PUBLIC HEALTH

Health Promotion and Public Health

Health Promotion and Public Health

Introduction

It is now recognized by all development actors that health is an essential dimension of economic productivity, and that improving the health status of the populations contributes significantly to development (Narayan et al. 2000, p. 89). However, More than a quarter of the developing world's people still live in poverty as measured by the human poverty index. One third of the developing world's people live in incomes of less than $1 a day. Residents of middle-income countries face a triple burden of disease (OMS 2008), and it can be assumed that people in under developed countries are in the same situation. More than a third of the world's population - around 2.4 billion people - currently has no access to a basic health facility. Many more live in countries where the system for providing health services is under-funded and overstretched. Lack of money is the most obvious cause. Countries with weak economies are unable to invest enough in buildings, staff, equipment and medicines (their health systems).

Discussion

People in the poorest countries of the world still face a heavy burden of disease of the first type, that is, health problems characteristic of the period before the epidemiological transition: infectious diseases, maternal and peri-natal conditions and malnutrition (OMS 2008, p.44). These causes of illness and death are highly correlated with poverty and the development deficit of state institutions (health, sanitation, etc.).

The burden of disease refers to an aggregate measure of mortality, morbidity, injuries and disabilities in a population, often expressed in DALYs (Disability Adjusted Life Years, i.e. the sum of years of potential life lost due to premature deaths and years of productive life lost due to disability) (Murray and Lopez 1996, p.58). HIV / AIDS is classified in the first group of diseases, because it is an infectious disease, although some authors prefer to frame it as a fourth burden.

The middle-income countries combine this first burden of disease with the second burden known as the burden of nontransmittable diseases, among which the most important worldwide are cardiovascular disease and depression (WHO 2008, p. 12). Non transmittable diseases account for the vast majority of deaths and disabilities in rich countries. Finally, there is a third burden of disease, death and disability due to injuries, both intentional and unintentional (accidents, violence, and suicide), not very present in the poorest countries, more frequent in middle-income countries, and also present but to a lesser extent in rich countries.

It is well established in the literature that poverty and ill health are interconnected. In a study of 56 developing countries, Gwatkin et al. (2007) find that “the health of the poor is notably worse than that of the better off” where health is measured by under-five mortality, malnutrition, and fertility (p. 7). This pattern of worse health is found in all countries for malnutrition and fertility and in all but two countries for the under-five mortality. The study also finds that “the poor use health services less and have less ...