Key Health Indicators in Developing Countries and Australia

Understanding the similarities and differences in health status and human development between developing countries and Australia Key indicators such as life expectancy, mortality, morbidity, burden of disease and the Human Development Index (HDI) provide valuable data.

Life expectancy has increased in most countries over time. However, there are occasionally fluctuations in life expectancy within countries. For example, war and conflict can have a significant impact on life expectancy in a relatively short period of time. Developing countries are more susceptible to health issues and generally experience more severe fluctuations than developed countries like Australia. Many African countries, for example, have experienced a decrease in life expectancy in recent years due to the AIDS epidemic. Remember, life expectancy is an indicator of how long a person can expect to live if mortality rates do not change. Healthy life expectancy (also known as health adjusted life expectancy or HALE) relates to the number of years a person can expect to live in full health, free from disease, illness and disability. HALE is based on current rates of mortality and morbidity.

Mortality and Morbidity Mortality and morbidity rates give valuable information not only about the causes of death and illness, but about the resources that might be employed to close the gap between developed and developing countries.

Child Mortality and Morbidity he under-five mortality rate (U5MR) is one of the most important indicators of the level of development of a country. The survival of a child is reliant on numerous factors. U5MR reports the number of deaths that occur in children under five years of age (per 1000 live births), and is a reflection of the: nutritional health of mothers health knowledge of mothers level of immunisation available availability of maternal and child health services income and food availability in the family availability of clean water and safe sanitation overall safety of the child’s environment. The U5MR in developing countries varies but is much higher than those in developed countries

Malnutrition Malnutrition is an underlying factor contributing to the high rates of mortality and morbidity experienced in these countries. Children who are undernourished have an underdeveloped immune system and struggle to fight off disease as effectively as those who are adequately nourished. As a result, communicable diseases (such as diarrhoeal diseases, malaria and pneumonia that cause few deaths in Australia have a huge impact on mortality figures in developing countries.. Australian children are more likely to experience mortality and morbidity due to accidental causes such as injuries and poisoning and congenital malformations.

Children Childhood deaths in developing countries make up around 99% of global deaths among children. As a result, the causes of childhood deaths in developing countries are prominent when examining global figures. Deaths due to measles are uncommon in Australia because of adequate health care and well nourished children. Children contracting measles in developing countries are not always as fortunate.

Adult mortality and Morbidity Child mortality and morbidity patterns provide a valuable indicator of the overall health and wellbeing of a country. However, some countries experience low child mortality but high levels of adult mortality. This can be due to the impact of lifestyle factors such as tobacco smoking and excessive alcohol consumption. To ignore adult mortality and morbidity figures would be to ignore an aspect of development that requires attention in many developing countries. Adult mortality rates generally increase as the level of development decreases. The Russian Federation is the exception. It experiences high rates of adult mortality, largely due to conditions associated with high rates of tobacco smoking and alcohol misuse. As with child mortality and morbidity, the causes of mortality and morbidity for adults differ depending on the level of development.

Adults Although communicable diseases such as HIV/AIDS, tuberculosis and influenza contribute to significant differences in mortality rates between adults in developed and developing countries, non-communicable diseases such as cancer, heart disease and type 2 diabetes are also high in developing countries. This creates a ‘double burden’ in many developing countries. This puts an added strain on the relatively basic health care available and contributes to poorer health outcomes. When adults in a family become ill, the children may have to take care of the adults and themselves, which adds to the cycle of poverty and ill health.

Adults Other causes of mortality and morbidity for those in developing countries include those associated with pregnancy and childbirth, with maternal mortality rates being high compared to Australia. Many of the problems that pregnant women face are associated with the birthing procedure, also another problem that is uncommon in Australia.

Burden of Disease Even though the proportion of deaths caused by non- communicable diseases (including cancer and cardiovascular disease) is lower in developing countries like Pakistan and Uganda when compared with Australia, it is important to remember that overall mortality rates are significantly higher (per 100 000 people) in developing countries. As a result, mortality rates for non-communicable diseases are often higher in developing countries when compared with Australia.

Burden of Disease Communicable diseases generally have a large impact on health in developing countries. HIV and tuberculosis are two conditions that contribute significantly to the burden of disease in many developing countries

Human Development Index Health is influenced by factors such as income and education, which are key components of the Human Development Index. Comparing the Human Development Index of Australia with that of developing countries provides another way to examine the similarities and differences that exist between these countries. When compared with other indicators outlined in this section, it also illustrates the close relationship between health and human development. Countries with a lower Human Development Index than Australia generally experience poorer outcomes with regards to life expectancy, access to education and income. The least developed countries show the greatest difference in the Human Development Index when compared with Australia. Lower Human Development Indices in developing countries indicate that people do not have the same opportunities to enhance their capabilities and to lead long, healthy lives to the same degree as most people in Australia.

Test Your Knowledge What has been the general global trend with regard to life expectancy over the past decades? How does Australia’s life expectancy and healthy life expectancy compare to developing countries? How does the U5MR of Australia compare to developing countries? What are the leading causes of mortality and morbidity in developing countries compared to Australia? Explain why malnutrition is an underlying factor in many causes of mortality and morbidity in developing countries.

Homework Compare the Human Development Index between Australia and developing countries, as shown in figure 8.24. Suggest reasons that may account for the differences in the HDI of these countries. Use the HIV/AIDS weblink in your eBookPLUS to find the link for this question. How has HIV/AIDS impacted on Kennedy’s life? What are the indirect costs of the AIDS epidemic in Nairobi? How is football used to educate young people about AIDS? Use the Malaria in Africa weblink in your eBookPLUS to find the link for this question. How many people are estimated to die from malaria each year? Who is most at risk? How many of the deaths occur in Africa? What is the World Bank’s booster program?

Answers Life expectancy has generally increased over the past decade. Australia’s life expectancy and healthy life expectancy are higher compared with developing countries. Life expectancy is around 81 in Australia compared to around 74 in China, 66 in the Russian Federation, 63 in Pakistan and 50 in Uganda. Healthy life expectancy is around 73 in Australia compared to 64 in China, 57 in the Russian Federation, 53 in Pakistan and 43 in Uganda. The under-five mortality rate is around 5 per 1000 live births in Australia, 15 in the Russian Federation, 25 in China, 95 in Pakistan and 130 in Uganda. Leading causes of mortality and morbidity include: communicable diseases such as malaria, measles, HIV and tuberculosis — more common in developing countries than in Australia diarrhoeal diseases — more common in developing countries than in Australia cardiovascular disease — causes more deaths in developing countries than in Australia injuries — responsible for a higher proportion of deaths in developing countries death during pregnancy and childbirth — more common in developing countries. Malnutrition is an underlying factor in many causes of mortality and morbidity, as a person who is undernourished generally does not have the strength and immune function to fight off infection. This can mean that common infections and conditions can take hold and lead to a deterioration in health. Similarities include: injuries contribute to the smallest proportion of deaths in all countries compared with cardiovascular disease, diabetes and injuries