- 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.
- 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.
- Palliative care.
- HIV treatment should be free.
- 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.
HIV Case Studies- Botswana & Thailand
- 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.
- 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.
CHD in the UK
- 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.
Non-Communicable Disease- CHD
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.
- Highest death rate from CHD is in India. 60% of CHD is in developing countries.
- 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.
Cholera in Haiti
- 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.
- UK sends aid to Haiti to prevent disease spreading. Going to improve health and water supply for 231,000 people.
Patterns of Mortality and 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
- Means death- high morbidity= high mortality.
- Mortality rate- how many people die in a population over a period of time.
Disease of Affluence- Obesity
- Energy imbalance between calories consumed and expended.
- Decrease in exercise, energy dense foods high in fat, sugar.
- Diabetes, cancer, cardiovascular disease, premature death.
- 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.
- 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.
Famine- Ethiopia 2000
- Drought, harvests falied.
- Population doubled.
- Inhospitable environment- 50+, increasing food costs.
- Government stops some aid groups. War.
- Death by hunger. Beri Beri (blind), aneamia, rickets (vit D deficiency)
- Starvation- 50% people become malnourished (lack of nutrition).
- Donations to help people affected. Adverts, medical aid.
- Distrubuting food that is rich in energy, eg oats, porridge, granola bars.
- 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.
- 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.
- 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.
- Aim to provide citizens with equal access to healthcare.
- Medicare, financed by taxes.
- Ensures indigenous groups (Inuits) can also get care.
- 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.
- Paid by taxes.
- 20 years copyricht.
- Decide price.
- Higher percentage of money spent on research of disease of affluence.
- Prevent rather than cure.
- 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.
- Branded drugs are more expensive- paying for the brand and money for advertising.
- Same drug as WHO list.
- Researching diseases of poverty.
- Creating WHO Essential drugs.
- Symptoms rather than cure.
- Money making business rather than healthcare.
- 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.
- 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.
Healthcare in Oxford
- Maternity Ward JR.
- Gyneacology, family planning.
- Fitness for both men and women.
- 30 care homes in Oxford.
- Children's Wing JR, opened in 2007, treats most pediatriv illnesses.
- Neonatal Unit treats babies who need intensive care.
- 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.