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Lecture 4

IDSB04H3 Lecture Notes - Lecture 4: Sub-Saharan Africa, Data Collection System, Visible Minority


Department
International Development Studies
Course Code
IDSB04H3
Professor
Anne- Emanuelle Birn
Lecture
4

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Lecture #4
Data on Health
What do we know, what do we need to know, and why does it matter
Data Paradox
- Require data for health decision making locally and globally
But
- There are enormous deficiencies in health data most are guestimates and extrapolations
- Reporting of international health to other countries is important, China held information of a virus and made it
worse
- Very few societies consider poverty to be an underlying cause of death
o Need to find correlations between things like death rates in low income areas as opposed to
high income
- Cannot assume causal pathways with the data on hand
Health Inequities: who/what is counted (197)
- Girl born in 2015 has a life expectancy of 73/8 boys have 69 years a child born in 2015 has a life expectancy 6
years higher then on born in 1990
- Not all lives are equally recorded: one third of births and two thirds of the estimated 56 million global annual
deaths, including almost 50% of child deaths are not registered
- Aggregate health indicators do not reflect variations by social class, geographic location, occupation, sex/
gender, race/ethnicity, and other important factors
- Children both in sub-Saharan Africa are on average 7 times more likely to die before the age of 5 then those in
Europe there is a wide variation within countries too
- When race and class are taken into account there is a staggering difference
Canada’s Shame: also a health data issue (199)
- Routine health data are not collected on visible minorities and indigenous identification for birth and death
registration remains inconsistent across provinces
- Difficult to track the mortality effects of the Canadian governments racially motivated public policies:
- 1980s-1990s more then 150,000 indigenous children were removed form their homes and compelled by
Canadian government policy to attend church-run residential schools
- Notoriously high rates of TB, violent treatment, and atrocious living and nutritional conditions: death rates up
to 5 times higher than the overall school aged population
o Hard to track this data because of the deficiencies
Louis-Rene Villerme (1782-1862)
- Tracking mortality by social factors
- Measured poverty by what percent of the population didn’t have to pay taxes on their rent
o So the lower percent of untaxed rent you were in a rich area
- Tracking death rates by poverty levels
- Debunks environmental theories of disease
- Propotation of households exempt from rent tax: perfect fit
Villermes Findings
- Poverty and mortality closely correlated:
o Social facts: ease= longevity, dis-ease= early death
- Disease socially produced, not divinely ordained
However rather than use these findings to justify the expansion of public health measures Villerme held:
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- Capitalist economic system Not responsible for death among slum dwellers and factory workers
- Instead, poverty- understood as personal immorality (drink, debauchery, idleness, bad habits) was the cause
- Bourgeois society absolved of need to invest in housing, sanitation, and other public health measures, personal
effort and long term, amelioration through capitalism would resolve mortality among poor
o Illustration of what we assume to be an obvious policy description based on the ideology of
him
19th century Public Health Paradigms Laissez-Faire, Reform, Revolution
- Villerme
o Poverty and vice cause illness and disease
o For individuals: moral improvements; for economy: laissez-faire
- Chadwick
o Filth and immortality cause disease and poverty
o Sanitary reform needed
- Engels
o Capitalism and class exploitation produce poverty, disease and death
o Revolution needed
Types of Health Data (199)
- Population data
- Vital statistics
- Morbidity statistics
- Health services statistics
- Data on social determinants of health and health inequities
Census taking (203)
- Individual enumeration
- Universality within a defined territory (the entire country should be apart of the census)
- Simultaneity
- Defined periodicity (a census should be conducted at regular intervals)
Census Challenges
- Cost and scope
o India:2.7 million enumerators, 240m h-holds, 25 days
o Nigeria: 300 ethnic groups (150m people), 1m workers, 7 days, GPS and 6 years of planning
- Errors and underestimates
- Canada long form controversy
- Carried application of categories (even age)
- Racialized and racist typologies
o US race-based classification (legacy of slavery)
o South African Apartheid (colored, black, Asian, white)
Vital Statistics
Births
Personal/Social
Birth Certificate
1. Establish date of birth/identity
2. Establish family relationship
3. Protect against child labor. Inscription
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