SOCI 254 Lecture Notes - Tuberculosis, Measles, Sub-Saharan Africa

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12 Dec 2012
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Poverty, Famine, and Diseases of Famine
Sept.18.12
- Basic measure of poverty: life expectancy
Economic aspects of poverty:
- Unprecedented poverty
- First world countries have reached a high level of well-being (education, life
expectancy, etc.)
- Industrial revolution caused the increase in well-being
- Cheap access to resources
- Productivity and efficiency gains are major in all aspects
- Long-century of growth 1820-1950 that affected many parts of the world
- 1960-2010 another period of growth
- Economic growth, measured by income per capita
- Paralleled by other aspects of socio-economic characteristics (summarized in
the HDI and the human development report)
- Undeniable success hides certain issues: inequality, absolute gap between
rich and poor countries is widening
- The poor have grown to be a little less poor and the rich have become much
richer over the last few decades
- The relative gap: proportion of poor in relation to rich, widening
- Few countries will be able to close this gap at some time
- Exporting products in poorer countries has become very popular (i.e. wheat
production and consumption) but can be a poor competitor in comparison to
rich countries (i.e. Canada’s wheat production)
- Technological changes has multiplier effects in rich countries
- The money that’s being made from technology goes back to rich countries
- Consequences of inequalities: emigration of educated people to rich
countries, shortage of qualified labor in poor countries, migration would
reduce the inequality (remove certain resources and the others become
more valuable), mass of unemployed and angry people in the poor countries
(revolts?)
- Present inequalities using Lorenz curve and gini coefficient (high gini value =
high inequality)
- GDP measured by square m
Inequalities
Diseases of poverty
- Malnutrition
- Widespread scarcity of food
- Aids
- Malaria
- Tuberculosis
- Measles
- Pneumonia
- Cholera
- These are observed in poor countries more than rich ones
- Aids: 95% of cases are in poor countries
- Pneumonia: 98% of cases are in poor countries
- Within countries there is a replication of the same trends
- Poor countries are more susceptible to these diseases than rich countries;
they are more exposed to infectious diseases (crowding, lack of healthcare,
etc.)
- Individual factors: malnutrition
- Structural factors
- Diseases make poverty even worse
- Many African teachers have aids, lack of teachers so there are fewer
educated kids, direct impact on economic levels, feedback loop (positive
feedback)
- Fewer services offered so the disease levels increase as well
- Cholera epidemic in Zimbabwe: control of water was taken over by the
government, new centralized control/provision, control taken away from
local councils who were against the central government, political decision,
punished the areas that voted for the opposition
- Politics and health go together, provision of services is subject to political
decisions (i.e. food security and vaccinations can be turned on or off by
centralized governments)
- Governments essentially decide who gets to live and die
- Political opportunities to fight diseases: selective biomedical interventions
(can be successful, intervention in sub-Saharan Africa to reduce malaria was
successful and cut in half, continuing protection after requires structural
change, not going to forever have the support and money from foreigners,
interventions are quite alien to the country so not always supported,
vaccinations may delay immunity, interventions may do more harm than
good if they aren’t supported after by structural changes) or decentralized
community based alternatives to have a proper healthcare systems (long run
they are more successful, more effective measure than great expensive
health campaigns even though they are sometimes necessary)
- Wealth, disease, and (wealth means health) brazil is relatively wealthy and
has relatively low infant mortality, but Sri Lanka has low wealth and low
infant mortality (smaller income inequality)
- Truth: smaller resource inequalities will mean better health of the population
- John Snow: London 1852, cholera epidemic, water came from public water
pumps, Snow made a map of cholera deaths, not spread evenly in any one
area, drinking water was the cause
Urban disease in a rural setting: cholera in Latin America
- hypotheses to be tested:
1. Locational disadvantage exacerbates the effects of poverty, the rurual poor suffer
more than the urban poor
2. Pronounced bias in infrastructure and service provision has left poor populations
vulnerable to epidemic disease
- cholera is urban: crowding, unprotected water, unsanitary waste disposal, transfer
between cities, slum conditions, mobile populations
- cholera in coastal areas: geographical factors (), biological factors (), social factors
(dense human settlement, culinary preferences)
Famine
- Lack of food from crop failures
- Difficulties in the distribution of food
- Extreme political decisions, allocating resources incorrectly
- Warfare, civil and international
- Irish famine in 1845: brought Irish to north America, mass starvation, Ireland
still continued to export food to England
- 1843 famine in Bengal, politically forced, British government continued
shipping food from Bengal, once you have a truly free market and democracy
you will no longer have famines, imperial evidence strongly supports this
- Institutional failures
- Simply sending food to a needy country does not solve the root of the
problem
- China did not lack the delivery and distribution abilities in the 1958 famine,
political system of adversarial journalism (no mechanism to make it known
outside their political system), 30 million died, caused by political decision
- In most cases at national levels famine is not caused by lack of food but
rather lack of access to food
- Production and buying discrepancies
- Not a matter of agriculture but purchasing power
- Food left production areas to places where they can be offered for a higher
price, result of political decision making
- Famines are best prevented by protecting and subsidizing production or by
creating jobs so people have more money
- Subsidizing production: producing seed to have something to plant,
pesticides and fertilizers
- Creating low skill jobs and infrastructural work in areas where there is
starvation will bring in money and the crisis is solved
- More efficient to promote food production where the food is needed
- Only very rich countries with functioning institutions can afford for non food
options to solve famine
- Inconceivable for small countries to feed themselves (Austria, Switzerland,
Luxemburg), they are so rich that they can afford to import
- We need to make a practical distinction between famine and chronic
hunger/undernourishment
- Famines are extreme events and demand a certain type of public responses
(i.e. immediate import of food)
- Chronic hunger kills large numbers of people but does not necessarily lead to
famines, related to poverty and persistent failure to generate and protect
resources
- Wars are the most common antecedent causes of famine (i.e. in Africa)