Change of Health Status Over Time

Health of a nation can be gauged from the available information on death.Disaggregated data by causes of death is more reflective of the status of health of a country. Data on death rates in developing countries show that they had higher death rates in the early part of the twentieth century than in the developed nations.

In the later half of the twentieth century, health conditions in these countries improved bringing many of them almost at par with the developed countries. Thus, there has been tremendous progress during the last five to six decades in the health status of these countries. In spite of improvements in some countries, conditions of health continue to be poor in many others with mortality rates remaining high. The main reasons for high mortality rates are:
(i) acute food shortage resulting in famines and conditions of malnutrition;
(ii) poor sanitation resulting in many endemic diseases, and
(iii) prevalence of widespread epidemics like cholera, gastro-intestinal diseases, etc.

In the pre-industrial phase, famines and food shortage were common as man had limited control over his environment. Food supply was severely affected by conditions like droughts, floods, etc. Due to these reasons, agricultural production was limited.

In these situations, malnutrition rendered the body’s defence mechanism weak resulting in various infections causing death. People also suffered from communicable diseases like typhoid, tuberculosis, pneumonia, yellow fever, plague, cholera, etc. Childhood diseases like measles, wh ooping cough, scarlet fever, diphtheria, etc.were also common. Poor sanitary conditions contributed to extremely unhealthy environment leading to epidemics and diseases. All these conditions were quite common until fairly recent times taking a heavy toll on human life. At the same time when conditions of health were poor in many countries (some of which have since attained developed health status), there were breakthroughs in technological advancement in countries of Europe, North America and Oceania.

Some of these inventions were in the field of medicine (e.g. invention of antibiotics, elimination of small pox, etc.). Advances in agriculture resulted in increased food production. Industrial revolution led to invention of steam engines, telegraph and telephone, and better transport and communication systems. Such improvements contributed to food surpluses being sent to countries with food deficiency. Improved sanitary conditions ensured potable water supply, better sewage disposal methods, etc. All these contributed to better personal hygiene practices leading to better health status. Cumulatively, they contributed to overall improvements in the health status of people in all parts of the world.One of the most important outcomes of improved health status was the priority that could be accorded by people to education. Education, particularly of girls and women, play a major role in improving the health status of the society. In most countries, women are responsible for a broad range of household activities that are important for better health. A number of studies have shown that an educated mother is also more likely to work outside the home, increasing family income and ensuring that her children attended schools. Educated women are also more likely to postpone having children and have fewer children which contribute to better maternal and child health.

Medical technology has helped in improving the health conditions by resulting in a decline in the mortality rates. This is easily evident in cases like smallpox which has since been eradicated through immunisation. Polio is likely to follow this stage soon. Since antibiotics became available in the 1940s, bacterial pathogens have been fought very effectively. Other developments for treating non-communicable diseases have also been remarkable. For instance, developments in anaesthetics have allowed for dramatic surgical interventions. Manipulation of genetic materials has made it possible to produce vast quantities of insulin.

Despite improvements in socio-economic conditions of people and advancement in medical technology, newer threats and challenges impacting on the health statuses of people have emerged. Instances of cancer, HIV/AIDS, cardio-vascular and other degenerative disabilities have posed tremendous challenges in the health sector. The nature of changing health status is thus a continuum of conquests and new challenges. The dynamics of health and its influence on development has thus been a mixed story with the health of people continuing to improve but cures for new diseases eluding us.