Tag: Health

Why is the UK’s Child Mortality Rate so High?

The United Kingdom has the highest child mortality rate in Western Europe except for Malta. The UK’s child mortality rate currently stands t 6.5 per thousand live births.

This has been the case for many years now and a recent research study into the causes has found that deprivation is the key factor which correlates with higher infant mortality rate.

Dr Karen Luyt from the University of Bristol lead the study which found that every extra 10% increase in deprivation, there is a corresponding increase in the child mortality rate.

To put it bluntly* the poorer a child is the more likely they are to die before they reach 18 years of age. (*and maybe crudely as poverty isn’t exactly the same thing as deprivation).

It’s not that being born into deprivation itself directly causes a child to be more likely to die compared to a child born into wealth, it’s the societal and lifestyle factors associated with being born into deprivation.

And the primary factor which causes higher child mortality rates is exposure to smoking.

The programme above features one interview with someone from a deprived background which illustrate how this works – she describes how she started smoking at 14, along with all her friends, and this wasn’t discouraged as her entire family smoked too.

She describes how her friends would pool their lunch money to buy cigarettes and do without lunch and sometimes use the school emergency fund not for lunch but again for cigarettes.

And then when these teenagers become adults they carry on smoking, and when some of them eventually get pregnant, around 6% of them continue smoking into pregnancy, and it’s that which increases the likelihood of child mortality.

(The link between smoking during pregnancy and damaging the foetus is well established).

There have been government intervention programmes to try and help people quit smoking but they are less successful in poorer areas where more people smoke as it’s simply harder to quit when more people around you in your daily life are smoking.

And not to mention cuts to government pubic health funding recently which mean many of these quit smoking programmes have been cut back.

This issue was the investigation of a recent News Night study which you can view on YouTube:

NB – the first half of the video is about the issue of smoking, the second half mainly consists of politicians lying about their commitments to improving public health funding.

Relevance to A-level sociology

This provides yet more evidence of the consequences of inequality in society, and the harmful effects of deprivation in particular, and it’s a useful update to topic of death rates, which have long been declining in rich countries, but this reminds us that even in rich countries like Britain the death rate can be relatively high in deprived areas.

If we look at the agenda of the report it’s also interesting that ‘deprivation’ is the main cause of high child death rates and yet the whole video is about the lifestyle issue of smoking – this might be an example of agenda setting from a Marxist point of view – shifting the emphasis away from the broader issue of inequality to the ‘lifestyle’ factor of smoking.

Finally, it’s a good example of quantitative data analysis – with a research team talking data from the public health database and correlating this with other factors such as the deprivation index. This is is research broadly in line with Positivist tradition.

Strategies for Improving Health in Developing Countries

These obviously stem from people’s theories about what the ‘causes’ of poor health are.

Long term economic growth

The first and probably most important point is that there is a broad, if not perfect, correlation between a country’s per capita income and its levels of health, as measured by life expectancy, infant mortality, overall death rates, and incidents of particular diseases. As countries get wealthier, they get healthier – thus increasing economic growth appears to be the best long term strategy for improving health. Theories of how to promote economic growth differs with different theories.

No one demonstrates the relationship between income and life expectancy better than Hans Rosling:

Biomedical Intervention

Currently two of the main global projects are the mass vaccination programme to eradicated polio and the mass distribution of free mosquito nets to populations in Malarial regions.

Improving water sources and sanitation

This is widely seen as one of the most effective means of reducing deaths from diarrheal diseases and involves such things as drilling bore holes to reach underground water sources in rural areas, or treating water in urban areas, as is done in the developed world. Improving sanitation might mean building sewage systems and installing flush toilets. In urban settings, both of these would involve massive infrastructural projects to install. 

Better diets

Many people in the world still effectively die of malnutrition – which weakens the body’s resistance to infectious diseases. Young children are especially vulnerable.

Improving women’s rights and maternal health

The importance of which is illustrated in the ‘Worst Place to a Midwife – Liberia’

Political solutions

Ending Corruption and Conflict – Obviously both of these are a drain on a country’s resources – corruption might mean money does not get effectively spent on developing health services while overt conflict can mean

Providing cheaper drugs

It is Western Pharmaceutical companies which manufacture anti AIDs drugs, and antibiotics, which they then patent and sell for a profit. Eventually other companies make cheaper copies of these drugs, but frequently The World Trade Organisation does not allow the cheap copies to be sold until the original patent has run out – this can be several years. The WTO could put the right to life before the right to Corporate Profit.

Controlling Corporations

Dependency Theorists point out that if Corporations are allowed to make workers work for 12 hours a day in dangerous, toxic conditions, this will have a long term detrimental effect on the health and life expectancy of workers.

Relevance to A-level Sociology

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Why do Developing Countries have so many Health Problems?

Health and Development is one of the aspects of development students taking the global development option for A-level sociology have to study…

There are a number of fairly obvious explanations as to why low income countries face poor health conditions.  

Lack of an improved water source

Hundreds of millions of people in sub Saharan Africa and Southern Asia especially, mostly living in rural areas, rely on water from local streams and rivers, which is often contaminated with disease spreading parasites, which are ingested and then cause diarrhoea – resulting in hundreds of thousands of death each year from the resulting malnutrition and dehydration.

Poor Sanitation

This is responsible for the spread of diarrhoeal diseases – living in close proximity to open sewers full of human and animal waste products exposes one to a host of disease pathogens

Malnutrition

Nearly a billion people in the world are malnourished – this is one of the leading causes of child mortality.

Underdeveloped public health services

In the developed world there is 1 doctor for every 520 people, in the developing world there is one doctor for every 15 000 people. In rural areas, hospitals are spread so far apart that pregnant women often find it a practical impossibility to get to one for child birth.

War and Conflict

Some countries, most notably Somalia and Afghanistan, are currently in conflict – obviously this increases the likelihood of people getting injured and puts additional strain on a countries economic and health care resources.

Poverty

All of the above are ultimately linked to underlying poverty – as emphasised by Hans Rosling in his various videos.

Patriarchy and Traditional values

  • Modernisation Theorists emphasise the internal cultural values of developing countries that can act as barriers to improving life expectancy etc.
  • Patriarchal traditions may prevent money being spent on training midwives and providing maternity resources which could help reduce deaths in pregnancy 
  • Patriarchy and religious values may prevent contraception use – which is linked to the spread of HIV in Sub Saharan Africa

Environmental Factors

  • Jeffrey Sachs also points out that Environmental Factors also play a role – simply put, Mosquitos, which spread Malaria, responsible for 5% of deaths in low income countries, are especially partial to the conditions in parts of sub-Saharan Africa.

Related Posts

You might also like this post: strategies for improving health in developing countries. Link to follow.

Theories of Development applied to Health

As a genera rule, people in developing countries suffer from poorer health than people in developed countries – with higher rates of deaths from preventable causes resulting in higher child mortality rates and lower life expectancies.

Theories of development aim to explain why this is the case and what the most effective solutions to improving health should be.

Modernisation Theory

Modernization Theorists would expect health patterns of developing countries to follow those of the developed world in the past. They believe that developing countries are entering the ‘epidemiological transition’ associated with economic development and rising GDP

Before the transition, infectious diseases are widespread and are the major causes of death; life expectancy is low and infant mortality high. With Industrialisation, urbanisation and economic growth come improvements in nutrition, hygiene and sanitation which lead to falling death rates from infectious diseases. After the transition, health improves.

It follows that the best way for developing countries to improve the health of the nation is to focus on industrialization, urbanization and economic growth. Improvements in health should follow.

Modernisation Theorists also argue that targeted aid can play a role in improving the health of developing nations

This can mainly be done through ‘Selective biomedical intervention’ – Such as mass immunization against disease, or distributing vitamin supplements to populations, or handing out mosquito nets.  One of the best examples of this is the work of the Bill and Melinda Gate’s Foundation work on combatting Malaria, the reduction of which has been one the great success stories of the last decade.

The eradication of Smallpox is a good example of this strategy working:

One limitation of using selective biomedical intervention is that theexpense means that it is difficult to maintain, and, where the distribution of mosquito nets is concerned, this may lead to choking off local entrepreneurs, as Dambisa Moyo argued in ‘Dead Aid’.

Dependency Theory

Dependency Theory points out that attempts by developing countries to improve health may actually be hindered by the West

Firstly, if you remember, Dependency Theorists point out that it is exploitation by developed countries that keep developing countries poor and they receive very little income from their dealings in world trade which means there is little money left over for investment in health care. 

Secondly, there is the problem of the ‘brain drain’ from the developing to the developed world. At least one in ten doctors in the west has been poached from the developing world – it is obviously much more appealing for people in Africa and Asia to work in Britain where they can receive several times the salary they would in their native country.

Thirdly, Many African companies have had to pay high costs for pharmaceuticals manufactured by Western corporations. This is especially true of AIDS drugs. Western companies are thus accused of exploiting desperate people in Africa.

Finally, some Transnational Corporations have actually contributed to health problems through selling products that would not be regarded as safe in the West, not to mention polluting in the pursuit of profit. 

Relevance to A Level Sociology

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How is Coronavirus Affecting Developing Countries?

It is worth distinguishing first of all between the negative health effects of the virus itself and the negative effects of government lockdowns. The severity of lockdowns and the capacity to enforce them vary from country to country, and so the consequences of this politically imposed response to the pandemic will vary greatly across countries.

EVEN IF the stats are unreliable, governments the world over have responded with lockdown measures in response to public concern, which has very real consequences.

Lockdowns are pushing people into poverty, hunger and children are being pulled out of school

This brief report from the ODI puts a human face on the consequences of Covid-19. They provide a case study of one woman in Nairobi, Kenya, who was eating three meals a day and sending her children to school pre-lockdown.

However, lockdown forced the shutdown of her street food stall and now she is eating one meal a day, the children are meal sharing at another household and she doesn’t have the money to send them back to school.

Coronavirus has pushed another 71 million people into extreme poverty

The World Bank estimates that 71 million more people will be pushed into extreme poverty in 2021 as a result of coronavirus, an increase of 0.5% and taking the total to nearly 9% of the world population, eradicating all progress towards ending extreme poverty since 2017.

A further 170 million people in low to middle income countries will be pushed below the global poverty lines of $3.20 and $5.50 a day.

How covid-19 has affected households in developing countries

Another World Bank report from December 2020 used phone surveys to interview people in IDA (countries qualifying for development assistance, mostly the poorest countries) and non-IDA countries.

The results show that the consequences have generally been harsher for people in developing countries:

  • People in IDA countries are less likely to have stopped working but more likely to have taken cuts in wages.
  • They are more likely to have skipped a meal.
  • Children’s education has suffered much more in IDA countries compared to non-IDA countries
  • Government bail outs are much less common in IDA countries.

This united Nations article suggests that poorer countries lack the capacity to respond to a global pandemic and that coronavirus could create further burdens in those countries having to deal with other major health problems such as aids and malaria.

It further notes that closure of borders will affect those countries reliant on trade, and reduce remittances from abroad (money sent home), reduce migrant labour opportunities and affect those countries which rely on tourism for income.

Covid-19 will increase inequality

A final World Bank report suggests that inequality will increase as a result of Covid-19.

This is based on evidence from how countries have recovered from previous Pandemics.

The theory is that households with resources are better able to weather the negative affects of a downturn, by keeping their children in school for example, and by using savings rather than taking on debt, and so can just ‘carry on’ as normal when economic recover comes, while poorer people are having to play catch up.

It’s explained in this handy infographic:

Those working in the informal sector are hardest hit

This LSE. blog post reminds us that many more people work informally in developed countries – and these people will be the hardest hit by lockdown policies – they are the first to be laid-off when work is reduced and they do not qualify for any government assistance measures either.

Other potential impacts

You should be able to find out about other impacts, such as:

  • In the long term more countries might cut their foreign aid budgets, like Britain has done recently.
  • Charities such as Oxfam are likely to receive less money from the general public.
  • It will be more difficult for migrant labourers to find work because of border restrictions.
  • I dread to think how all of this has affected the movement of refugees!
  • There have probably been more cases of domestic abuse worldwide as a result of lockdowns.
  • Possibly the most devastating long-term affect is the number of days of schooling that children in poorer countries would have missed – low income countries have much less capacity to offer home based, online learning, compared to wealthier countries.

Relevance to A-level sociology

This is mainly relevant to the health and global development topic, but there are also some useful links here to social constructionism and social action theory.

Are there really fewer covid-19 cases in poorer countries?

According to this New York Times heat map, Covid-19 cases seem to be much more prevalent per capita in developed countries compared to developing countries…

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The counts are especially high in America, Europe and South America doesn’t fair too well either.

But the count per capita is much lower in Sub-Saharan Africa.

Analysis from Brookings (source) shows the contrast much more starkly – People in developing countries make up 50% of the world’s population but account for only 2% of covid deaths.

The infographic below shows how many people die from covid (the circle) compared to the other main causes of death – if you look at the left hand side, they are generally poorer countries, on the right, generally richer countries…

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Are there really fewer covid cases and deaths in poorer countries?

Brookings suggests the different may not be as great as the statistics above suggest. Because….

  1. The different age profiles – Covid-19 affects the very old more severely – especially the over 70s – and to put it bluntly there are hardly any people aged over 70 in poorer countries, because of the lower life expectancy, whereas in developed countries have a more older age profile.
  2. Differences in detecting and reporting covid-19 as a cause of death. In developed countries we have much better detection capacity and it’s possible that Covid has been mis-recorded as a cause of death when really, because of co-morbidity, something else was really the cause. While in the developing world people may well be dying of (or with) covid-19 but it hasn’t been traced.

in short, remember that these covid-19 death statistics are a total social construction.

However, the statics may lack validity, but government responses the world over have been severe – and this social reaction has had very real negative consequences in rich and poor countries alike!

Relevance to A-level sociology

This material is mainly relevant to the global development health topic, but there are also some nice links here to the problems with official statistics.

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How has Coronavirus Affected the UK?

What are the short and long term affects of Coronavirus for the UK’s social and economic development?

in this post I focus on how Coronavirus has affected health (obviously) education, work and employment, as well economic growth prospects.

There are many more consequences I could focus on, but all of the above are specifically on the Global Development module specification as aspects of development for students of A-level sociology to consider.

How has Coronavirus impacted health in the UK?

NB – forgive me if the stats below date pretty quickly, this is a rapidly evolving situation, and I can’t update every post daily!

At time of writing the total number of covid related deaths in the UK has just surpassed 100 000, in the 11 months since recording of covid-deaths began in March 2020.

You can find out the latest figures at this government site.

The Office for National statistics allows you to look at the latest figures for covid-19 infections and covid-19 related deaths, without any of the ‘panic’ aspects (and without the distractions of flashing adverts) of the mainstream media.

The covid-related death rate is three times higher among men working in elementary and service occupations (the working classes) compared to those working in professional and managerial occupations (the upper middle classes)

There has been a reduction in the quality of care for those with other chronic-conditions, because of a combination of the NHS having to cope with covid-cases, and people being reluctant to seek treatment because of the pandemic.

This is an interesting article from the BBC which outlines the possible long term negative effects on mental health of dealing with Covid – including increased anxiety and OCD (hand washing!), loneliness, a sense of meaningless and uncertainty (anomie?) and depression – not least because of so many people having to deal with loss of someone they know among that 100, 000 death toll.

This research adds to above finding that there were statistically fewer people who started cancer treatment in 2020 compared to 2019, probably because of lower test rates due to covid-19.

How has Coronavirus impacted education in the UK?

Lockdown measures meant that students missed several months of in-school education in 202.

This report by the Nuffield Foundation suggests that pupils started school in September 3 months behind as a result of lockdown in 2020. There is also evidence that poorer students suffered more as they were less able to access online learning provision.

Exams were also cancelled in 2020, but GCSE and A-level pupils received better grades than students in previous years, because of the reliance of Teacher Predicted Grades. It remains to be seen whether this will be the case in 2021.

How has Coronavirus impacted work and employment in the UK?

The effects have varied enormously be sector. The service sectors have been hardest hit, with accommodation and food services suffering a 25% downturn by GDP because of the lockdown rules imposed in response to the pandemic.

Education has also taken quite a hit, but I guess the switch to online learning has lessened the impact here.

The impact has generally been a lot less (somewhat obviously) on sectors where it’s easier to work from home, on professional occupations and on rural occupations.

How has Coronavirus impacted economic growth the in the UK?

The UK has seen a projected decline in GDP growth in 2021 of – 12.9%, which is going to take years to recover from and an expected increase in unemployment going forwards into 2021-2024 – with unemployment figures double that what we’d anticipated for these years.

Also note the debt figures shown in the bottom rows – almost £400 bn borrowed in 2020-21 to cover the cost of dealing with the Pandemic. Not exactly small change!

And then the debt repayments as a percentage of our GDP increase from 5% to 15% – meaning the government is going to be spending 20% more for at least the next five years (and probably longer) to pay for the Pandemic!

This probably means cuts to welfare and public services sometime in 2021 or 2022 – given that the government is neoliberal and will be reluctant to raise taxes, also something which is difficult to do when the economy is struggling.

Selected Sources

HM Gov (November 2020) – Analysis of the Health, Economic and Social Consequences of Covid-19

UK Gov – an enquiry into the impact of covid-19 on education

ONS – Coronavirus impact of covid-19 on Higher Education

The coronavirus class-divide

Those in working class jobs are about two to three times more likely to die of covid-19 related deaths compared to those in middle class jobs.

The Office for National statistics allows you to look at the latest figures for covid-19 infections and covid-19 related deaths, and one of the aspects of the death rate it focuses on is how it varies by occupation.

The covid-related death rate is three times higher among men working in elementary and service occupations (the working classes) compared to those working in professional and managerial occupations (the upper middle classes)

The class difference in the covid related death rate isn’t quite as large for women – those in ‘working class’ jobs are only around twice as likely to die as those in professional jobs…

OK so I’m being quite crude in my measurements of social class, but nonetheless, this is yet more evidence of social class inequality in the UK

Why are the working classes more likely to die from Covid-19?

This article from The Conversation sums it up nicely:

Referring to the ‘coronavirus class divide’ (there’s a not so nice new concept for you!) the answer is very simple:

Working class jobs are the kind of jobs you have to be physically present to be able to do – cleaning, care work, taxi-driving, food and accomodation services – you simply have to be ‘out there’ away from home and you are more likely to be interacting with people.

And thus you are more exposed to the virus if you are working in a manual, working class job:

While if you’re in a managerial or professional role, it is much easier for you to work remotely, to work from home, or if you must go into your workplace, it is easier for you to maintain social distance by shielding yourself in an office or at your individual work station.

The figures for stay at home work, post lockdown, are much higher for those in middle class jobs:

So there is even a class divide when it comes to your chances of contracting and dying from covid-19

Relevance to A-level sociology

This can be used as a rather depressing update to the ‘death rate’ topic which is part of families and households, or the ‘health’ topic within global development.

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Globalization and the Coronavirus

sociological perspectives on the coronavirus

Coronavirus is an extremely useful virus to illustrate perspectives on globalisation

Generally the rapidity of the spread from China to America and Europe demonstrate how interconnected we are: from the outset this very contagious virus was always going to be very difficult to stop.

Global Optimists might point to the importance of working collaboratively and internationally to share information and maybe find a vaccine: it’s pointless if every laboratory repeats work towards the vaccine goal, after all.

Global Pessimists might point to the role of just-in time supply lines in spreading the virus and how weak the capitalist economy is if a virus can cause such a profound economic crash.

This might also be a good example of the importance of the Nation State in managing the crisis, especially where health care is concerned – might vulnerable people without health insurance in the United States die if they catch the virus?

Traditionalists, or anti-globalists might use this as an opportunity to criticise gloablisation, especially the migration aspect of it, and use this crisis as a means to support view that we should be less reliant on global supply chains- they may have a point when it comes to the shelves in supermarkets being empty!

The rice isle in my local Tesco!

Maybe we need to look at becoming more self-reliant!

Whatever your perspective, this virus is certainly is a global problem!

Coronavirus – like the Borg but worse, apparently!

The World Health Organisation is meeting today to decide whether the Coronavirus constitutes an international global health emergency.

The first human case of the virus was found in the Chinese city of Wuhan, but it has since spread beyond into other parts of China and internationally to other countries such as South Korea and Japan.

I listed to an interesting item this morning on Radio 4’s Today programme which featured an interview with David Quammen, the author of Spillover: Animal Infections and the Next Human Pandemic.

Quammen says that the characteristics of this latest virus were predicted by the various health experts he spoke to when he wrote his book, which was 10 years ago. The experts he spoke to said the next major Pandemic would probably have the following features:

  • It would be a single strain RNA virus
  • It would probably come from the Corona family
  • It would be spread through respiratory transmission
  • And possibly from a live market in China

The problem with the single strand RNA virus is that they make a lot of mistakes, they don’t copy directly, the evolve and adapt, which means when the virus transmits from an animal to a human, it can adapt so that it can replicate and then transmit between humans.

NB – that’s the bit that reminded me of The Borg (from Star Trek) – they adapt to Phaser attacks, rendering further attacks impotent – just like the Coronavirus might adapt to treatments in the future, except that virus works inside humans, which kind of makes it more terrifying!

It is also a possibility that it can become more harmful when it mutates, however it could become less harmful – we just don’t know, there is a lot uncertainty.

Relevance to A-level sociology

This is a great example of how we live in a Risk Society – we simply don’t know what the consequences of this virus will be, so we have to put in place extreme measures to deal with it – The Chinese Authorities have put Wuhan into lock-down, shutting transport hubs for example.

It also reminds us about how global problems transcend national boarders – the virus has already spread to other countries, and the World Health Organisation is coordinating a global response.

However, it also maybe reminds us of the importance of the Nation State for dealing with a crisis like this – it’s difficult to see how an effective strategy to stop the spread of the virus could work without a massive power like the Nation State putting in place measures of control.

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