environment , health and wellbeing

• mortality means death
• morbidity means illness
• morbidity measured using disability adjusted life year (DALY) - measure of overall disease burden expressed as number of years lost to disability
• mortality in children under 5 around the world declined by 60% between 1990 and 2016 , death rate before was 90 deaths per 1000 babies , now 36
• risk of a child dying before their fifth birthday highest in african region - 57 per 1000
• pace of decline in under-five mortality increased from 0.6% per year between 1990 - 1995 to 4.5% per year between 2005- 2016
• infectious diseases include influenza , AIDS , malaria , chlorea
• deaths most results from non-communicable diseases like cancers , diabetes , heart disease etc
• stages of epidemiological transition model :

  1 - age of pestilence and famine

  2 - age of receding pandemics

  3 - age of degenerative disease

  4 - age of delayed degenerative disease
• Orman stated that socio-economic development is responsible for movement of society through these stages
• 1 - Age of pestilence and famine:

  • mortality is high
  • causes of death are infectious disease , poor maternal conditions, reinforced by malnutrition
• 2 - age of receding pandemics

  • socio-economic developments and advances in medical science and healthcare
  • infectious diseases reduced and life expectancy increases
• 3 - age of degenerative diseases

  • increased visibility of degenerative diseases e.g cancer and heart disease
  • diseases associated with modernisation and industrialisation (obesity and diabetes) also increase
• 4 - age of delayed degenerative diseases

  • causes of death same as 3rd stage (dementia more common)
  • such diseases occur later in life as life expectany increases
• air pollution a major environmental risk to health
• by reducing air pollution levels countries can reduce burden of disease from stroke , heart disease , lung cancer and acute respiratory diseases , including asthma
• indoor smoke is a serious health risk for 3 billion people who cook and heat their homes with biomass fuels and coals
• according to WHO , ambient pollution in both cities and rural areas caused 4 million premature deaths worldwide in 2016
• 88% of premature deaths due to air pollution occured in low and middle income countries as in Western Pacific and south east asia regions
• 1 billion people lack access to safe , clean water
• 2 million annual deaths are beacuse of unsafe water , sanitation and hygiene and diarrhoea
• schistosmiasis - parasitic worms that live in irrigation ditches and other water courses have infected an estimated 260 million people
• international agencies:

  • WHO
  • UNICEF
  • UNAIDS
• the WHOs work:

  • providing information of vaccines ,cancer researches, nutrition and drug addition
  • advises on prevention and treatment of disease
  • working with other UN agencies and NGOs on international health issues (Ebola crisis -2014/15)
• NGOs are non-governmental organisations e.g Oxfam and Bill and Melinda Gates Foundation