Geography of Mortality - created from Mind Map

key mortality indicators Crude death rate standardised death rate Age-specific mortality rates Life Expectancy at Birth Number of deaths per 1000 population in a given year limitations variations advantages measure distorted by age structure variations various other factors e.g. natural disaster Australia and Bolivia have similar crude death rates ~7 but for different reasons AUS lowest 40 IMR (4.43) vs Bolivia 57th highest IMR (38.61) by country by region Highest: South Africa (17.49), Ukraine (15.72), Lesotho (14.91) Lowest: Kuwait (2.16), UAE (1.99), Qatar (1.53) Southern Africa region: HIV epidemic Ukraine: weak healthcare system non-communicable diseases account for 82% of deaths a third of Ukrainians die prematurely before 65 Qatar world's richest country best and widely recognized healthcare systems in the world Largest drop in Africa: 15/1000 to 11/1000 in 2013 Important to note variations within region Algeria: 4.3/1000 Swaziland (14/1000) one of the best healthcare systems in Africa 0.1% of sexually active population with AIDS/HIV nationwide electronic healthcare project simplifies administrative procedures and eliminates paperwork reforms in health sector has majorly improved the health status of ppn severe tuberculosis infection access to clean water and sanitation access to healthcare life expectancy fell from 63 (1990) to 49 highest HIV prevalence: 26% among sexually active population 90% Antiretroviral (ART) coverage IMR reduced from 100 to 79 per 1000 live births (2008-14) Maternal mortality rate reduced TB/HIV co-infection rate 80% 1380 per 100,000 annually only 37% of rural population has access to safe water (2009) 0.17 physician density indicates level of healthcare provision, water quality, sanitation and living conditions indicates the CDR if population had same age and sex composition useful for comparative studies Infant Mortality Ratio Child Mortality Ratio Maternal Mortality Ratio no. of infants who die within the first year of age per 1000 live births reflects level of healthcare provision, sanitation, water quality, nutrition and living conditions declining trend with improved medical and health services and better nutrition highest: Afghanistan (117), Mali (104), Somalia (100), Niger (86) lowest: Monaco (1.8), Japan (2.1), Singapore (2.53) Bolivia's IMR( 38.61)>halved since 1990s Afghanistan common causes: infections, diarrhoea, and dehydration most births done at home lack of skilled medical personnel 0.19 physicians/1000 education: 12.6% female literacy rate - lack of midwives Singapore Monaco: 7.06 physicians/1000 (2012) 1st for IMR, 2nd for MMR, 9th for life expectancy universal health coverage at public hospitals and government polyclinics no. of children who die before age 5 per 1000 annual no. of pregnancy-related deaths of women per 100,000 live births highest in South Sudan (>2,000) early marriage most women in rural areas give birth at home due to lack of knowledge or accessibility to proper health facilities only one midwife per 125, 000 women brain drain of skilled midwives average number of years a person is expected to live in his lifetime difficult to calculate as it is normally derived from national life tables Highest: Monaco (89), Japan (84), Singapore(84), San Marino (83) Lowest: Chad (49), South Africa (49), Swaziland (50)

Factors affecting Mortality Demographics Medical Technology Public Health Measures Socio-economic Changes Political Epidemics and Pandemics (morbidity) environmental mortality higher for infant/child and old population gender ageing population higher risk of death from cardiovascular disease women higher life expectancy men higher risk of heart attack than women 82.8 vs 79 for men narrowing gap access to healthcare changes in health education improvements in medicine and treatment physician density Niger: 0.02, Monaco 7.06 Niger: 29% of births attended by skilled health personnel vs Czech Republic 100% breakthroughs in cancer treatment cell research - how to block movement of cancer cells Singapore A*STAR scientists discovered early detection methods and personalized treatment for ovarian cancer discovery of drugs made from tree bark by the Cancer Research Campaign (CRC) Water andSanitation immunisation eliminate conditions favourable to the spread of diseases e.g. cholera and typhoid most easily controlled by purification of water ss Chad: only 6% of rural population and 31% of urban population use improved sanitation dysentery can be controlled with proper food hygiene unclean water and poor sanitation are the world's second biggest killer of children mid-1990 vaccines to provide 'basic' coverage for TB, polio, tetanus, pertussis, and measles averted 2 million deaths in 2002 infant immunisation vital for improving infant and child survival Smallpox Hepatitis B vaccine e.g. DTP-3 coverage e.g. significant progress of MEASLES coverage polio cases decreased by 99% since 1988 reduced measles mortality in Africa by 60% between 1999-2004 African region lagging behind global immunisation coverage e.g. DTP-3 coverage e.g. DTP-3 coverage coverage in Africa increased from 54% in 2000 to 74% in 2011 endemic in Africa and Asia in 1960s Immunisation campaign by WHO eradicated smallpox by 1980 deadly disease that threatened 60% of the world's population and killed every fourth victim 1982 79% of infants in WHO's member states receive vaccination inverse r/s between socio-economic status and mortality Rising living standards education changing pattern of diseases characteristic of modernisation Pollution High death rates and low life expectancies improving overall life expectancy in Africa increased from 51 (1990) to 59 (2013) reversed trend for countries affected with AIDS healthcare (environmental)sanitation and hygiene nutrition resistance to disease influenza pneumonia diarrhoea TB knowledge about health and medical care Ethnic cleansing civil war genocide Darfur in Sudan: 300,000 deaths Sudan: 2mil deaths since 1983 congo war: 3.3 million deaths between 1998-2002 life expectancy ~56 Rwanda genocide 1994: 800 000 Tutsi minorities killed 6 million killed in Nazi Holocaust Botswana, Lesotho and Swaziland polio-endemic: Nigeria, Afghanistan changing pattern of diseases characteristic of modernisation 2014 ebola outbreak severe AIDS/HIV epidemic Romania: free ART treatment affects children under 5 Nigeria 124/1000 under-5 mortality ratio worldwide obesity has doubled since 1980 chronic non-communicable diseases leads to cardiovascular diseases, musculoskeletal disorders and cancer DCs and low-and-middle income countries vulnerable to inadequate nutrition low in cost but lower in nutritional quality death toll >2000 Sierra Leone, Liberia and Guinea droughts floods natural disasters pollution 10,000 killed from heatwave in France in 2003 Indian Ocean tsunami caused >200k deaths smog in China reduces average LE by 5.5 years

Zimbabwe, Swaziland, Lesotho, South Africa, Botswana

increased intake of energy-dense foods high in fat; increasingly sedentary nature of work, with advancements in xportation and urbanisation

Czech republic IMR 2.63 lowest 10 in the world Niger top 10 IMR (86)

Geography of Mortality

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