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Global Health

CHAPTER 30. GLOBAL DISPARITIES IN NUTRITION AND HEALTH

 

CHAPTER INTRODUCTION

Humans must have food to survive. Hunting and gathering provided a precarious existence, but with the development of agriculture, surpluses of food could be produced. Concerns about food supplies and popu lation appear periodically but predicted global shortages have not materialized. Yet there is hunger, even in an affluent country like the United States . This chapter examines the geography of nutrition, and should cause you to consider not the success of the past, but the question of a hungry world of the future.

Just twenty years ago, predictions of regional famines in countries with large populations and high growth rates regularly made headlines, and the warnings seemed to have a Sound basis: population growth was outpacing the Earths capacity to provide enough food, let alone distribute it where it was most need ed. Today, daily caloric consumption still varies from high levels in the richer countries such as the United States Canada , European states, Japan , and Australia to very low levels in poorer countries of Africa . Yet the overall situation has improved markedly over conditions two decades ago. How was this accomplished in light of the rapid growth of population?

The Green Revolution

The ‘miracle that was seen as the only solution for a hungry world, with rapidly increasing population numbers, in the 1970s came in the form of miracle rice and other high-yielding grains developed by tech nicians working in agricultural research stations. Crop yields rose dramatically, especially in Asia ’s pad dies, but also on wheat fields throughout the world. As fast as the world’s population grew, food produc tion grew faster, and the gap between demand and supply narrowed. In countries such asIndia and China the threat of famine receded. The threat of global food shortages seemed gone. Or is it?

The “miracle” of increased food production was the result of the so-called Green Revolution (the introduction of new, more productive strains of grains and the resulting harvest increases), also called the Third Agricultural Revolution. Actually underway since at least the l950s, the biogenetic advances in the l970s appeared to have permanently solved the world’s food shortages. But this may no longer be true.

Some researchers believe that the Green Revolution has run its course. Lack of commercial ferti lizers, water for irrigation, and additional farm land may revive the threat of widespread malnutrition or worse. In addition, the Green Revolution primarily increased the yields of wheat, rice, and some other cereals but not all grains or food production. It also had far greater affect in Asia and the Americas than in Africa —currently the continent with the fastest rate of population growth. Finally, there is more to the issue of adequate food supplies than supply alone. Food availability is also a matter of geography. Even with adequate supplies, people are deprived of food because of inadequate transportation systems. In today’s world, starvation results from human shortcomings, not nature’s shortfalls.

Distribution of Dietary Patterns

The map of average daily calorie consumption is based on data that are not always reliable, so it gives only a general impression of the global situation. Statistical information about caloric intake, especially for countries in the periphery, is often based on rough estimates rather than on accurate counts. Nevertheless, the map reveals rather clearly the world distribution of hunger and malnutrition—conditions of ill health resulting from the deficiency or improper balance of essential foodstuffs in the diet. It is ap parent that malnutrition still afflicts and shortens the lives of hundreds of millions of people, especially children, who are often the first victims in villages when food supplies dwindle. Pockets of malnutrition occur even within many of the better-nourished countries where pockets of poverty still exist.

Future Global Food Emergency?

Although global food production is sufficient to feed the worlds people (if it were evenly distributed), concerns are rising that a food emergency may develop. Among the factors and circumstances that may contribute to future food emergencies, the most serious are population growth, climatic change, and rising energy costs.

Population growth is a major factor in any consideration of future food supplies, particularly in Africa where the Green Revolution has had a minimum impact and some of the highest population growth rates are found. Add to this the political turmoil widespread poverty, the poor stains of women, and threat of drought and the concerns become very real. For the world as a whole, some 90 million people are added to the population each year, creating the need to produce even more food just to keep pace.

Climatic change is also a risk factor. If some predictions are true, the primary environmental prob lem of the first quarter of the twenty-first century may be wide fluctuations in weather conditions pro ducing extremes capable of destroying crops and farmland. If this were to be the case, sustaining food production, let alone increasing it, may be difficult

There is a good chance that the cost of energy may rise again, as it did during the 1970s. If it does so will the cost of fertilizers and fuel for equipment. For farmers in many countries, this would be dis astrous.

A More Secure Future

The mitigation of a future food crisis depends on policies and practices ranging from family planning and women’s rights to improvement of distribution systems and expansion of farm lands. These and other is sues would require cooperation on a global scale that may be difficult, if not impossible, to achieve. Yet the food crisis of the 1970s was a harbinger of the future. In time, a rising tide of world hunger may again threaten world order. All humanity has a stake in the war on malnutrition.

Spatial Patterns of Health and Disease

Americans take good health for granted. It may be expensive, but the capacity for good health is present in our society, as it is in all developed countries. For much of theworld’s population, especially those re siding in tropical areas and other poorer countries, the situation is quite different. Good health, like adequate food is unevenly distributed. Patterns of health show even greater regional differences than those for the distribution of food. When people are inadequately fed they are susceptible to many debilitating diseases. Similarly, women who are healthy tend to bear healthy babies, but women who suffer from malnutrition and related maladies are less fortunate. In many poorer countries people, especially children, are visibly malnourished The resulting disadvantages will be with them for life--if they survive childhood.

The study of health in geographic context is called medical geography.  Many diseases have their origin in the environment They have source (core) areas, spread (diffuse) through populations along identifiable routes, and affect clusters of population (regions) when at their widest distribution. Mapping disease patterns can provide insights into relationships between diseases and environment and sometimes give clues to source regions.

Malnutrition and Child Mortality

It is difficult to identify the specific effects of malnutrition on peoples susceptibility to disease, because so many other factors are present. However, there is little doubt about the effects of malnutrition on growth and development. The impact on children is especially important, who are often the first to be affected when food supplies become inadequate.

Infant and child mortality reflect the overall health of a society. Infant mortality is recorded as a baby’s death during the first year following its birth; child mortality records death between ages 1 and 5. The map showing the world distribution of infant mortality reveals the high rates in many poorer countries. The map also clearly shows the relationship between social disorder and high IMRs. Conflict, dislocation, and refugee movements produce high IMRs, and the map reflects this.

Even if there is general adequacy of available calories, protein deficiencies still have a devastating affect on children, as they do for entire populations. In tropical areas especially, dietary deficiencies inhibit the development of young bodies and the resultant problems follow children through their entire lives.

Life Expectancy

Figure 30-3 maps average life expectancies as of the late 1990g. The map is important in understanding the world population because life expectancy is another key measure of the well-being of a population. Life expectancies have increased significantly over the past half-century, as the map suggests and it does under score the aging of many populations, but the map does not show a number of other important aspects about a population.

For example women have far greater life expectancies than men virtually everywhere. In the late 1990s, the world average life expectancy was 68 for women and 64 for men, and the map reveals huge regional contrasts Most African countries fell well short of these averages. The figures represented on the map are actually averages that take into account the children who die young and the people who survive well beyond the average. Thus the dramatically lower figures for the world’s poorer countries primarily reflect high infant mortality. These figures should change as improvements in medical facilities, hygiene, and drug availability suppress death rates.

Types and Patterns of Disease

The incidence and types of diseases that affect a population, like life expectancy, also reveal the conditions in which people live. Certain kinds of environments harbor dangerous disease carriers, and diseases have ways of spreading from one population to another. Medical geographers are interested in both the regional distribution of diseases and the processes and paths whereby diseases spread of disease.

Tropical areas, wherein are located many of the worlds people (see text Figures 3-7 and 4-I), are zones of intense biological activity and hence are the sources of many disease-transmitting viruses and parasites. Certain major diseases remain contained within tropical or near-tropical latitudes (much of this is due to limited environment tolerance by these diseases), but others have spread into all parts of the world. Before European exploration and colonization, many diseases were limited to region outbreaks (called epidemics) and only took on global significance when they were carried to all parts of the globe (termed pandemics). As transportation improved and human movement on a global scale increased, so did the spread of many diseases. AIDS, for example, originated in tropical Africa and is now a global pandemic.

In the rapidly expanding urban areas of periphery countries today, densely populated shantytowns with inadequate sanitation and contaminated water supplies are highly susceptible to outbreaks of disease. In December 1990; a cholera outbreak began in the slums of Lima Peru and by early 1995 had killed more than 10,000 people with more than a million cases reported in every country in the Western Hemi sphere . And cholera is a disease who’s causes are known and prevention and treatment possible.

Dramatic as are the global pandemics of AIDS, influenza, or cholera, the number of cases of heart disease, cancer, stroke, and lung ailments are far greater. These chronic diseases (also known as degen erative diseases and generally associated with old age) have always been the leading causes of death and remain so today in the United States and throughout the Western world. Problems of chronic diseases areas heavily concentrated in the urban, industrial core as some of the major infectious diseases prevail in the periphery.

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