I
have to admit that when our professor Dr. Jo Dunham asked us to write
down what we knew about population dynamics at the start of our third
class, I was really at a loss for words. From the many quizzical looks
that I saw around the room, I was not the only one. Eventually the
wheels began to turn and terms began coming to mind such as population
growth, birth and mortality rates, fertility and migration. I also
started to think of gender and age demographics (i.e. is a population
younger or aging) and how they influence the economic and social systems
of a country, but more on that in the next post.
Perhaps
the best way to identify what those figures mean and how they impact
societies is to compare them both between and within countries,
especially as their populations transition. But the numbers are not
always what we expect. We did a short quiz comparing the
infant mortality rates of nine pairs of countries and many of the
answers proved to be quite surprising.
The Quiz:
In
each pairing, one of the countries has an infant mortality rate that is
twice as high as the other. The answer from each pair is in bold.
Sri Lanka vs Turkey
Poland vs South Korea
Cuba vs Russia
Pakistan vs Vietnam
Thailand vs South Africa
Germany vs Singapore
Romania vs Chile
United States vs Slovenia
Seychelles vs Mexico
I
only managed to correctly select six of the nine right answers and in
truth, they were all guesses with the exception of Cuba vs Russia
(simply because I am familiar with the Cuban health system). I have to say that I was blown away by the size of the differences between the countries, many of which I previously thought would have been quite comparable. I suppose it shows that preconceived notions cannot and should not be trusted in public health.
The answers could be indicative of several things, including the value placed on providing good healthcare (especially antenatal, maternal and postnatal services) and maternal education in one society compared to another. They could also point to harmful (or, for the countries who have done better, beneficial) cultural/social practices, gender inequality, malnutrition, unstable governments (and therefore unreliable services), extreme poverty or socioeconomic disparities, long distances to health services, hygiene and sanitation concerns as well as poorly managed levels of communicable disease.
The answers could be indicative of several things, including the value placed on providing good healthcare (especially antenatal, maternal and postnatal services) and maternal education in one society compared to another. They could also point to harmful (or, for the countries who have done better, beneficial) cultural/social practices, gender inequality, malnutrition, unstable governments (and therefore unreliable services), extreme poverty or socioeconomic disparities, long distances to health services, hygiene and sanitation concerns as well as poorly managed levels of communicable disease.
Overall,
I would say education and the implementation of and access to services
generally make the biggest differences, especially after watching the
following IdeasLab with Julio Frenk:
While
discussing the triple health burden facing many countries, Frenk points
out the significant impact knowledge and modern medical discoveries
have had on improving health, even in impoverished settings. I have to
say that I was incredibly impressed when he highlighted Chile's success
at raising its national life expectancy to 79 in 1990, despite having a very low income per capita (equivalent to that of the U.S.A in 1900).
It's proof that even people living in developing countries can live
significantly longer lives (probably provided that the country is not caught in civil war or ravaged by natural
disaster).
In the end, sharing and utilizing information can and has (in some
cases) dramatically reduced the disparities in survival between the rich
and the poor of the world so long as health and education can be made a
priority. If we know better, we do better.
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