world.
• Is an insured guarenteed consumer product. Patient pays but is reimbursed.
• 3 doctors for every 1000 patients.
• Expensive system.

Cuba- Socialised:

• Spends 10 times less than USA, very effective, healthcare is state provided.
• 2nd highest life expectaancy in Caribbean.
• Over 30,000 family doctors and 10,000 dentists for 11 million.
• 21 medical schools with free training.

Canada- NHS:

• Aim to provide citizens with equal access to healthcare.
• Medicare, financed by taxes.
• Ensures indigenous groups (Inuits) can also get care.

India- Emergent:

• Healthcare is an item of personal consumption.
• Private ownership of facilities.
• Direct payment to physicians.
• Patient:doctor ratio are 500:1
• Rural areas lack clinics.
• Government spending on healthcare is low.

UK- NHS:

• Paid by taxes.

1. Research

• 20 years copyricht.
• Decide price.
• Higher percentage of money spent on research of disease of affluence.
• Prevent rather than cure.

2. Distribution

• Doctors are advised what to give out- may be given 'freebies' as a bribe.
• Treat symptoms not a cure to make more money.
• WHO Essential drug focusses of LEDCs- malaria, diarrhoea.

3. Production

• Branded drugs are more expensive- paying for the brand and money for advertising.
• Same drug as WHO list.

Good:

• Donate
• Researching diseases of poverty.
• Creating WHO Essential drugs.

Bad:

• Symptoms rather than cure.
• Money making business rather than healthcare. 

GlaxoSmithKline:

• 4 billion packs of medicine each year.
• MEDCs- CHD, LEDCs- polio vaccinations.
• Huge profits but donates drugs to LEDCs. 750 million drugs donated to cure elephantitis.
• Helps with community projects.

Tobacco Companies:

• 80% of smokers live in poorer countries- 1/3 world pop over 15 smokes.
• 4 million people die every year from smoking related illness.
• MEDCs stopping smoking, they recognise it is bad, education, pictures and slogans on cigarettes, smoking ban in England July 2007.

BAT (British American Tobacco) in India:

• BAT has cigarette factories in 44 countries- 2008 annual revenue was over £30,000 million.
• Targetted children
• Selling single sticks- more affordable.
• Advertising, parties.
• Target countries that haven't signed the WHO treaty on smoking.
• In India, increase of smoking related diseases.

Gender:

• Maternity Ward JR.
• Gyneacology, family planning.
• Fitness for both men and women.

Age:

• 30 care homes in Oxford.
• Children's Wing JR, opened in 2007, treats most pediatriv illnesses.
• Neonatal Unit treats babies who need intensive care.

Wealth:

• Manor Hospital Headington, Bupa Health Insurance, Oxford Private Medical Hospital.
• Low socio-economic classes more likely to use public hospitals.
• Good bus links to most hospitals, even public hospitals.