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GEOG 2HI3 (5)
Lecture 9

Lecture 9 - Diseases of Affluence

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Carolyn Eyles

Diseases of Affluence Types of Diseases of Affluence - Heart disease - Some forms of cancer - Cerebro- and peripheral vascular diseases - Type II Diabetes - Substance abuse - Obesity - Psychological disorders o Eg. depression - Neurological disorders o Eg. Alzheimer’s disease Diseases of Affluence: Bases - Individual level changes o Diet o Physical activity o Sedentary work (sitting work) - Population level changes o Developments in energy-intensive technologies for food production , processing, transport, and storage o Year-round supply of foods o Increasing levels of urbanization - These bases of the disease of affluence often come together Heart Disease Definition Geographical Distribution Cardiovascular Diseases: include heart attacks, hypertension, In the United States congential heart disease, and heart failure among others - H.D. is the leading cause of death for both women and men in the - The major causes of cardiovascular disease are tobacco US use, physical inactivity, and an unhealthy diet - 29% of all US deaths. The age-adjusted death rate was 241 per 100 000 population - Globally, cardiovascular diseases are the number one - Crude death rates – highest in whites and blacks cause of death and are projected to remain so. - There are also geographical differences with Mississippi (the o An estimated 17.5 million people died from highest state) having twice the rate as Minnesota (the lowest) cardiovascular disease in 2005, representing - In 2006, H.D. is projected to cost more than $258 billion, 30% of all global deaths including health care services, medications, and lost productivity - Of these deaths, 7.6 million were due to heart attacks and 5.7 million due to stroke In Canada - About 80% of these deaths occurred in low- and - Much of the decline in overall mortality rates is attributable to the middle-income countries more than 70% decline in death rates related to circulatory - diseases – most notably ischemic H.D. and cerbrovascular disease Natural Experiments: occurring event which produces data (including stroke) similar to that of a scientific experiment - Mortality rates vary by neighbourhood income. Death rates due to - Eg. Poland- social and dietary change ischemic .HD. are decreasing for men, gap between highest and - John Snow’s removal of the Broad Street pump handle lowest income is narrowing Cancer Definition Distribution Worldwide Risk Factors - Leading cause of death worldwide: - About 70% of all cancer deaths - About 30% of cancer could be it accounted for 7.9 million deaths occurred in low- and middle- prevented by modifying or (around 13% of all deaths) income countries avoiding key risk factors - Lung, stomach, liver, colon, and - Deaths from cancer worldwide are 1. Being overweight or obese breast cancer cause the most cancer projected to continue to rise to over 2. Low fruit or vegetable intake deaths each year 13.1 million in 2030 3. Physical inactivity - The most frequent types of cancer - The most frequent types of cancer 4. Tobacco use differ between men and women worldwide are: 5. Alcohol use - Tobacco use is the single most - Among men: lung, stomach, liver, 6. Unsafe sex important risk factor colorectal, oesophagus, prostate 7. Urban air pollution - Among women: breast, lung, 8. Indoor smoke from household stomach, colorectal, and cervical use of solid fuels 9. Hepatitis B or C – contaminated injections in health-care settings 10. Sun exposure Cancer Cluster: a greater-than-expected Environment and Cancer Prostate Cancer and Diet number of cancer cases that occurs within - Along with individual - Dietary patterns reflect a group of people in a geographic area over susceptibility, environmental combinations of dietary exposures, a period of time factors play a role in most human and these patterns in relation to - The time between exposure to a cancer prostate cancer risk were examined cancer-causing agent, or the - However, new molecular evidence in a case-control study in Kingston, existence of other risk factors, and indicates that specific groups – Ontario the development of cancer can be characterized by predisposing - The results suggest that a dietary decades; therefore causes are hard genetic traits or ethnicity, the very pattern including refined grain - May not actually be a cancer young, and women – may have products, processed meats, and red cluster; may be within expected heightened risk from certain and organ meats contributes to range of new cases exposures increased risk Comparative Incidence Figure (CIF) - A ratio of the age-standardized incidence rate for a disease in a specific area compared with the incidence rate for all of a larger area o Those areas with a CIF less than one have an incidence rate that is less than average o If the CIF is above one, then the area has a higher rate of disease Comparative Mortality Figure (CMF) - A ratio of the age-standardized mortality rate for a disease in a specific area compared with the mortality rate for all of a larger area o Those areas with a CMF less than one have a mortality rate that is less than the average o If CMF is above one, then the area has a higher rate of mortality due to the disease Type II Diabetes Definition Geographical Distribution - Caused by a complicated interplay of genes, environment, In Canada th insulin abnormalities, increased glucose production in the - 7 leading cause of death liver, increased fat breakdown, and possibly defective - Accounted for approx. 25 000 potential years of life lost hormonal secretions in the intestine
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