Problems of Illness and Health Care
THE GLOBAL CONTEXT: PATTERNS OF HEALTH AND ILLNESS AROUND THE WORLD
Classification of countries for international comparisons of health and illness.
Developed countries (high-income countries) have relatively high gross national income per capita and diverse
economies made up of different industries.
Developing countries (middle-income countries) have relatively low gross national income per capita, and their
economies are much simpler, often relying on a few agricultural products.
Least developed countries (low-income countries) are the poorest countries of the world.
Morbidity, Life Expectancy, and Mortality
Morbidity refers to illnesses and diseases and the symptoms and impairments they produce.
Measures of morbidity
Incidence: number of new cases of a specific health problem in a given population during a specified time
Prevalence: total number of cases of a specific health problem in a population that exists at a given time
Patterns of morbidity vary according to the level of development of a country.
In less-developed countries, where poverty and chronic malnutrition are widespread, infectious and
parasitic diseases, such as HIV disease, tuberculosis, diarrheal diseases, measles, and malaria are much
In developed countries, chronic diseases are the major health threat.
Wide disparities in life expectancy—the average number of years individuals born in a given year can expect to live
—exist between regions of the world.
In 2005, Japan had the longest life expectancy (82 years), Swaziland had the lowest life expectancy (30 years),
and 31 countries (primarily in Africa) had life expectancies of less than 50 years.
As societies develop and increase the standard of living for their members, life expectancy increases and
At the same time, the main causes of death and disability shift from infectious disease and high death rates
among infants and women of childbearing age (owing to complications of pregnancy, unsafe abortion, or
childbearing) to chronic, noninfectious illness and disease.
This shift is known as the epidemiological transition, whereby low life expectancy and predominance of
parasitic and infectious diseases shift to high life expectancy and predominance of chronic and
As societies make the epidemiological transition, birthrates decline and life expectancy increases, so
diseases that need time to develop, such as cancer, heart disease, Alzheimer’s disease, arthritis, and
osteoporosis, become more common and childhood diseases, typically caused by infectious and parasitic
diseases, become less common, as do pregnancy-related deaths and health problems.