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Social characteristics of high, middle and low income countries

Health care systems:
Due to increased cash flow from tax systems and higher average wages, many high income countries are able to provide their citizens with government funded healthcare systems

Employment levels:
As a result of a number of other characteristics including education levels, gender equality levels and a range of industries, employment levels in high income countries tend to be high. In low and middle income countries where the citizens have lower levels of education, the employment possibilities are limited

Legal systems
Population growth
Gender equality
Social security systems


Economic characteristics of high, middle and low income countries

Debt levels
High income countries generally have lower levels of international debt

High income countries have high average incomes vs low income countries are much lower

Trade opportunities
High income countries generally have a wide variety of trading opportunities, like infrastructure including roads, ports and airports.

Range of industries
High income countries generally have a wide range of industries to allow their citizens to earn a sufficient income.


Environmental characteristics of high, middle and low income countries

Housing conditions
Generally, people living in high income countries live in housing conditions of a good standard e.g. heating and cooling facilities, ventilation, cooking, refridgeration etc.

Food security
People living in high income countries generally experience high levels of food security

High income countries have the revenue to be able to provide clean water sources directly to most households for drinking and cooking

High income countries have the revenue to provide the infrastructure to ensure adequate plumbing and sewerage systems to allow for effective removal of human waste

High income countries generally have well-developed infrastructure including telecommunications systems, water, sanitation, electricity, roads and tail


Similarities and differences in health status and burden of disease

Life expectancy at birth:
Similarity: all income groups are increasing
Difference: life expectancy between high and low income are still a large gap

Infant mortality:
Similarity: all income groups, infant mortality rate has decreased
Difference: the infant mortality rate between high and low income countries is still considerably large

Similarity: all income groups are decreasing
Difference: still a large gap between high and low income countries

Maternal mortality:
Difference: large gap between high and low income countries

Causes of death by non communicable diseases:
High income countries are much higher compared to low income countries
e.g. cancer

Causes of death by communicable disease and maternal, prenatal and nutrition conditions:
Low income countries are much higher, e.g. HIV/AIDS


Factors that contribute to similarities and differences in health status

Access to safe water
Inequality and discrimination
Global distribution and marketing of tobacco, alcohol and processed foods


Access to safe water

Safe water: Water that is free from contaminants and disease causing bacteria and chemicals

Why do we need water?
Human consumption
Personal hygiene
Food production and agriculture
Cooking and food hygiene

Impact on h&w:
refer to women having to go out and collect water:
- tiring, late at night hence sexual assault and increased violence risk
- this takes time out of school and reduces social networks - social h&w
- carrying heavy loads of water for extended periods of time increases injuries and back pain - physical h&w

Impact of health status:
Lack of clean water accounts for a range of:
- water bourne diseases like cholera
- diarrhoeal diseases
Without access to water, this increases the risk of diseases and illnesses listed to the above which contributes to:
- lower life expectancy
- higher infant mortality rate
- higher under 5 mortality



Is the provision of facilities and services from the safe disposal of human urine and faeces

Impact on h&w:
- when children are sick from consuming water contaminated with faecal matter, their physical health declines
- they are also likely to be unable to attend school, reducing social interaction and impacting negatively on social and mental health
- children who take long periods of time off schooling may lose that sense of belonging which is an important aspect of spiritual health and wellbeing

Impact on health status:
- Increased rates of waterborne diseases such as cholera, bookworm, and diarrhoea decreases life expectancy and accounts for high infant and under 5 mortality rates.



People living in poverty lack the income to be able to access resources to live healthy and fulfilling lives

Impact on h&w:
- reduced access to nutritious food - physical
- reduced access to healthcare - physical
- reduced access to adequate shelter - physical and mental
- reduced access to education - social, spiritual and mental

Impact on health status:
- reduced access to healthcare - higher risk of maternal death
- reduced access to nutritious food - poor immune systems and hence susceptible to disease
- reduced access to adequate shelter - higher rates of communicable disease
- reduced access to education - higher risk of communicable diseases, child marriage and early pregnancy


Inequality and discrimination

Race, religion, sexual orientation, gender identity

Inequality: the state of not being equal, especially in status and opportunities

Discrimination: Unjust prejudicial treatment of different categories if people especially in grounds of age, sex and race

Impact on h&w:
- racial and religious discrimination leave a person questioning their sense of belonging in the community - spiritual
- due racial discrimination there may be a restriction in access of resources such as health, employment etc - physical and social
- those facing racial discrimination and social exclusion are at risk of engaging in violence and crime
- negative emotions such as stress and fear are common - mental

Impact on health status:
- lower life expectancy


Global d and m of tobacco

Tobacco smoking is a leading cause of premature death and disability

Reasons for increasing smoking rates in low and middle income and high income countries:
- Tobacco is only sold to those over 18, many public spaces are smoke free, there are health promotions and interventions in place

Low and middle:
- lack of regulation on sale of tobacco, often sold cheaply to children
- no restriction on where people can smoke
- limited knowledge on the health consequences, therefore no health promotion programs evident
- tobacco is advertised and promoted widely alongside the western culture


Tobacco smoking

Impacts on h&w and health status

- physical: reduced physical fitness, poorer functioning body systems due to illness and/or disease
- social: potential decrease in the ability to form productive relationships especially intimate relationships if partner is a non smoker
- mental: lower confidence and self esteem if smoking leads to bad breath, discolouration of fingers etc. and perhaps increased levels of stress
- emotional: a smoker may be unable to control emotions if they are forced to go long periods without a cigarette

Health Status:
Cancers and chronic diseases can impact:
- life expectancy
- burden of disease


Global d and m of alcohol

Reasons for increase in uptake of alcohol consumption in low and middle income countries:
- weak regulations related to sale of alcohol - age restrictions aren't a thing
- selling of new and low cost products to target younger drinks, lack of tax on alcohol products
- lack of health promotion campaigns and health education on health dangers of excessive alcohol consumption



Impacts on H&W and Health Status

- physical: heavy alcohol use can lead to communicable diseases such as cancer, liver disease and CVD

Health Status:
- alcohol contributes to many injury deaths worldwide
- liver disease, cardiovascular disease and cancer
- increases burden of disease


Global d and m of processed foods

Due to rapid urbanisation, there has been an increase in the consumption of energy-dense diets in low and middle income countries which are high in refined sugar, salt and saturated fat and low in complex carbohydrates, fruits and vegetables

Reasons for increase in intake of processed foods in low and middle income countries:
- increased levels of urbanisation
- increased income levels
- aggressive marketing strategies (targeting children, cheaper products)
- lack of health promotion awareness

Health Status:
- increase in non-communicable disease leads to double burden of disease as some countries face health challenges associated with undernutrition


Double burden of diease

The coexistence of undernutrition along with overweight and obesity, or diet-related or related non-communicable diseases