GLOBAL
CHALLENGES AND
2
HEALTH DYNAMICS
MODULE 2 PART 1
21st Century Health Dynamics and Inequality
2 LEARNING OBJECTIVES
Describe some of the major global
1 challenges impacting health
2 GLOBAL CHALLENGES FOR HEALTH
The 21st century brings many complex
and interacting challenges.
Some of the major global challenges directly
and indirectly impacting health include:
1 Globalization
2
Urbanization
3 Poverty
4 Socioeconomic inequality
5 Food insecurity
6
Environmental degradation
7 Demographic transition
GLOBALIZATION: TRADE, MIGRATION
2 AND INDUSTRIALIZATION
1
The world is more and more economically
interconnected. Trade between countries
is one indication of this.
– Between 1960 and 2017, the value of trade in goods and services
as a share of global GDP increased from 12% to 37%. 1
The number of people travelling
and migrating is increasing.
1 World Bank, World Development Indicators. Accessed https://data.worldbank.org/indicator/NE.EXP.GNFS.ZS
GLOBALIZATION: TRADE, MIGRATION
2 AND INDUSTRIALIZATION
1
Many low- and middle-income economies
have industrialized and grown significantly.
– Consequences for rural to urban migration, urbanization
and socioeconomic change.
This globalization is impacting health in multiple ways:
– Increases risks of global epidemics such as severe acute
respiratory syndrome (SARs) and the spread of health hazards
including contaminated foods and products;
– Rapid economic growth places pressure on the labour force,
infrastructure and environment.
2 URBANIZATION
2
Urbanization is the process of the population
moving from rural areas to urban areas,
which leads to many changes in economic,
social and physical environments.
The world is rapidly becoming more urban.
– Between 2010 and 2050, the percentage of
the world’s population living in urban areas
is predicted to increase from 50% to 70%.
– At present, nearly 1 billion people or 33%
of the urban population live in slums.
2 URBANIZATION
2
As with rapid economic growth, urbanization can place strain on
infrastructure resulting in poor living conditions and an inability
to properly access social services like education and medical
care.
Rapid, unplanned urbanization creates congestion and pollution,
and has impacts on health-promoting behaviours and risk factors
for non-communicable diseases (NCDs).
ECONOMIC GROWTH, POVERTY
2 AND GOVERNANCE
3
Economic growth is the most powerful instrument
for reducing poverty and improving quality of life.
In 2015, 736 million people lived on less than $1.90
a day, down from 1.85 billion in 1990. 2 While poverty rates have
declined in all regions, progress has been uneven. Increasingly,
the majority of the world’s poor live in middle-income countries.
2 The World Bank, Understanding Poverty, accessed (page updated Apr 03, 2019):
https://www.worldbank.org/en/topic/poverty/overview
ECONOMIC GROWTH, POVERTY
2 AND GOVERNANCE
3
Health is traditionally viewed as an end product
of the growth process. However, in the other direction, a healthy
population is also a driver
for economic growth.
In many countries, the past several decades of economic growth
have been accompanied
by a shift in the discourse of public policy
and governance towards neoliberalism.
2 SOCIOECONOMIC INEQUALITY
Interrelated to poverty, there is also socioeconomic inequality.
Socioeconomic inequality relates to disparities in both economic
and social resources.
Large inequalities exist not only across countries, but also
between population groups within
each country.
2 SOCIOECONOMIC INEQUALITY
Growth in many countries has disproportionally benefited
higher income groups while lower income households have
been left behind.
Income and wealth inequalities are fundamental causes of health
inequalities. They influence other factors such as housing,
alcohol use and smoking.
2 SOCIOECONOMIC INEQUALITY
INEQUALITIES ARE ON THE RISE AND HALTING THIS TREND HAS
BECOME A PRIORITY FOR POLICY-MAKERS IN MANY COUNTRIES.
Global Income Inequality
Inequality is Rising or Staying Extremely High Nearly Everywhere
Top 10% income shares across the world, 1980-2016
Africa
Brazil
60
China
Share of National Income (%)
Europe
India
50 Middle-East
Russia
US-Canada
40
30
20
1980 1985 1990 1995 2000 2005 2010 2015
Source: World Inequality Lab, World Inequality Report, 2018
2 SOCIOECONOMIC INEQUALITY
RISING INCOME INEQUALITY
CHANGE IN REAL HOUSEHOLD INCOME, OECD AVERAGE
The gap between
low income and high
Top 10%
income earners keeps on increasing
over the years
40%
Bottom 40%
20%
Bottom 10%
0%
1980 1985 1990 1995 2000 2005 2010
Source: In It Together - Why Less Inequality Benefits All (2015)
2 FOOD INSECURITY
5
Food security exists when all people at all times have physical, social
and economic access to sufficient, safe and nutritious food to meet
dietary needs and food preferences for an active and healthy life.
New shocks related to climate change, conflict, pests
(such as locusts) and infectious diseases are hurting food production,
disrupting supply chains and stressing
people’s ability to access nutritious and affordable food.
2 FOOD INSECURITY
The widespread incidence of microbiological, chemical or other
food safety hazards in food also continues to be a serious issue
for the food system.
Recent world economic reports have highlighted economic
slowdowns and downturns in several economies, impacting
global food security and nutrition trends.
2 ENVIRONMENTAL DEGRADATION
6
Conserving the earth’s ecosystem on which human society
depends is a precondition for economic and social
development, including good health.
Although human health has improved dramatically since 1950, this
gain has been accompanied by unprecedented environmental
degradation from human activities that now threaten both human
health and life-support systems.
2 ENVIRONMENTAL DEGRADATION
Environmental factors – polluted air, built environment
hazards, agricultural practices, occupational hazards,
radiation, climate change, chemical exposures and inadequate
water and sanitation – were associated with 12.6 million
deaths (23% of deaths worldwide) in 2012. 3
3 Prüss-Ustün, A, Wolf, J, Corvalán, C, Bos, R & Neira, M 2016, Preventing disease through healthy environments:
a global assessment of the burden of disease from environmental risks, WHO, Geneva.
2 ENVIRONMENTAL DEGRADATION
GLOBAL IMPACTS ON HEALTH OF THE PLANET
AND HUMAN HEALTH, 2018 – 50.
Household or urban pollution and greenhouse gases
Air
Interconnectedness of Earth system
Greatest cause of death and sickness; causes displacement globally globally.
Socioecological systems
Desertification, deforestation, and chemical pollution
Land
Impact on access to land, number of jobs
Pollution (including antibiotics or nano), extraction greater than recharge
Freshwater
Impact on water security, health and jobs
Fish population declines, plastic pollution, coral bleaching, polar ice melting
Oceans
Loss of cheap protein and jobs
Pollinators decline; extinction of genes, species, or ecosystems
Biodiversity
Food security decrease, potential zoonoses increase
Planetary Impact Good Stable Reversible Irreversible
Human Health
Low
Impact
Source: Gupta, J et al. (2019). Communicating the health of the planet and its links to human health.
The Lancet, Planetary Health, DOI:https://doi.org/10.1016/S2542-5196(19)30040-3.
2 DEMOGRAPHIC TRANSITION
7
Demographic transition is the transition from high birth and
death rates to lower birth and death rates as
a country or region develops from an agricultural society to an
industrialized economic system.
Population growth: according to the United Nations, the global
population is predicted to increase from 6.8 billion to 9.1 billion
between 2010 and 2050.
2 DEMOGRAPHIC TRANSITION
Other demographic processes undergoing change include
women’s fertility and increasingly older populations in the
developed world.
This demographic transition places strain on the health care
system as more people need care, especially for chronic illnesses
such as NCDs.
End of
Module 2 Part 1
Please continue to
Module 2 Part 2
