Population
General Information
- DTM stage 1: Amazon tribes
- DTM stage 2: Uganda
- DTM stage 3: Brazil
- DTM stage 4: United Kingdom
- DTM stage 5: Germany
Uganda’s Youthful Population
Overview
- Fastest growing population in the world
- Rate of 3.2% a year
- Population doubling time of 21 years
- Birth rate 44
- Death rate 11
- Fertility rate 6
- Life expectancy 55
Causes
- Economy based on export of primary products
- Open to fluctuation
- Lack of consistent tax source for government
- Limits spending on education and healthcare
- Over 70%of land is used for agriculture
- Couples have lots of children to help them look after the land
- Only 64% have access to clean water
Social Impacts
- High dependency ratio
- Absence of social security
- Cultural & religious views reduce use on contraception
Economic Impacts
- Secondary education unaffordable
- High government borrowing
- Girls sold as an economic asset
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Political Impacts
- 14% of health budget spent on contraception
- Dependant on donors
Education
- Primary education is free and universal
- Few secondary schools
- Fees to high for many
Debt Cancelling
- Been cancelled by the G8 under certain conditions
- Money must be spent on healthcare, poverty and education
- Healthcare spending has risen by 70%
- Free basic healthcare
- Education spending up 40%
- 2.2 million extra people with clean water
The UK’s Ageing Population
Overview
- Major problem in developed nations
- Big problems with the state pension
- Increased reliance on a smaller working population
Causes
- Emancipation of women (they now have careers)
- Increase in life expectancy
- Baby boom post war now beginning to retire
Social Impacts
- Ageism in employers
- Migration to retirement towns (Bournemouth)
- Facilities need to be adapted for elderly people
Economic Impacts
- Grey pound accounts for £230 million each year
- Over 50s represent 76% of the nation’s wealth
- Provide business in leisure during the week
- Contributed £37bn last year through holidays
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Political Impacts
- Government focusses on policies for older people, they make up the majority
- Funding diverted from elsewhere
- State pension currently costs £95bn
- Government raises retirement age
- Met with strong opposition of those who always planned to retire at a set age
Japans Lost Generation
Details
- A generation who tend to have never held down full-time jobs
- Completed education in 1990s
- Real estate bubble burst at this time
- Companies cost cut rapidly
- 20% still live with parents
- 60% suffer a mental health issue
Australia’s Migration
Overview
- Encourage migration
- Fertility rate below replacement of 1.77
- Entry on a points based system
- Allows revenues to be generated
Economic Impacts
- Contributes to economic development
- Fill skills shortages
- Knowledge of overseas trade markets
- Have lower unemployment than natives (4.2% compared to 6.0%)
- Increase gov costs on health and education
- Processing requests cost $1.5bn a year
- Concentrate in specific areas where demand for resources is already strained
Social Impacts
- 74% take up citizenship showing commitment to the nation
- Ethnic enclaves are rare, this maximises social mixing which is rare in HIC’s
- Tension did result in 2005 Cornulla riots
- 104 arrests made
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Political Impacts
- Increase tax revenue
- Each migrant benefits the government $14,000 a year
- Counter ageing population
- Location makes it a target for boat people
- 17,800 arrived like this in 2013
China’s Population Problem
Overview
- Rapid population growth
- Population of 1.35bn
- Chairman Mao encouraged growth
- To create a larger military
- Contraception was banned
- Population became out of control
1970s Control
- Introduced “wan, xi, shao” meaning “later, fewer, longer”
- Weak deterrents & poor enforcement meant it was woefully ineffective
One Child Policy
- Couples could have one child only
- Strictly imposed
- Incentives included:
- Cash
- Better housing
- Free education
- Free contraception
- Severe fines ($750) if broken
- Officials known as “Granny police” enforced the law
- Forced sterilisation
Impacts
- Lowered fertility rate from 6.s to 2.1
- This has dropped further to 1.6
- Too far
- Males preferred to continue family name
- 90% of abortion were female
- Little emperor syndrome
- Difficult to enforce in rural areas
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France’s Pro Natalist Policy
Overview
- Trying to encourage births
- Use of incentives
- Fertility rate currently 2.0 (has been lower recently)
- Large dependency ratio
The Policy
- “Code de la famille”
- Into force in 1939
- Incentives included:
- Contraception ban (removed in 1967)
- Generous maternity pay
- 30% reduction in travel costs
- Less income tax
- Free entry to public facilities
- Childcare subsidies – care will cost no more than 500 euros a month
Effectiveness
- Increased fertility from:
- 1.73 in 1993 to 2.08 in 2015
- The policy worked but not as well as hoped
- The UN predicts growth up to 70 million not the 75 million target
- Costs a lot of money to implement
- This combined with a significant national debt questions its sustainability
- However, the problem is nowhere near as bad as in German [1.4] and Russia [1.6]
Social Welfare in Shear Brow
Migration can have many impacts on the character of both rural and urban areas. Two
contrasting areas include Shear Brow and Whalley.
Shear Brow
This is an inner city area in Blackburn, close to the old cotton industry.
- Housing – predominantly Victorian, high population density
- Ethnicity – 76% Indian/Pakistani because of low cost housing for migrants
- Mean age – 32, greater tendency for a bigger fertility rate
- Wealth & unemployment – 6.1% are unemployed and only 11% have managerial jobs
- Services – halal butchers & Tauhedal Girl’s school
- Average house price – £101,000
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Whalley
This is a village on the rural-urban fringe of Blackburn. This area had good transport links
through the A59 and to Manchester by train.
- Housing – tends to be larger and detached as at Calderstones
- Ethnicity – 96% are white British as services do not reflect migrants needs
- Mean age – 42 as house prices are expensive and there is a lack of social prospect
- Wealth & unemployment – 2.5% are unemployed with 19.2% managers or directors
- Services – upmarket shops such as Checkmate and Amico Mio
- Average house price – £207,000
Social Welfare
This is how well a certain area provides facilities and services for its residents. The level of
social welfare influences the quality of people’s lives. Migration has many implications on
social welfare.
Impact on Shear Brow
As housing has become cheaper, more migrants move in and the white British population
move out in a process known as the “white flight”. Migrants initially move for cheap
housing but as more suitable services become available, more migrants move to exploit
these services.
Impact on Whalley
The availability of space has led to the development of estates such as Calderstones.
More affluent families move in and services begin to better reflect their need. However,
as traditional services for the elderly close, they become isolated and services no longer
reflect their needs.
Population Change in Cornwall
Overview
- Growing at 0.8%, despite natural decrease (lots of retirees)
- There is high inward migration, especially at the weekend from Londoners
Economic Issues
Cornwall has no major city so has little inward investment, it is geographically isolated.
- No motorways
- Slow rail services
- One airport at Newquay
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Employment Issues
There has been a major decline in jobs because of the loss of industries such as mining
and fishing.
- Tourism is the biggest industry
- Employs 25%
- Jobs are seasonal
- Weather dependent
- Money leaks through national chains
Housing
- Unaffordable for younger people
- These people therefore migrate out of the county
Services and Welfare Provision
- Lack of post-16 education
- Resulting in a “brain drain”
- 29% have no bus services
- 78% don’t have a village shop
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Health
General Information
- Healthhhh
- Healthhhh
United Kingdom Health Overview
- Stage 4
- Leading cause of death is corony heart disease [60]
- 61.7% of adults are overweight
- Diseases of affluence
South Africa Health Overview
- Stage 3
- Leading cause of death is HIV [412]
- HIV is a major problem
- Expensive to treat
- Lack of education
Sierra Leone Health Overview
- Stage 2
- Leading causes of death are pneumonia and tuberculosis
- Easily treatable in HIC’s with antibiotics or vaccinations
HIV in the United Kingdom
Overview
- Small epidemic
- Good education
- 100,000 people have HIV
- 17% of cases are undiagnosed
- Spending at £1.2 million
Health Impacts
- Stage Large proportion on NHS budget
- Become susceptible to additional infections
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Economic Impacts
- Costs £18,000 a year to treat
- Highly active retroviral therapy
- Sufferers cannot work
- Large economic burden
Lifestyle Impacts
- Big stigma
- Good education means people know how to avoid
- Quality of life is reduced
HIV in South Africa
Overview
- Most high profile case
- Government investing heavily
- 6.3 million people affected
- 340,00 new infection in 2013
- Biggest treatment plan in the world ($1bn)
Health Impacts
- Reduced life expectancy
- Unable to work
- Spiral of decline
- Treatment is not free
Economic Impacts
- Development is stalled
- People cannot work
- Have to fund $1bn treatment programme
Lifestyle Impacts
- Low self-esteem
- Strong stigma
- Orphaned 2.3 million children
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Type 2 Diabetes in the UK
Overview
- 3.1 million sufferers
- 1 in 16 have it
- Grow to 4.6 million in 2030
Health Impacts
- Increases risk of CHD and heart disease
- Complications place additional burden on the NHS
- Spend 3 days longer in hospital
Economic Impacts
- Costs the NHS £10bn a year
- Additional expense of complications
- 19% of hospital admissions
Lifestyle Impacts
- Most effective method is self help
- Take responsibility
- Better diet, more exercise and less alcohol
- Take flu jabs
Malnutrition
Overview
- Lack of nutrition common in LIC’s
- Results in a “spiral of decline” with many complications
Impacts
Spiral of Decline
- Has many complications:
- Poor nutrition
- Weight loss
- Muscle wasting
- Impaired immune system
- Susceptible to illness
- Nutritional needs increased further
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Vitamin A Deficiency
- Is a complication of malnutrition
- Effects 250 million children
- 1.15 million deaths a year
- Results in blindness
Treatment
- Food fortification (costs $0.5bn and saves $35bn)
- Biofortification
- Exclusive breast feeding
Periodic Famine
Overview
- This is an extreme scarcity of food
- Niger is particular vulnerable
- Close to Sahara
- Is a land locked country
- It suffered from a serious famine in 2005
Causes
- August 2004 is exceptionally dry killing most crops
- October 2004 a plague of locusts destroys any remaining crops
- Results in the worst harvest on record
- Journalist attempt to report he problem but are suppressed
- Told that they are being “unpatriotic”
- UN pledges money which the government withholds
- Over farming (a lack of knowledge)
Effects
- 3 million without food
- 300,000 ton food deficit
- Half of children malnourished
Management
- UN provide $16 million investment
- “Communes de convergence” initiative coordinates responses
- This has included digging wells, irrigation and land reclamation
- 3N initiative (Nigerians feeding Nigerians)
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Obesity
Overview
- 64% of UK adults are overweight
- Too many calories in and not enough out
- BMI measures obesity
Causes
- Excessive food consumption
- Ready meals with high sugar content
- Lack of exercise
Effects
- Wider costs of £27bn
- Costs the NHS £5.1bn
- Stigmatisation
- Low self-esteem
- Increased sick absences
- Reduces life expectancy by 3 years
Health Implications
- Heart disease
- Stroke
- Cancer
- Depression & anxiety
- Type 2 diabetes
Management
- Sugar tax
- Change 4 life campaign
- Sugar smart app
- Couch to 5k programme
- Nutritional labels
- Gastric bands (£2600)
- Gastric bypass (£6000)
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Tanzania’s Healthcare System
Overview
- Small and basic
- Severe shortage of workers
- Particularly limited outside of the capital Dar es Salaam
- Major problem since 80% live in rural areas
- Employment of community health workers (CHW’s)
- This costs £350
Funding
- Taxation
- National insurance fund (employers pay 3% of their salary in)
- The WHO and AMREF also provide donations
Management
- Village health service (basic healthcare)
- District hospitals (more advanced but routine treatment)
- Consultant hospitals (best facilities available)
Effectiveness
- Lacks basic equipment and doctors
- Tanzania has 1 doctor to 20,000
- The UK has 1 doctor to 440
- Despite these shortcoming the system has improved key indicators
- Infant mortality has more than halved
- Death rate and maternal mortality have also seen significant reductions
Conclusion
- System is improving
- Allowing Tanzania to progress through stage 2 of the DTM
- Reducing the spread of some diseases
China’s Healthcare System
Overview
- Experiencing rapid population growth
- Struggling to support and meet demand
- Spending is being increased by $25bn
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Problems
- System was privatised
- Profit seeking firms have driven up prices
- Over prescribing drugs
- 75% are prescribed antibiotics for the common cold
Solution
- To provide affordable care a number of reforms have been introduced
- Ne cooperative medical scheme covering basic healthcare
- Workers pay a small contribution
- Regulation introduced to ensure companies offer fair deals
Management
- Scheme is only voluntary
- Not everyone is covered
- Physicians are also being retrained to meet a skills shortage
Effectiveness
- Reduced medical bankruptcy
- 95% of the population is covered by some sort of care
- Not yet universal
- Rural areas have much poorer facilities
Britain’s Healthcare System
Overview
- Purely socialised system
- All treatment free on the NHS
- Funded through taxation
- Budget of £115bn
- Employs 1.7 million people
- Free at the point of use
Management
- People first see a GP
- Then referred to a specialist if required
- Any UK citizen has free and equal use of the service
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Effectiveness
- Most effective system in the world
- For both care and research
- Medical bankruptcy is unheard of
America’s Healthcare System
Overview
- Pluralistic approach
- Funded through insurance funds
- Spend the most as GDP on medical care
- Biggest cause of bankruptcy
- Rank consistently last amongst comparable nations
- Operations cost 8x more than in the UK
Solutions
- Affordable care act
- Setting up an online insurance market place
- Reduce the number of people without cover
- 13% of Americans remain uninsured
Management
- Those who can pay have access to pioneering healthcare
- Short waiting lists
Effectiveness
- Very poor
- Spend 17.1% of GDP on it
- Still ranks last
- Bankruptcy is exceptionally high
- Biggest problem facing the country
Pharmaceutical TNC’s (GSK)
Overview
- Companies that research, produce and distribute drugs
- GlaxoSmithKline (GSK) is one such example
- 96,500 employees
- Invested £3.1bn in 2015
- Distributed 690 million vaccines last year
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Research
- Average spend of £500,000 on each drug
- Time consuming clinical trials
- Can go wrong (France example)
- Once completed they hold exclusive rights for 20 years
- Currently producing a “not for profit” malaria vaccination
Production
- Sell drugs as banded products
- Up 30x more than non-branded versions
- Examples include Zantac & Aquafresh
- Usually made in LIC’s (cheaper production costs)
- Essential drugs list has been drawn up
- These are drugs which should be available in large amounts readily…
- At an affordable price
Distribution
- The way drugs are delivered
- Prescription or over the counter
- GSK has provided incentives for GP’s to sell their drugs
- Even if they aren’t necessary
- Making these “false and misleading” claims cost them $3bn in America
- Do make charitable donations to LIC’s (1bn tablets this year)
- These are usually older dugs
- Which are no longer profitable in HIC’s
Tobacco TNC’s (BAT)
Overview
- Major role in economic development
- Many countries rely on the trade
- Big public health issue
- Kills 6 million a year
- 80% of smokers ae in MIC’s or LIC’s
- 350 harmful chemicals
British American Tobacco
- Employ 55,000 people
- Sold 667bn cigarettes in 2014
- Accused of selling stick cigarettes to hook them at a younger age
- Contributed £9.5bn in taxation
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Malawi Case Study
- 75% of the country employed in tobacco
- 66% of yearly income
- Has received charitable donations from BAT
- Children are employed
- Can result in tobacco poisoning
Health Implications
- Results in 6 million deaths
- Increased risk of cancer, stroke and lung damage
Responses
- Adverts
- No sale to under 18s
- Behind counter
- Sponsorship s banned
- No smoking in public places
- NHS drop in clinics
Indonesia Case Study
- No legislation against smoking
- 6 fold increase in child smoking
- 200,000 deaths a year
- 66% of men smoke
- Led BART to concentrate more on developing markets
Regional Variations in Health
Overview
- NHS responsible for national care
- Clinical commissioning groups (CCG’s) monitor local healthcare
- Blackburn & Darwen is covered by one CCG
- Allows local health issues to be addressed
Problems
- High unemployment [5.3%]
- Lack of education [22%]
- This problems are mainly caused by a lack of wealth
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Low Skilled Jobs
- Many people are unemployed or in low skilled jobs with low incomes
- There are proven links between lower income and poorer healthcare outcomes
- CCG has implemented a “Beez card” scheme
- Provides discounts on public facilities
- Gets more people involved
- Only 8.1% of people currently do enough
Teenage Pregnancies
- Above the national average (49 in 1000)
- CCG have set up a virtual baby project to educate girls
- Rolled out across secondary schools
Lack of Exercise in Older Age Groups
- The elderly tend to take part in less physical activity
- The CCG has introduced a “Local strategic partnership”
- A group where people can meet and take part in activities together
- Also, centres have opened women’s only sessions
- Overcoming cultural and religious barriers
Conclusions
- Because of this, I feel wealth plays the biggest part of the problem
- All issues are related to this in some way
- Major problems do however persist
- Low life expectancy [76.4]
- 25,000 harmful drinkers
- Rank at the bottom
- Half do no exercise at all
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