week4readings

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Published on 20 Apr 2011
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GGRC02 Week 4 readings
Newbold, Chapter 5 (Mortality)
-in North America and Europe decline in mortality was seen soon after onset of industrial revolution
-longer lifespan resulted in pop growth, aided by modernization and advances in sanitation/nutrition
-first half of 20th C, developed countries completed mortality transition (long life expectancies, low infant
death rates and slow pop growth)
Mortality transition
-much of human history life expectancy was 2-30 yrs, with half of deaths occurring before age 5.
-emergence of sedentary lifestyle led to infectious diseases such as bubonic plague, where it became
prevalent cause of death due to denser pop and poor sanitation. Illness travelled through trade routes
-poor health standards and living conditions in N.A and Europe led to rise of public health initiatives
-incidence of infectious diseases decline with environmental improvements (living conditions) long
before medical intervention took place.
-mortality transition results in shift in the ages when majority of deaths occur.
-countries in beginning of demographic transition: younger ages die
-in developed world: most deaths occur among elderly, 2% of deaths for those under 20.
-life expectancy in developed world average 77 years. For women it is 81, for men it is 74.
-life expectancy in developing world are 67 for women, 63 for men.
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-modernisation not only brings about reduction in overall mortality levels and timing of death, but
also results in a shift in major causes of death from infectious/contagious to chronic/degenerative.
-in developed world, chronic-noncommunicable diseases (cancer, diabetes, liver, cardiovascular)
replaced infectious diseases as leading cause of death.
-most developing countries moved quickly through epidemiological transition, benefiting from
transfer of public health knowledge, medical technology and medicine from developed world.
Differences in Mortality
-two assumptions: (neither are correct)
1) assume that health indicators will constantly improve
2) assume that poor indicators of health are only found in the developing world
-Race and ethnicity (USA):
-since USA used largest portion of GDP, one would expect it to have lowest IMR
-US IMR is higher than 28 countries including Cuba and Hungary.
-reflects poor health status and mortality conditions of its minority populations.
-disparities observed between African-Americans(IMR: 13.63) and whites (IMR:5.76).
-black life expectancy is shorter than whites, and they have higher death rates from heart disease,
cancer, HIV/AIDS, and homicide (leading cause of death for young African males).
-reflects the marginalization of blacks in American society, with inequalities in education,
economic status or occupation.
-minority children suffer disproportionately from deprivation, with proportion of black children in
poverty 3 times higher than white children. Difference in mortality remains even with people in
similar income levels
-lower SES of blacks makes it hard to afford private medical insurance, while public health such
as Medicare and Medicaid are limited and means-tested.
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