Health and Diseases

1. HEALTH AND DISEASES
Are we more vulnerable than before?

2. BY THE END OF THE LESSON
We will be able to
1. Describe the indicators used to measure
health.
2. Describe the variations in the health of
people between DCs and LDCs.
3. Explain the the variations in the health of
people between DCs and LDCs.

3. INDICATORS USED TO MEASURE HEALTH
1. Infant mortality rate (IMR)
– Number of infants that die before reaching
one year old per 1000 live births in year.
2. Life expectancy
– The average number of years from the time of
birth that a person can expect to live.
3. Daily calories intake
– The energy obtained from food consumed per
person per day.

4. INFANT MORTALITY RATE

5. LIFE EXPECTANCY

6. DAILY CALORIE INTAKE PER CAPITA

7. QUESTION
• Why are there variations in the health of
people between DCs and LDCs?

8. REASONS FOR VARIATIONS
• Economic
– Poverty/affluence, investment in healthcare
and access to health services
• Social
– Diet, lifestyle, education
• Environmental
– Living conditions, access to safe drinking
water, proper sanitation

9. POVERTY AND AFFLUENCE
• People in LDCs are more likely to suffer from
poor health as they suffer from poverty,
which limits the purchasing power that
people have to afford basic healthcare, hence
exposing them to health risks.
• For example,

10. POVERTY AND AFFLUENCE
• People in DCs are likely to enjoy good health
as they enjoy affluence, which provides
people with greater access to food and better
quality health services, thereby increasing
their resistance to diseases and improving
their ability to deal with diseases.
• For example,

11. INVESTMENT IN HEALTHCARE
• People in LDCs are likely to suffer from poor
health as the investment in healthcare
devoted by their governments is low,
resulting in less hospitals, clinics, healthcare
professionals and supplies.
• For example,

12. ACCESS TO HEALTH SERVICES
• People in DCs are likely to enjoy good health
as they enjoy high accessibility to
healthcare as health services are within
reasonable distance and have sufficient
capacity to meet the needs of the people.
• For example,

13. DIET
• People in LDCs are likely to suffer from poor
health as they are more likely to have poor
diets which results in malnutrition, which
can lead to damaged tissues and organs.
• For example,

14. LIFESTYLE
• People in DCs may suffer from poor health as
the more affluent people are more likely to
lead sedentary lifestyles due to the easy
availability of hired help and the convenience
of technology that contributes to physical
inactivity.
• For example,

15. EDUCATION
• More people in DCs enjoy good health as
more people are educated, hence more likely
to be informed on how to lead a healthy
lifestyle. They are also able to earn higher
incomes that give them greater access to
medical treatment, food and living
conditions.
• For example,

16. LIVING CONDITIONS
• People in LDCs are likely to suffer from poor
health as they tend to live in poor living
conditions such as in slums that are
overcrowded which contribute to the spread
of diseases.
• For example,

17. ACCESS TO SAFE DRINKING WATER
• People in LDCs are likely to suffer from poor
health as the accessibility to safe drinking
water is low, which contributes to the spread
of waterborne diseases such as cholera and
also lead poisoning.
• For example,

18. PROPER SANITATION
• People in LDCs are likely to suffer from poor
health as they do not have proper
sanitation hence resulting in the dumping of
sewage into water bodies such as rivers which
creates pollution that led to the spread of
waterborne diseases.
• For example,

19. HEALTH AND DISEASES
Which diseases causes more deaths in
DCs and LDCs?

20. BY THE END OF THE LESSON
We will be able to
1. Describe the variations in the types of
diseases between DCs and LDCs.

21. TYPES OF DISEASES
• Infectious diseases are caused by
pathogenic microorganisms such as bacteria,
viruses, parasites and fungi. These diseases
can be spread directly or indirectly from one
person to another.
• Degenerative diseases are diseases where
the function of affected tissues or organs
changes for the worse over time because of
lifestyle choices, wear and tear or genetic
causes. These diseases are not contagious.

22. DEATH RATES FOR CANCER

23. QUESTION
• Describe the death rates of cancer around the
world. [4]

24. SUGGESTED ANSWER
• Countries such as ____ and ____ have the
highest death rate for cancer of ____.
• Countries such as ____ and ____ have high
death rate for cancer of ____.
• Countries such as ____ and ____ have
relatively low death rate for cancer of ____.
• Countries such as ____ and ____ have the
lowest death rate for cancer of ____.

25. HEALTH AND DISEASES
What influences the spread and impact
of infectious diseases?

26. BY THE END OF THE LESSON
We will be able to
1. Describe the difference between epidemics
and pandemics.
2. Describe the transmission of malaria.
3. Describe the extent of spread of malaria in
the world in a selected country in Asia
(Indonesia).

27. EPIDEMICS
• An epidemic occurs when an infectious
disease spreads rapidly to many people.
• An example of a common epidemic is
cholera, which is caused by bacteria that grow
in unclean food and water and affects the
small intestine.

28. PANDEMIC
• A pandemic occurs when a disease spreads
across a large area, such as an entire country,
continent or the whole world.
• An example of a pandemic is SARs, which
quickly spread from Asia to other regions
such as North America and Europe.

29. TERMS
• Endemic:
– A disease that is constantly present at low
levels in a particular population or region.
• Epidemic:
– A sudden and large outbreak of a disease
which affects a population at higher than
normal rates.
• Pandemic
– A widespread epidemic, usually continent-
wide or global in reach.

30. MALARIA
• A life-threatening vector-borne disease
caused by a parasite.
• Vector-borne diseases refer to diseases
transmitted from person to person via living
organisms, commonly insects such as
mosquitoes.

31. TRANSMISSION OF MALARIA
• The mode of transmission of malaria is through
mosquito-human-mosquito chain.
• Female mosquitoes of the Anopheles species carry
malaria parasites in their salivary glands.
• The parasites are introduced into a person’s blood
when a female Anopheles mosquito takes a blood
meal.
• The parasites then migrate to the liver of the person
and reproduce before re-entering the blood stream.
• The parasites are then picked up by another
mosquito when it bites the infected person and the
cycle continues.

32. SYMPTOMS OF MALARIA
• Sweating
• Shivering
• Anemia: a condition in which the number of
red blood cells is reduced.
• Swelling of the brain
• Liver failure
• Enlarged spleen

33. QUESTION
• Describe the extent of spread of malaria in
the world. [4]

34. DEATH RATES FROM MALARIA

35. QUESTION
• Describe the extent of spread of malaria in
Indonesia. [4]

36. EXTENT OF SPREAD, INDONESIA

37. SUGGESTED ANSWER
• The extent of spread is highest in Papua, with
50 – 100 cases per 1000 people.
• It is also high in Maluku and Nusa Tenggara
with 10 - 50 cases per 1000 people.
• It is low in central Kalimantan and north
Sulawesi with 1 – 10 cases 1000 people.
• The extent of spread is lowest in Sumatra and
Java, with 0 – 1 case per 1000 people.

38. BY THE END OF THE LESSON
We will be able to
1. Explain the factors contributing to the
spread of malaria.
2. Discuss the impact of malaria in a selected
country.

39. FACTORS CONTRIBUTING TO MALARIA
• Socio-economic factors
– Overcrowded living conditions, lack of proper
sanitation, limited provision of and access to
health care
• Environmental factors
– Poor drainage and stagnant water, effect of
climate

40. QUESTION
• With the use of examples, explain the factors
contributing to the spread of malaria. [4]

41. OVERCROWDED LIVING CONDITIONS
• In overcrowded conditions where large
numbers of people live very closely together
in a small area, people interact with one
another more often and closely, hence
resulting in diseases such as malaria
spreading quickly and easily.
• For example,

42. LACK OF PROPER SANITATION
• The lack of proper sanitation contributes to
the spread of malaria as if waste water is not
disposed of properly, stagnant pools of water
may form which are favourable breeding
grounds for mosquitoes.
• For example,

43. LIMITED PROVISION OF AND
ACCESS TO HEALTHCARE
• Limited provision of and access to healthcare
contributes to the spread of malaria as the
longer an infected person waits to receive
treatment, the greater the chances of the
person spreading the disease.
• For example,

44. POOR DRAINAGE AND
STAGNANT WATER
• Poor drainage and stagnant water contributes
to the spread of malaria as poor drainage of
water leads to stagnant water which are
favourable breeding grounds for mosquitoes.
• For example,

45. EFFECTS OF CLIMATE
• Climate contributes to the spread of malaria
as mosquitoes thrive in places with high
temperature, rainfall and humidity.
• For example,

46. IMPACT OF MALARIA
• Socio-demographic impact
– Increased death rate, increased infant
mortality rate
• Economic impact
– Increased burden on households, increased
cost of healthcare, loss of productivity

47. QUESTION
• With the use of examples, describe the
impact of malaria. [4]

48. INCREASED DEATH RATE
• One impact of malaria is increased death
rate, especially in the LDCs due to lacking
healthcare.
• For example,

49. INCREASED INFANT MORTALITY RATE
• Another impact is increased IMR as women
who have contracted malaria during
pregnancy may infect the unborn child,
leading to low birth weight and premature
death.
• For example,

50. INCREASED BURDEN ON
HOUSEHOLDS
• Malaria patients require malaria medication
and are more likely to lose income due to days
off from work for treatment, hence increasing
the economic burden on individuals and
households.

51. INCREASED COST OF HEALTHCARE
• Countries affected by malaria would need to
set aside funds for the provision of health care
to address the impact of the disease, of which
the funds could have been used for the
building of infrastructure and investments to
improve the country’s development.
• For example,

52. LOSS OF PRODUCTIVITY
• People infected with malaria might not be to
work or work as well which leads to the loss of
productivity, which eventually translates into
slower economic growth.
• For example,

53. BY THE END OF THE LESSON
We will be able to
1. Describe the transmission of HIV/AIDS
2. Describe the extent of spread of HIV/AIDS
in the world.

54. HIV/AIDS
• Human immunodeficiency virus (HIV) is a
virus that attacks the cells of the immune
system by destroying white blood cells that
are critical to fighting infections.
• Over time, the body loses its ability to fight
infections, leading to Acquired Immune
Deficiency Syndrome (AIDS), which refers to
the severe loss in the body’s cellular
immunity.

55. TRANSMISSION OF HIV/AIDS
• HIV/AIDS may be transmitted from person to
person through blood or bodily fluids.
• This may happen through
– Sexual contact
– Sharing of infected needles
– Blood transfusion
– Pregnant mother to baby

56. SYMPTOMS OF HIV/AIDS
• Fever
• Fatigue
• Skin rashes
• Profuse night sweats
• Blurred vision
• Pneumonia
• Swollen lymph nodes
• Weight loss

57. EXTENT OF SPREAD
• HIV/AIDS can be spread through expansion
diffusion, which refers to the spread of the
disease to areas within its geographic range in
the location of its origin.

58. EXTENT OF SPREAD
• HIV/AIDS can be spread through relocation
diffusion, which refers to the spread of the
disease to areas outside its geographic range,
whilst still being present in the location of its
origin.

59. QUESTION
• Compare the difference between expansion
diffusion and relocation diffusion. [3]

60. DISTRIBUTION OF HIV/AIDS

61. GROUPS VULNERABLE TO HIV/AIDS
• People who participate in risk-taking
behaviour such as casual unprotected sex and
sharing of contaminated needles.
• Women as in some societies, women are more
likely to be subjected to sex without their
consent.
• Babies born to HIV-positive mothers.

62. HEALTH AND DISEASES
Factors contributing to the spread of
HIV/AIDS

63. BY THE END OF THE LESSON
We will be able to
1. Explain the factors contributing to the
spread of HIV/AIDS.
2. Discuss the impact of HIV/AIDS in a
selected country.

64. FACTORS
• Social
– Social stigma, education, lifestyle choices,
lapses in medical practices
• Economic
– Vice trades, mobility

65. SOCIAL STIGMA
• Refers to an extreme disapproval associated with a
particular circumstance, or quality of a person.
• As HIV/AIDS patients tend to be subjected to social
stigma or discrimination such as rejection by family
and expulsion from school or the workplace,
HIV/AIDS sufferers tend not to seek help early when
diagnosed with the virus, and risks infecting others
with the disease.
• For example in Cambodia, HIV/AIDS patients tends
not to disclose their HIV status as HIV/AIDS
sufferers are generally treated as outcasts by the
society and face abuse and discrimination by both
family and the community.

66. EDUCATION
• The lack of education and awareness on how
HIV/AIDS is transmitted can result in
increased vulnerability for individuals and
groups.
• For example, it is taboo to discuss about sex
in Nigeria hence sexuality awareness
education is not conducted, which
contributed to high rates of transmission of
HIV.

67. LIFESTYLE CHOICES
• Certain lifestyle choices such as the sharing of
needles when taking drugs or the refusal to
practice safe sex can put people at risk of
getting HIV/AIDs.
• For example,

68. LAPSES IN MEDICAL PRACTICES
• Lapses in medical practices such as mistakes,
corruption and negligence can lead to the
spread of HIV/AIDs, such as when there is no
effective blood screening during blood
transfusion and the use of contaminated
syringes.
• For example,

69. VICE TRADES
• The presence of vice trades such as
involvement in illegal drugs or commercial
sex work can also contribute to the spread of
HIV/AIDs.
• For example,

70. MOBILITY
• Easy mobility which refers to the increased
ease of movement of people from one place to
another may lead to the spread of HIV/AIDS.
• For example,

71. HEALTH AND DISEASES
Impact of HIV/AIDS

72. BY THE END OF THE LESSON
We will be able to
1. Describe the impact of HIV/AIDS.

73. QUESTION
• What are the impact of HIV/AIDS?

74. IMPACT
• Socio-demographic impact
– Life expectancy
– Infant mortality rate
– Orphan crisis
• Economic impact
– Health care expenditure
– Slower economic growth

75. LIFE EXPECTANCY
• HIV/AIDS increases the number of deaths
and reduces life expectancy and population
growth, of which the impact can be
significant when HIV/AIDS is prevalent in a
country.
• For example,

76. INFANT MORTALITY RATE
• HIV/AIDS also has the effect of increasing
IMR as newborns born to HIV/AIDS victims
tend to not survive the age of one.
• For example,

77. ORPHAN CRISIS
• HIV/AIDS creates orphan crises as the
number of orphans increase as more parents
are infected and die from the disease, leading
to deep poverty among the orphans and their
caregivers.
• For example,

78. HEALTH CARE EXPENDITURE
• Health care costs for HIV/AIDS which
includes treatment and research is expensive
for both individuals and governments
respectively.
• For example,

79. SLOWER ECONOMIC GROWTH
• HIV/AIDS slows economic growth through a
shortage of labour in the workforce as high
death rates and frequent absences among
HIV/AIDS sufferers lead to lower
productivity.
• For example,

80. HEALTH AND DISEASES
Challenges in managing the spread of
infectious diseases

81. BY THE END OF THE LESSON
We will be able to
1. Explain the difference between emerging
and re-emerging diseases.
2. Explain the reasons for the re-emerging of
malaria.
3. Describe the challenges in managing the
spread of malaria.

82. EMERGING VS. RE-EMERGING
• Emerging infectious diseases are diseases that
appear in the population for the first time.
• E.g.?
• Re-emerging infectious diseases are diseases
that may have existed in a population or
region previously but are rapidly increasing in
incidence and geographic range.
• E.g.?

85. REASONS FOR RE-EMERGENCE
OF MALARIA
1. Resistance to anti-malaria drugs
2. Air travel
3. Climate change
4. Insecticide-resistant mosquitoes

86. RESISTANCE TO ANTI-MALARIA DRUGS
• The resistance of malaria parasites to anti-
malaria drugs has increased due to the use of
counterfeit malaria drugs.
• For example,

87. AIR TRAVEL
• The increase in air travel allowed vectors of
the malaria parasite to be easily transported
to new areas hence spreading the disease.
• For example,

88. CLIMATE CHANGE
• As the climate gets warmer due to global
warming, places at the higher altitudes and
latitudes which used to be free of malaria may
become favorable breeding ground for
malaria mosquitoes.
• For example,

89. INSECTICIDE-RESISTANT MOSQUITOES
• The frequent use of insecticides may become
ineffective against malaria mosquitoes as the
mosquitoes gained resistance after recurring
exposure to the insecticides.
• For example,

90. CHALLENGES IN MANAGING
THE SPREAD OF MALARIA
• Socio-economic
– Health care
– Population movement
– Forest clearance
• Environmental
– Climate
– Monsoons

91. HEALTH CARE
• The ability of surviving malaria parasites,
present in victims who did not complete their
treatment, to develop resistance to anti-
malaria drugs is a health care challenge as
anti-malaria drugs lose their effectiveness
over time and new drugs have to be
developed.
• For example,

92. POPULATION MOVEMENT
• Increased population movement brought
about by improvements in transportation and
the high mobility of certain segments of the
population reduces the effectiveness of
malaria control programmes as the disease is
easily diffused to new locations.
• For example,

93. FOREST CLEARANCE
• Forest clearance or deforestation provides
favorable breeding grounds for mosquitoes
to breed as water is less able to seep into the
ground in the absence of vegetation.
• For example,

94. CLIMATE
• Climate changes in temperature and rainfall
poses a challenge to controlling malaria as
mosquitoes thrives in high temperatures and
wet environments, resulting in the inevitable
spike in the number of malaria cases during
seasons with high temperatures and rainfall.
• For example,

95. MONSOONS

96. MONSOONS
• The annual monsoons is a challenge to
controlling rainfall as monsoons bring high
rainfall during the wet seasons which creates
long-lasting pools of stagnant water for
mosquitoes to breed.
• For example,

97. BY THE END OF THE LESSON
We will be able to
1. Describe the challenges in managing the
spread of HIV/AIDS.

98. CHALLENGES IN MANAGING
THE SPREAD OF HIV/AIDS
• Socio-economic
– Difficulties in HIV detection
– Lifestyle choices
– Social stigma
• Economic
– Health care
– Population movement

99. DIFFICULTIES IN HIV DETECTION
• HIV is difficult to detect because there are no
visible signs of the disease for most of the
period of infection and infected people may
potentially infect others.
• For example,

100. LIFESTYLE CHOICES
• Lifestyle choices such as being sexually active
at a young age and the use of injection drugs
pose a challenge to the control of HIV as the
disease is spread through these ways.
• For example,

101. SOCIAL STIGMA
• Social stigma associated with HIV/AIDS
causes many people to stay away from being
tested and receiving treatment which
increases the spread of the disease.
• For example,

102. HEALTH CARE
• The use of antiretroviral therapy which has
some effectiveness in reducing the number of
HIV/AIDS-related deaths is costly and and
unaffordable to many HIV/AIDS sufferers.
• For example,

103. POPULATION MOVEMENT
• Increased population movement brought
about by improvements in transportation and
the high mobility of certain segments of the
population reduces the effectiveness of
HIV/AIDS control programmes as the disease
is easily diffused to new locations.
• For example,

104. HEALTH AND DISEASES
What can we do to manage the spread of
diseases?

105. BY THE END OF THE LESSON
We will be able to
1. Evaluate the roles of different groups in
managing the spread of infectious diseases.

106. ROLES OF DIFFERENT GROUPS
1. Individuals
2. Communities
3. Governments
4. International organisations

107. ROLES OF DIFFERENT GROUPS
1. Individuals
2. Communities
– CLTS (Sierra Leone), Community-based mosquito
control (Nicaragua), GIS to monitor dengue outbreaks
(India)
3. Governments
– H1N1 vaccinations (Singapore), Thermal fogging
(Thailand), SARS control measures (Singapore)
4. International organisations
– DOTS (WHO), Rolling Back Malaria (World Bank),
Getting to Zero (UNAIDS), HIV, Health and Rights
(IHAA)

108. QUESTION
• Assess the effectiveness of measures taken by
two groups to contain the spread of diseases.
[8]
• Refer to page 233.