GEOG20011 Lecture Notes - Lecture 6: Sub-Saharan Africa, Infant Mortality, Cardiovascular Disease
16 May 2018
School
Department
Course
Professor
LECTURE 6: HEALTH (Inequality, Health and Sanitation)
• What are the biggest barriers to reducing health inequalities?
o Poverty
o Access to sanitation, first aid and medicine
o Education
o Funding
o Stereotypes
• Health, bigger political problem, not just the physical problems felt by individuals/groups
SCALES OF HEALTH INEQUALITY
Between countries
• Vast inequity in access to basic health facilities
• Sub-Saharan Africa and South Asia markedly worse off than remainder of world
• Widespread absence of anything like a public health care system – low GDP spending on health
Within countries
India issues: pollution, lack of clean water and poor sanitation (only 14% in rural areas have access to a latrine)
• 40-60% of children malnourished – not just lack of food, also obesity
• Only spends 2% of GDP on health care, with corruption at every level
• 35% of Indian households incur Catastrophic Health Expenditure – one sick person in households could result in poverty –
economic way of thinking about health on a household scale
• UK: life expectancy up to 5 years different between best and worst regions – based on economic and social geographies
Across social lines
Indigenous Health in Australia: limited public health reach and mutually reinforcing inequalities
• Poorer health – cardiovascular disease, cancers, diabetes
• Lower life expectancy
• Mental health – large % of suicides are Indigenous
• Insights: close connection between inequality & mental health, rapidly increasing health issues in marginalised populations
USA: African Americans (twice as high infant mortality, 2.5 times more likely to die in childbirth, 9 times likely to be diagnosed with
HIV)
• Reflects lack of affordable, accessible and comprehensive healthcare system in the USA
• Reinforces inequalities based upon race, class and geography
Tackling Health Inequalities
• Roots of health disadvantage lie in structural disadvantages
• Social policies:
o Early childhood development
o Education across lifespan
o Good employment & working conditions
o Fair minimum income
o Socially healthy communities
Policies of Health Inequalities
• Neoliberal policies:
o Erosion of public healthcare
o De-emphasis on human development
o Spread of new health risks
• Public health care becomes ‘residualised’ – only the poorest and least politically-influential use it
• Health care not a major electoral issue in countries worst affected by health inequalities
GROUNDED APPROACH TO HEALTH
Lecture Outline
• Scales of inequality
• Towards a grounded
approach
• Politics and public
action
Obesity as a
‘neoliberal’
epidemic –
follows neoliberal
policies
(employment,
income,
availability of
processed food)
Social Determinants of Ill Health
• Causes of the causes!
• The social conditions that give rise to high risk of ill health, based on:
o Stress, social exclusion, social support
o Work, unemployment
o Addiction, food, transport
• Understanding long-term social change and improving basic services in remote locations
Document Summary
Lecture 6: health (inequality, health and sanitation: what are the biggest barriers to reducing health inequalities, poverty, access to sanitation, first aid and medicine, education. Stereotypes: health, bigger political problem, not just the physical problems felt by individuals/groups. Between countries: vast inequity in access to basic health facilities, widespread absence of anything like a public health care system low gdp spending on health. Sub-saharan africa and south asia markedly worse off than remainder of world. Obesity as a (cid:858)(cid:374)eoli(cid:271)eral(cid:859) epidemic follows neoliberal policies (employment, income, availability of processed food) India issues: pollution, lack of clean water and poor sanitation (only 14% in rural areas have access to a latrine) 40-60% of children malnourished not just lack of food, also obesity: only spends 2% of gdp on health care, with corruption at every level. Indigenous health in australia: limited public health reach and mutually reinforcing inequalities: mental health large % of suicides are indigenous.
