6.3 - Global Patterns in Health Indicators
Health-adjusted life expectancy (HALE) as a measure of population health
Health-adjusted life expectancy (HALE) is a comprehensive indicator that reflects both the quantity and quality of life within a population. It integrates data on age- and sex-specific health and mortality to estimate the number of years a person can expect to live in full health, based on average population experiences.
Key observations about HALE
- Gender disparities - Women generally face a higher burden of ill health compared to men, impacting their overall HALE.
- Age-related impact - The burden of ill health tends to be more significant in early old age, particularly between the ages of 60 and 70.
- Primary health burdens - Sensory issues and physical pain constitute the largest components of ill health affecting HALE.
- Socio-economic influence - Higher socio-economic status provides a double benefit of longer life expectancy and a reduced burden of ill health. For instance, in Canada, individuals in the lowest income third experience a reduction in HALE at birth of approximately 3.2 years for women and 4.7 years for men compared to higher income groups.
Infant mortality rate (IMR) and its global variations
The infant mortality rate (IMR) measures the number of deaths of children under one year of age per 1,000 live births annually. It serves as an age-specific mortality rate, focusing on a particular age group to highlight health challenges faced by the youngest members of a population.
Calculating and interpreting IMR
The formula for IMR is as follows:
Global disparities in IMR
- Lowest rates - Some countries report extremely low IMRs, such as around 2‰ in places like Iceland, Japan and Singapore.
- Highest rates - In contrast, rates exceed 100‰ in nations like Afghanistan and Mali, with the majority of the highest IMRs found in sub-Saharan Africa.
- Regional patterns - A clear divide exists globally, with sub-Saharan Africa and parts of South Asia showing the highest IMRs, while North America, Europe, and Australia typically have much lower rates.
Maternal mortality rate (MMR) and regional differences
The maternal mortality rate (MMR) represents the number of female deaths per 100,000 live births each year, highlighting the risks associated with pregnancy and childbirth. Efforts to reduce MMR were a key focus of the Millennium Development Goals (MDGs) from 2000 to 2015, aiming for a three-quarter reduction by the end of the period.
Regional variations in MMR
- Highest rates - Sub-Saharan Africa and parts of South Asia report the highest MMRs, with a nation in sub-Saharan Africa recording over 2,054 deaths per 100,000 live births, followed by others at around 1,100 and 1,000.
- Exceptions - Outside these regions, countries like Haiti and Guyana also exhibit high MMRs, standing as anomalies.
- Lowest rates - High-income regions, including the European Union, Australia, and Singapore, consistently show the lowest MMRs, often due to better healthcare infrastructure.
- Progress and challenges - While global progress has been made in reducing MMR, significant challenges remain in sub-Saharan Africa, alongside moderate rates in Southeastern and Eastern Asia and Oceania.
Access to sanitation and its impact on health
Access to improved sanitation facilities is a critical determinant of public health, influencing the spread of diseases and overall well-being. The World Health Organization (WHO) tracks global access to these facilities as a key health indicator.
Global and regional access to sanitation
- Current global access - Approximately 68% of the world's population has access to improved sanitation facilities, falling short of international targets by about 9 percentage points.
- Population without access - Around 2.4 billion people worldwide lack access to improved sanitation, a significant barrier to health improvement.
- Regional disparities - In sub-Saharan Africa, the number of people without access has risen since 1990, exacerbating health risks.
- Urban vs. rural divide - About 80% of urban populations have access to improved sanitation, compared to only 50% in rural areas, highlighting stark inequalities in infrastructure development.
Access to health services and disparities worldwide
Access to health services is often measured by the ratio of people per doctor or per hospital, reflecting the availability of medical care. Beyond mere numbers, the quality and type of facilities available also play a crucial role in determining health outcomes.
Variations in access to health services
- Extreme disparities - Access varies widely, from one doctor per 100,000 people in some African nations like Burundi, to one doctor per 280 people in countries such as Hungary and Iceland.
- Specific examples - In China, there are roughly 610 people per doctor, while in India, the ratio is closer to 1,960 per doctor, illustrating significant national differences.
- Beyond numbers - Inequalities in health services extend beyond staffing ratios to include the availability of advanced equipment and the quality of care in hospitals and clinics, which often vary within and between countries.