Defining health and its measurement using indicators

Health is understood as a state of physical, mental, and social well-being, coupled with the absence of disease. It varies significantly across the globe and is measured using health indicators.

Key indicators for measuring health

• Healthy life expectancy (HALE) - This measures the number of years a newborn is expected to live in full health, free from major diseases. HALE tends to be higher in more developed countries and lower in less developed regions.
• Morbidity indicators - These focus on the presence of disease within a population:
  • Prevalence - Represents the total number of cases of a disease in a population at a specific point in time.
  • Incidence - Refers to the number of new cases of a disease that occur within a population over a defined period.
• Factors influencing health - The health status of a country is determined by the extent and types of diseases present.

Global variations in health and morbidity patterns

Health outcomes and the burden of disease are not uniform worldwide.

Disparities in healthy life expectancy

• More developed countries - Typically exhibit higher HALE.
• Less developed countries - Often have lower HALE.

Morbidity patterns vary significantly in different regions depending on the type of disease.

Differences in infectious and non-communicable diseases across regions

Diseases are broadly categorised into two types: infectious and non-communicable. Their distribution and impact differ markedly between more developed and less developed countries.

Distribution of infectious diseases

• Definition - Infectious (communicable) diseases are those that can be transmitted between individuals, such as cholera or measles.
• High morbidity in less developed countries - Conditions like tuberculosis (TB) show elevated prevalence in less developed regions, especially in parts of Africa. Contributing factors include:
  • Lack of access to clean water and proper sanitation.
  • Insufficient healthcare facilities and resources.
  • Limited health education to prevent disease spread.
  • Overcrowded living conditions that facilitate transmission.
• Low morbidity in more developed countries - Countries such as Sweden, Canada, and New Zealand experience lower rates of infectious diseases like TB.

Distribution of non-communicable diseases

• Definition - Non-communicable diseases are not transmissible between people and include conditions like diabetes and hypertension.
• High morbidity in more developed countries - Diseases such as breast cancer have higher incidence in developed nations like Norway, France, and Singapore. Reasons for this include:
  • A greater proportion of older individuals due to higher overall life expectancy.
  • Lifestyle factors such as unhealthy diets and lack of physical activity, which are more prevalent in these regions.
• Low morbidity in less developed countries - Lower rates of non-communicable diseases like breast cancer are observed in areas such as parts of Central Africa and Southeast Asia.

Mortality rates and their relation to morbidity

Mortality, or the rate of death within a population, is closely linked to morbidity.

Connection between morbidity and mortality

• General association - High morbidity often correlates with high mortality.
• Mortality rate - This is defined as the number of deaths in a population over a specific timeframe.

Regional differences in mortality outcomes

• More developed regions - These areas frequently report higher incidence of diseases like cancer but lower mortality rates.
• Less developed regions - The percentage of fatal cases is significantly higher. Key reasons include:
  • Malnutrition - Weakens the body's ability to combat illness.
  • Limited healthcare access - Many individuals cannot obtain necessary treatments.

The epidemiological transition model and health improvements

The epidemiological transition model describes how the primary causes of death shift over time as societies develop economically and socially.

Stages of the epidemiological transition model

• Stage 1: Age of pestilence and famine - Dominated by high mortality from infectious diseases, with life expectancy around 50 years.
• Stage 2: Age of receding pandemics - Infectious disease mortality declines, raising life expectancy to approximately 60 years.
• Stage 3: Age of degenerative and man-made diseases - Non-communicable diseases become the leading cause of death, with life expectancy reaching about 70 years.
• Stage 4: Delay of degenerative diseases - Advances in medical treatment delay deaths from non-communicable diseases, pushing life expectancy to around 80 years.
• Potential Stage 5: Re-emergence of infectious diseases - Suggests a future resurgence of infectious diseases due to factors like antibiotic-resistant bacteria and increased global travel.

Health improvements with development

As countries progress through the stages of the model, several factors contribute to better health outcomes:

• Reduced malnutrition - Greater food availability strengthens health.
• Improved water and sanitation - Access to clean water and better hygiene decreases the spread of infectious diseases.
• Enhanced healthcare access - Wider availability of medical services and treatments.
• Better health education - Increased awareness of health practices and disease prevention.