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Non-communicable diseases increase when clean drinking water is provided, poverty has been reduced, and malnutrition is gradually eliminated. Relative poverty The second approach, which is more country-specific, deals with what is frequently referred to as ‘relative poverty’.Basic health care will lead to good-quality treatment of infections, and implementation of vaccination programmes will increase life expectancy; therefore the lifelong incidence of cancer, and probably of cardiovascular diseases, will increase. The practice here is to define the poverty line in terms of relevance for a specific society. One way, analogous to the international approach just described, is to determine how much income one needs to live decently according to some locally established definition of decency.On the other hand, epidemiologists have a message that is of interest to the public and therefore to the media. ‘Concentrate first on overall growth’, was the prevailing view.Thus they have much more influence than their sparse financial resources would suggest. The result might be a rise in inequality over the short term, but eventually the benefits would trickle down to the poor and, in the long run, they would end up better off than under a development strategy oriented towards their immediate needs.The problem in passing on the information is that when health consequences are addressed they are placed in a distant future—people are asked to give up habits that give them pleasure at present and no any guarantees are given that these changes will actually prevent the diseases in question. The ‘trickle-up’ and ‘basic human needs’ schools of thought, which emerged to counter the view just presented, advocated dealing directly with the poor as the best means of producing sustainable growth.The concept of disease causation is used, which apparently is far away from a common-sense concept and therefore has low credibility (J. Rose’s paradox of prevention (Rose 1992) is well documented. The many discussions about how best to define the poor population groups of concern produced two approaches.The shift from communicable to non-communicable diseases in many developing countries is an achievement that cannot and should not be prevented as it is largely driven by forces that prevent premature death. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. The second approach is simply to define the national poverty line as some proportion—often arbitrarily determined—of a society’s average per capita income or expenditure.The challenges lie in reducing the avoidable deaths and disabilities related to non-communicable diseases as much as possible with the available resources. B., Williams, P., Fosher, K., Criqui, M., and Stampfer, M. In the United Kingdom, a statistic frequently cited to document the prevalence of poverty refers to the proportion of the population (currently just under a quarter) with less than half the country’s average per capita income (Anonymous 1999).
Many people want to influence our lifestyle, yet there are few epidemiologists or public health workers and their financial resources are comparatively sparse. At the time, a concern for distribution was thought likely to detract from the overall economic growth that was considered a necessary condition for the long-term alleviation of poverty.
There is no magic treatment that will make arteriosclerosis go away and it is unlikely that any cancer treatment will ever be able to eliminate the excess cancer mortality associated with smoking. However, others feel that relative poverty and deprivation are just as important, if not more so.
Cancer treatment may in time be able to cure a growing number of cancer diseases, but many opportunities for prevention have been lost because we have waited in vain for this to happen. Inequality in health While a concern for improving the health of the poor is widespread, it is by no means universally preferred.
What should be avoided is a community suffering acute diseases related to overcrowding and poverty, as well as chronic diseases related to overeating, alcohol abuse, and smoking. This distinction between absolute and relative poverty carries over into the field of health.
Although wealthy countries spend 90 per cent of world health resources on 10 per cent of world health problems, history clearly shows that expenditure of health resources on treatment alone is not a very efficient way of reducing the number of non-communicable diseases (Mc Keown 1965; Mc Keown and Lowe 1974), simply because many of these diseases are not curable. For instance, a careful reading of the World Bank policy statement on health, nutrition, and population cited above reveals an absolute-poverty orientation through its reference to a concern for ‘the world’s poor’, which is in line with the overall World Bank interest in people below the global poverty line as just described.
Making changes in society that will make it easier to exchange unhealthy habits for more healthy ones will most likely have a large effect on life expectancy. Many focus more on reducing inequalities, both in general and with respect to health in particular.