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Life Expectancy-1930 Life Expectancy-1960 Life Expectancy-1990 Factors Affecting Human Population Size Current Status • World Population Size: 6.8 billion • World Growth Rate: 1.4%, ~84 million/year • U.S. Population Size: 273.6 million 6.1 billion people are breeding exponentially. The process of fulfilling their needs and wants is stripping Earth of its biotic capacity to produce life. Birth & Death Rates * Birth and death rates are coming down, but death rates have fallen more sharply than birth rates. Hence more birth than death occur. Population Growth World’s population will double in 52 years Population projections by regions (1999 – 2025) Over 95% of this increase will take place in “Developing Countries” Total fertility rates in 2000 Total fertility rates for the US Infant Mortality Rates 3. Human Carrying Capacity Can the world/biosphere provide an adequate standard for the increasing population or are we at the limit? Computer Models • The Limits to Growth (1972) predicted economic & environmental collapse U.S.: 278 million people • fertility near replacement rate; • continued population increase because of immigration. India: 1 billion =1/5 of world’s population • 1952 first national family planning program; • program disappointing; • fertility still 3.5. China: 1.3 billion people =1/5 of world’s population • since 1970 efforts to better feed people & control population growth; • strict population control measures prevent couples from having more than one child; • although considered coercive, the policy is significantly slowing population growth. How to Reduce Population Growth? • improve access to family planning & reproductive health care; • improve heath care for infants, children, & pregnant women; • improve equality between men & women; • increase access to education, especially for girls; • increase the involvement of men in child rearing & family planning; • reduce poverty; • reduce & eliminate unsustainable patterns of production & consumption. Current Situation • Each year nearly 11 million children die before the age of five,30,000 every day,largely from preventable causes. • 50% of these deaths occur in only six countries; 90% of these deaths occur in 42 of 192 countries. • 41% of these deaths occur in Africa, which has only 10 % of the world’s under-five population. ~11 Million Children Die/year (70% From 5 Major Causes) Malaria 7% Other 31% ARI 29% Malnutrition 56% Measles 8% Birth Trauma Neonatal Deaths Tetanus Fever Low Birth Weight Diarrhea 25% Causes of Death in the World Age<5 yrs % of Deaths Malaria 20 18 16 14 12 10 8 6 4 2 0 Injuries Mealses Non Communic. Disease Other Perinatal Acute Resp. Infections Diarrhea COD Main Causes of Death Disease or Condition Proportion of Underfive Deaths Neonatal Illnesses 33% Diarrhea 22% Pneumonia 21% Malaria 9% AIDS 3% Measles 1% Other 9% Source: The Lancet. Vol.361, June 28, 2003 Malnutrition is an underlying cause of 53% of all child deaths Under-Five Mortality Rate: Regional and Global Averages Deaths per 1,000 Live Births 300 250 Summit Goal 200 Global 150 Latin America and Caribbean Asia Near East 100 Africa 50 Source: UNICEF Times Series Estimates, 2000 0 1960 1970 1980 1990 Year 1995 1998 2000 Neonatal Mortality Relative to Infant Mortality Deaths per 1,000 Live Births 110 100 90 80 70 60 Post-Neonatal Deaths 50 Neonatal Deaths 40 30 20 Source: Demographic Health Surveys 10 0 Bangladesh (1999/2000) Ethiopia (2000) Haiti (2000) Country India (1998/99) Nigeria (2003) Infectious Diseases • Tuberculosis prevention, control & treatment • Malaria prevention, control & treatment • Anti-microbial resistance • Local capacity for surveillance and response Gaps in Child Survival • Gaps in child mortality are increasing between rich and poor countries. • Mortality rates in sub-Saharan Africa average 175 per 1,000, compared to 6 per 1000 in industrialized countries. • Within countries, gaps in mortality rates between rich and poor children are also increasing. Deaths per 1,000 Live Births Urban/Rural Under-five Mortality Rates by Country 250 200 150 Urban Rural 100 50 Source: Demographic Health Surveys 0 Bolivia Cambodia Ethiopia India (1998) (2000) (2000) (1998/99) Country Nepal (2001) Zambia (2001/02) We Know What Works • Six million children each year could be saved with basic, cost-effective measures such as: vaccines, antibiotics, insecticide-treated bed nets, breastfeeding, micronutrients, and health and nutrition education. • We know what it takes to improve child health but increased resources are needed to ensure all children have access to these proven measures. Child deaths from HIV/AIDS during 1997 Estimated impact of AIDS on under-5 child mortality rates DALYs Disability Adjusted Life –Years QALY= Quality Adjusted Life-Years Both are attempts to express burden of disease in a single number • • • • • Most significant public health achievements in the U.S. in the th Century 20 Vaccination Motor-vehicle safety Safer workplaces Control of infectious diseases Decline in deaths from coronary heart disease and stroke • Healthier mothers and babies • Recognition of tobacco as the major killer and cause of disease 20th Century Environmental Health Events • • • • • • • 1906 Pure Food and Drug Act 1918 Flu Epidemic 1948 Donora PA. Air Pollution Episode 1952 London England Air Poll. Episode 1958 Mercury Poisoning Minamata Bay 1962 Rachel Carson’s “Silent Spring” 1970 Earth Day-Sen. Gaylord Nelson 20th Century Environmental Health Events Cont. • 1970 U.S. Clean Air Act, EPA, OSHA Created • 1972 Federal Water Pollution Control Act, Consumer Product Safety Act • 1974 Superfund Act • 1975 Safe Drinking Water Act • 1976 Resource Conservation and Recovery Act – Toxic Substances Control Act • 1979 Three Mile Island • 1984 Bhopal India • 1986 Chernobyl