chapter 4 - DRK

More documents

Recommendations

Info

Strictly under embargo until Wednesday 22 September at 00:01 GMT (02:01 Geneva time)– two-fifths of the world’s population – are now at risk, according to WHO.The organization estimates that there may be as many as 50 million infections every year,with most going unreported. In the Americas there were more than 890,000 reportedcases of dengue in 2007, of which 26,000 were of the often-fatal haemorrhagic fever type.104CHAPTER 5peopleYet 50 years ago, the disease was virtually unknown. It first appeared in Manila in thePhilippines in 1953 and had jumped to Bangkok, Thailand by the end of the decade.Before 1970, only nine countries had experienced epidemics of the severe haemorrhagicfever, which kills in almost 25 per cent of cases. By 1995, this number had risento around 40. The disease is now endemic in more than 100 countries in Africa, theAmericas, the eastern Mediterranean, South-East Asia and the western Pacific. Notonly is the number of cases increasing, as the disease reaches new areas, but so too is thenumber of serious outbreaks. In 2007, Venezuela reported over 80,000 cases, includingmore than 6,000 cases of haemorrhagic fever.The disease is spread by the Aedes aegypti mosquito, which has come to thrive in tropicalurban environments. It breeds in and around city homes, in roof gutters, beneathrefrigerators, under flowerpots and anywhere there is stagnant water, including in wastepackaging and discarded food tins. Used tyres are a favourite breeding ground. Withglobalization, the mosquito also gets to travel easily. Dengue is thought to have arrivedin Brazil, now one of the most affected countries, in the rims of tyres exported from Asia.Cities change usWith 70 per cent of the global population forecast to be living in urban areas by 2050,the predominant lifestyle around the world will become increasingly an urban one. Butwhat are the implications of an urban lifestyle for health? It is a mixed picture wherebymany improvements in basic health indicators, such as infant and child mortality ratesand life expectancy, have to be balanced against health threats which stem directly fromurban living.The major risk factors for non-communicable disease are an unhealthy diet, lack ofexercise, smoking and excessive use of alcohol: all of them fostered one way or anotherby urban living.Perhaps the most visible and most health-threatening manifestation of the risk factorsis obesity. Being significantly overweight greatly increases the chances of developingtype 2 diabetes, heart and respiratory problems and even some forms of cancer.According to WHO, over 1.6 billion adults are overweight and nearly one in four isobese. By 2015, the figure for those overweight will have risen to 2.3 billion. As anexample of the likely impact on health, WHO forecasts that the number of peoplewith obesity-related diabetes will double to 300 million between 1998 and 2025 –with three-quarters of that growth projected in the developing world.
Strictly under embargo until Wednesday 22 September at 00:01 GMT (02:01 Geneva time)Urban life affects the way people work, move around and relax. Office jobs require lessphysical exertion than farm work, while getting around in a city is more likely to involvesome form of transport – often door to door, if it is a car or motorcycle – rather thanwalking. Pressure to build within urban areas can leave less and less space for parks andareas of recreation. “What urbanization does is to change behaviour patterns,” notedWHO’s Kumaresan. “People have different eating habits, different levels of physicalactivity. If there are no fields or parks, kids have nowhere to run around and play. Theseare some examples of what urbanization does to our changing patterns of lifestyle.”Although there is no firm statistical correlation between rising urbanization and thegrowth of non-communicable diseases, there is no doubt that both have been advancingalmost hand in hand. At the beginning of the last century, only some 10 per cent of theworld’s population was urban, and infectious diseases, such as malaria and tuberculosis,were still by far the biggest causes of premature death among adults. But by the final decadesof the 20th century, nearly half of the world already lived in urban centres, some toosmall to be considered cities, and the burden of early death had also changed radically.In the developed countries of North America and Europe, non-communicable diseaseshad long been fatal, which is why they used to be known as the ‘diseases of the rich’.But by the beginning of the 21st century, 60 per cent of premature deaths aroundthe world were being caused by non-communicable disease. In Latin America andthe Carib bean, they account for two out of every three deaths, according to the PanAmerican Health Organization (PAHO).New ways, new dietThe Gulf region is a case in point. Over the last 30 years it has experienced remarkableeconomic growth, modernization and urbanization. As the population has becomericher and increasingly urban, diets have changed and now include a greater intake ofprocessed and fast foods, rich in fats, saturated fats, salt and sugars, all of which fuelobesity. The percentage of people who are overweight in Kuwait, the United ArabEmirates and Egypt ranges from 68 per cent to 74 per cent.In the Americas, the story is similar. The Latin American and Caribbean region is oneof the most urbanized in the world, with more than three-quarters of its 433 millionpeople living in towns and cities. Eating habits are changing, with people consumingless fruit, fewer vegetables and more processed food. According to PAHO, 50 to 60per cent of adults in Latin America and the Caribbean are overweight or obese. Evenmore worrying for the future, the same goes for 7 to 12 per cent of children under 5.At the same time, 30 to 60 per cent of the population do not take the minimum levelof exercise – 30 minutes a day – recommended by WHO. Predictably, in the past fewyears, the region has witnessed an explosion in chronic non-communicable disease– cancers, hypertension and heart problems. According to WHO figures, more thanWorld Disasters Report 2010 – Focus on urban risk105
Page 1 and 2:
Strictly under embargo untilWednesd
Page 4 and 5:
A global humanitarian organizationT
Page 6 and 7:
Strictly under embargo until Wednes
Page 8:
Page 12:
Page 17 and 18:
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
Page 31 and 32:
Page 33 and 34:
Page 35 and 36:
Page 37 and 38:
Page 39 and 40:
Page 41 and 42:
Page 43 and 44:
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Page 53 and 54:
Page 55 and 56:
Page 57 and 58: Strictly under embargo until Wednes
Page 101: Strictly under embargo until Wednes
Page 118 and 119: 114CHAPTER 6Strictly under embargo
Page 142 and 143: 138CHAPTER 7Strictly under embargo
Page 158 and 159:
Page 160 and 161:
Page 162 and 163:
Page 164 and 165:
Page 166 and 167:
Page 168 and 169:
Page 170 and 171:
Page 172 and 173:
Page 174 and 175:
Page 176 and 177:
Page 178 and 179:
Page 180 and 181:
Page 182 and 183:
Page 184 and 185:
Page 186 and 187:
Page 188 and 189:
Page 190 and 191:
Page 192 and 193:
Page 194 and 195:
190ANNEX 2Strictly under embargo un
Page 196 and 197:
Page 198 and 199:
Page 200 and 201:
Page 202 and 203:
Page 204 and 205:
Page 206 and 207:
Page 208 and 209:
Page 210 and 211:
Page 212 and 213:
Page 214 and 215:
Page 216 and 217:
Page 218 and 219:
214INDEXStrictly under embargo unti
Page 220:
The International Federationof Red
show all

chapter 4 - DRK

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?