Throughout the mid 1900’s there were many public health
advancements including vaccinations, antibiotics, and implementations for
improved sanitation and hygiene. These advancements led to a drastic decline in
the number of deaths due to infectious diseases. In 1900, the top 3 leading
causes of death were pneumonia, tuberculosis, and diphtheria and 30.4% of deaths
were among children ages less than 5 years old. A century later, these diseases
are rarely seen in the developed world; we have ways to prevent them and cure
them, and the percentage of deaths in children dropped to just 1.4% of deaths. When
looking at these statistics and charts, it is easy to think that we have
eradicated infectious diseases; however, this is far from true. People in
impoverished and developing countries are still suffering every day. Currently,
the five leading causes of death in low-income countries are diarrheal
diseases, HIV/AIDS, tuberculosis (claiming ¼ million lives per year), neonatal
infections, and malaria- all of which are treatable infectious illness that are
no longer found on the leading lists in high-income countries.
At a first glance you would of course assume that
higher-income nations are much healthier and that we need to provide these
poorer countries with the resources to live a healthy life of higher quality.
As I believe that we absolutely need to help these countries, the
infectious-disease “free” countries now have many more problems regarding chronic
diseases. It seems as if there is no escape to disease- no matter where you
live there will be a trend of infectious disease or chronic disease. Which is
worse? Which is easier to fix? And why was there a shift from infectious to
chronic diseases in higher-income countries? Can we provide these poorer countries
with education and vaccinations? Or can we teach Americans and other
higher-income countries to lead healthier lifestyles-exercise more, eat
healthier, take care of their mental health and social ties? Were chronic
diseases always around, people just didn’t live long enough to experience them
because they died of infection? Or has the way we live as humans transformed so
much and because of that cannot be as active and healthy as we once were?
Although there have been tremendous advancements in public
health, there are still many improvements needed. We need to help these
countries still suffering from treatable, preventable diseases. And we need to
decrease the amount of people dying from preventable chronic diseases.
Resources:
Farmer, Paul, Kim, Jim Yong, Kleinman, Arther, Basilico,
Matthew. Reimagining Global Health. (pgs. 2-3).
https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4829a1.htm
Hannah, this is a good question. I think the more we understand about how viruses and bacteria work the more we realize how much we have yet to know. At one time doctors prescribe antibiotics for everything until they found that this was creating antibiotic resistant bacteria and now that is a use only if necessary. We have yet to learn and we are also now understanding how the role of the enviroment on the impact of disease and genes, this theory was consider junk 10 years ago, but is now held in good standing. We now have superbugs resistant to Colistin, the antibiotic of last resort. This is really scary when we thing that these superbugs kill up to 50% of the people who become infected with them. I don't think that we know about everything that's out there and how we impact and influence those things.I look at science as every changing and we are exploring etiologic factors, pathogenesis and causality. We still have so much to discover and I think in order for us to survive we can't do this in a bubble, we need the knowledge of international experts. We need to work together on a global scale because there are some viruses and bacteria that doesn't present any symptoms in certain populations of the world because they are immune. The virus or bacteria may be endemic to that country but we still need to understand how and why something that could be so deadly only affect certain people and not others. Why are there people with Ebola who are immune to it's deadly effects? Until we can answer some of those questions, I don't believe that we are any closer to escaping disease.
ReplyDeleteHannah, this blog touched on really hot topics in public health. It is so sad to think about the fact that the United States has a lot of resources that could be saving thousands and thousands of lives if they were given to other countries. It makes you wonder why we aren't doing more. I am going to propose some potential answers to the questions that you posed.
ReplyDeleteWhich is worse: I think that they are both equally terrible because they are both killing millions.
Which is easier to fix: At this point I would say the infectious diseases are easier to fix because of the vaccinations, medical advancements and medications that we have discovered.
Why was there a shift in higher-income countries: I think this is because of the technological advancements and the fact that we are all living long enough to be killed by chronic diseases.
I think as public health practitioners we should be working on improving global health by providing education and vaccinations to these place suffering from infectious diseases.
excellent question Hannah. I would opine, we can escape diseases to a great extent. In fact we have as life expectancy averages have increased across the world and number of children, people dying due to Vaccine Preventable Diseases have reduced. Non-infectious chronic lifestyle related diseases are on a rise though and there are a host of other factors behind this epidemiological transition. As a society we certainly can be most more healthy than we are now and as PH experts we have to devise multiple ways to reach that state. Bring this question up in next class when we discuss some historical roots and Neoliberalism and lets examine the question and possible solutions in that context.
ReplyDeleteHannah .. Great topic for discussion!
ReplyDeleteI believe that this point is the core of our scope as public health professionals. My point of view is that it is a matter of prioritization of interventions and dealing with different countries and populations as different local worlds with different circumstances and challenges. In developing countries, lack of resources, health facilities, health awarness and education in addition to social and religious norms maybe some reasons for persistance of infectious diseases. On the other hand, availablity of resources and technological facilities predisposes to unhealthy lifestyles which in turn lead to increase the rate of chronic diseases in developed countries. In my opinion, this is a distinct consequence of health inequity.
Global health care systems should take such differences into consideration during interventions. Achieving a balance and working on the problem of health inequity may contribute to solving this public health dilemma!
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