Risk Factors for Disease in Developing and Developed Countries

Though this is one of my core ideas, I never put it down on paper until my younger brother prodded me to write it.

I write here, the risk factors for disease in developing as well as developed countries. This knowledge will help you in preventing your own diseases and to prevent the diseases of our poor brethren - if you are so inclined.

Risk Factors for Disease in Developing Countries:

Close to 25 % of disease is due to Undernutrition
(Underweight 15%; Zinc, Iron, Vitamin A - each about 3 %)

About 11% of disease are due to unsafe sex, and lack of contraception in females.

11% of disease is due to unsafe environment. Unsafe water, sanitation and hygiene (6 %), Indoor smoke from solid fuels (4 %) , and Lead exposure (1 %).

8 % of deaths are due to other dietary (I would say mostly overnutrition) and physical inactivity. Blood Pressure (3 %); Cholesterol (2 %); Overweight, Low fruit and vegetable intake, and Physical inactivity (1 % each).

4 % of deaths are due to addictions. Alcohol (1.5 %), Tobacco (2 %), Drugs (0.5 %).

1.5 % of deaths is due to Occupational Injuries, and 1 % due to Unsafe Health Care Injections.

We find that more than 60 % of deaths/disease can be prevented by removing these risk factors.

The above figures are for the total populations of third-world countries, rich and poor included. Therefore, it is common sense to assume that deaths due to malnutrition, unsafe sex, and unsafe environment will be higher in poor people than what the above numbers indicate. How much higher they are, depends on the rich-poor mix and the prevalence of risk factors among the rich and poor.

If one goes into further causal analysis, one finds that the great majority of the poor people's diseases can be prevented by making them literate, and giving them health education. Of course, undernutrition can be prevented mostly by higher incomes that come with creating more employment opportunities. This in turn will require making them skilled labor in contrast to unskilled, and also a lot of other factors that promote enterpreneurship.

Risk Factors for Disease in Developed Countries:

Well, if you are reading this, you most likely fall into the other category of people whose risk factors are different. 2 % of your disease are due to environmental factors, 1 % are due to undernutrition, unsafe sex, and occupational injuries each. 33 % are due to Overnutrition and Physical Inactivity, and 22 % to Substance Addictions (tobacco 12 %, alcohol 9 %, illicit drugs, 2 %). It is not wise to think that these numbers are similar to those of the poor - and if I am not going to die of infectious disease, I'm going to die of other diseases. These numbers (see p 87) are only percentages, and the actual disease level is three times higher in the poor.

The World Health Reports

Take care of your diseases first, and if you have the compassion and power in you, help prevent those diseases in the poor.

'I don't want a kingdom, I don't want salvation,
I want relief from suffering of the diseased'

- Translated from a Sanskrit poem

1. On Rebuilding India

This site is for ideas, and to actually 'Rebuild India' - as inspired by Swami Vivekananda (SV). SV envisioned an India which is materially as well as spiritually developed. India, now, as we know, is a backward country - actually the second most backward region in the world after Sub-Saharan Africa. Some people might argue that India is not backward. They may say that we have satellites, missiles, nuclear weapons, IT industry, IITs, metro trains, English-speaking educated people, and so on. I do not totally disagree with it. Actually, India should be divided into two parts to study - Urban India and Rural India. Urban India is somewhat better, and can be compared to the Middle-Income countries as classified by the World Bank. On the contrary, Rural India is very backward. I'm afraid it competes very hard with Sub-Saharan Africa for the title of 'Most backward population in the world'. I'm not saying this without evidence.

For example, take poverty. Almost 30% of Indians live in poverty, according to the Indian government's own data. The official definition of poverty is 'not able to afford to buy the minimum food required per day - about 2200 calories'. What about clothes, drinking water, housing, etc.? Half of the world's poor live in India, by that definition. Half of the world's Lepers and a third of the world's Tuberculosis patients are Indians. And, half of the world's Illiterates are Indians. and if you look at the various health indicators like infant mortality rate, child mortality rate, maternal mortality rate, malnourishment rate, life span, etc. we are almost the worst.

The Human development Index (HDI) of the UNDP, is the best indicator so far of 'how well the people are living'. It is a weighted index of per capita income, health and education . We are ranked about 140 among 180 nations. Per capita income, or income earned by a person is not the only measure of 'quality of life'. A person may not be poor, but if he has disease, he will not be happy. A person may not be poor or diseased, but if he is illiterate, his socio-economic status will be very low. He may even be subjected to oppression by the upper castes.

As such, the HDI is the best measure of our country's development, and we should increase the rank by as much as possible. I envision our country to achieve a top ten position by 2030, provided a large number of Indians work towards it with full dedication. It is a formidable task, but let's be confident. After all, India was one of the greatest civilizations from time immemorial till a few hundred years back. When India had Kings and Kingdoms, Europeans were living in stone ages - till about 2,000 years back. We have become backward due to various reasons, but we can regain our rightful place in the hierarchy of nations, if we are dedicated enough for the cause.

In my future blogs, I'll elaborate on some ideas which I have thought over the past decade as a student. I can't assure you regular posts as I'm obligated to my studies for admission to post-graduation in medicine in US.

This site is dedicated to you, the reader, and all the people who are or will be rebuilding India.

Jai Hind!