Human Development Index: Basic Dimensions of Human Development

HSCI 160 Instructor: Mandana Salajegheh
Some Important Concepts

Human Development Index
The Human Development Index (HDI) measures the average achievements in a country in three basic dimensions of human development:
Health Education Living Standards

It is calculated for 177 countries and areas for which data is available.

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Human Development Index

http://hdr.undp.org/en/statistics/hdi/

http://hdr.undp.org/en/humandev/

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http://www.youtube.com/watch?v=vddX4n30sXY&feature=PlayList&p=B85108E4B2D56890&index=0

Introductio n 1

Key health indicators
No. deaths between birth and age 1 year X 1000 Total no. live births

Infant Mortality Rate (IMR)

Perinatal Mortality Rate (PMR)

No. deaths from the 28th completed week of gestation till the end of the 1st week of life Total no. live & stillbirths

X 1000

Under five Mortality Rate (U5MR) Maternal Mortality Rate (MMR)

No. deaths occurring below the age of 5 years X 1000 Total no. live births No. maternal deaths X 100000 Total no. live births
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What do you think is the current under 5 mortality rate in the following countries?
Britain 6/1,000 China 37/1,000

Nigeria
198/1,000

Pakistan 103/1,000

Click to Reveal Answers

(Source : Unicef State of the World’s Children 2005)

6 Source : Partnership for Global Health Education, The School of Medicine, Swansea University, Swansea, UK

What do you think is the current average life expectancy in these countries?
Britain

78 years China 71 years Nigeria 51 years

Pakistan 61 years

(Source : Unicef State of the World’s Children 2005)

Click to Reveal Answers
7 Source : Partnership for Global Health Education, The School of Medicine, Swansea University, Swansea, UK

Other estimates of disease burden

Both mortality rates and life expectancy are useful – but do not tell us anything about disease burden in people living with diseases HALE - Health Adjusted Life Expectancy Expected number of years to be lived in good health (calculated based on the current rates of morbidity and mortality).
A man with polio begging for money
8 Source : Partnership for Global Health Education, The School of Medicine, Swansea University, Swansea, UK

Introductio n 1

GLOBAL BURDEN OF DISEASE

Measurement of the gap between the current health of a population & an ideal scenario where everyone completes their full life expectancy in full health. 9
Source : Partnership for Global Health Education, The School of Medicine, Swansea University, Swansea, UK

n t r o d u c t i o n 1

Disability-Adjusted Life Years (DALYs)
DALY= YLL + YLD
Years of Lost Life (due to premature mortality) Years Lost to Disability (due to injury or illness) Internationally-accepted measure of death and disability # of years lost to premature death + # of productive years lost to disability. Calculation of DALYs is based on the assumption that everyone in the world has a right to the best life expectancy in the world. ____years for men and ____years for women. Combines information about mortality and morbidity in a single number. Useful to: Compare the health of one population with another and allow decision makers to focus on health systems with the worst performance Compare the health of the same population at different points in time Compare the health of subgroups within a population to identify health inequalities
10 Source : Partnership for Global Health Education, The School of Medicine, Swansea University, Swansea, UK

True or False?
a)

The Infant Mortality Rate (IMR) expresses the number of deaths in the 1st year of life, according to the total number of live and stillbirths The Perinatal Mortality Rate (PMR) expresses the deaths in infants delivered in the last trimester of pregnancy until the end of the age of 1 month according to the total number of live and stillbirths In the absence of adverse effects on health, men are expected to live for 80 years DALYs capture the number of healthy years lost to disability

Click for the correct answer

a

b)

b c

c)

d)

d
e)

The calculation of DALYs involves an index of the disability attributed to specific diseases

e
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Classification of countries
Three major groupings of countries can be defined by geography, state of economic and demographic development, and mortality patterns.
Group I developing countries with high mortality developing countries with low mortality developed / industrialised countries Sub-Saharan Africa South-East Asia China Latin America Europe North America

Group II

Group III

Source: WHO World Health report 2002

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Introductio n 1

Where do the major diseases occur in the world today?
Which country group has the greatest burden of the following diseases?

Diseases
A B C

Country group I, II or III?

Infectious and parasitic diseases Cardiovascular diseases Injuries

? ? ?
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Introductio n 1

Where do the major diseases occur in the world today?
Diseases
A
Country group

Infectious and parasitic diseases Cardiovascular diseases Injuries

Group 1 Group 1 Group 1

B

C

All of these diseases occur more commonly in developing countries with high mortality!!
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n t r o d u c t i o n 1

What are the major risks to health in the developed world?
Overweight and obesity are important risk factors that lead to adverse metabolic changes, including elevated blood pressure, unfavourable cholesterol levels and increased resistance to insulin. They raise the risk of coronary heart disease, stroke, diabetes mellitus and many forms of cancer. Tobacco and excess alcohol consumption are major risks to health in the developed world. Alcohol was estimated to cause 20-30% of oesophageal cancer, liver disease, epilepsy, motor vehicle accidents, and homicide worldwide.
The world is living dangerously, either because it has little choice, which is often the case among the poor, or because it is making the wrong choices in terms of it’s consumption and it’s activities. Dr Gro Brundtland (Former Director General, WHO)
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Global Cardiovascular Disease Burden Due to High Blood Pressure, Cholesterol & Overweight
Cardiovascular Disease 100% High Blood Pressure 45% High Cholesterol 28%

Overweight 15%

Source: Disease Control Priorities in Developing Countries, second edition, 2006, Figure 45.2

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Disease Burden Distribution by Select World Bank Region, 2001
Percent 100
70 50 44 44 21 11 0 South Asia Sub-Saharan Africa High-income countries World 8 6 8 11 53 37 87

Communicable, maternal, perinatal, and nutritional conditions Noncommunicable diseases Injuries
Note: Numbers are rounded. 17 Source: Disease Control Priorities in Developing Countries, second edition, 2006, Table 4.1

Demographic & Epidemiologic Transitions
Demographic transition: the change of patterns fromhigh fertility and high mortality to patterns of low fertility and low mortality over time. Epidemiologic transition: As life expectancy increases, the major causes of death and disability shift from communicable, maternal and perinatal causes to chronic, non-communicable ones.
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Age Distribution of the World’s Population
Population Structures by Age and Sex, 2005
Millions

Less Developed Regions

Age
80+ 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4

More Developed Regions

Male

Female

Male

Female

300 200 100

0

100 200 300

300

100

100

300

Source: United Nations, World Population Prospects: The 2004 Revision, 2005. 19

Trends in Aging, by World Region
Population Ages 65 and Older
Percent

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14 11 7 3 4 6 10 6 10

World

Africa

Asia

Latin America and the Caribbean

More Developed Regions

2000

2025

Source: United Nations, World Population Prospects: The 2004 Revision (medium scenario), 2005. 20

The World’s 15 ‘Oldest’ Countries and the U.S.
Percent Age 65 or Older
Japan Italy Germany Greece Sweden Bulgaria Belgium Portugal Spain Estonia Latvia Croatia France United Kingdom Finland United States
Sources: Carl Haub, 2006 World Population Data Sheet. 21

19.5 19.5 18.6 17.8 17.3 17.2 17.1 17.0 16.9 16.7 16.5 16.4 16.4 16.0 16.0 12.4