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This lesson examines the global geography of health, exploring spatial patterns in life expectancy, mortality, disease burden and nutrition. It addresses the Edexcel Enquiry Question: "What is human development and how does it vary globally?" by focusing on the health dimension of development. Health is not merely the absence of disease — the World Health Organization (WHO) defines it as "a state of complete physical, mental and social well-being."
Understanding health geographies requires examining both the biomedical factors (disease, nutrition, genetics) and the social, economic and political determinants that shape health outcomes. This lesson provides the data, patterns and theoretical frameworks you need to analyse health at a global scale.
Life expectancy at birth is the average number of years a newborn would live if current mortality rates continued throughout their lifetime. It is the most widely used summary measure of population health and is one of the three components of the HDI.
| Region / Country | Life Expectancy (2023 est.) | Key Factors |
|---|---|---|
| Japan | 84.6 years | Excellent healthcare, diet rich in fish and vegetables, culture of physical activity, strong social cohesion |
| Hong Kong | 85.3 years | High-quality healthcare system, dense urban living with good access to services |
| Western Europe (avg.) | 81.2 years | Universal healthcare systems, high living standards, clean water and sanitation |
| Latin America (avg.) | 75.3 years | Improving but uneven healthcare access; growing NCD burden |
| South Asia (avg.) | 70.5 years | Improving rapidly but high maternal/child mortality; air pollution |
| Sub-Saharan Africa (avg.) | 61.5 years | HIV/AIDS legacy, malaria, limited healthcare, conflict, undernutrition |
| Central African Republic | 53.1 years | Ongoing civil conflict, extreme poverty, minimal healthcare infrastructure |
| Chad | 52.5 years | One of the lowest globally; high infant and maternal mortality |
Key spatial pattern: Life expectancy follows a strong north–south divide, though this is an oversimplification. The highest life expectancies are found in Western Europe, East Asia (Japan, South Korea, Hong Kong), Australasia and North America. The lowest are concentrated in sub-Saharan Africa, particularly the Sahel region, the Horn of Africa and conflict-affected states such as the Central African Republic, South Sudan and Somalia.
Temporal trends: Global life expectancy has increased from approximately 46.5 years in 1950 to 73.4 years in 2023 — a remarkable gain of nearly 27 years in seven decades. This is one of the greatest achievements in human history, driven by improved nutrition, sanitation, vaccination, antibiotics and public health infrastructure. However, progress has been uneven:
Exam Tip: When discussing life expectancy patterns, always provide specific data and explain the underlying causes of the patterns, not just the patterns themselves. Examiners reward analytical depth — not just stating that sub-Saharan Africa has low life expectancy, but explaining why (HIV/AIDS, malaria, poverty, conflict, limited healthcare).
The infant mortality rate measures the number of deaths of infants under one year of age per 1,000 live births. It is one of the most sensitive indicators of a country's overall development because infant survival depends on maternal nutrition, access to clean water, sanitation, vaccination and healthcare.
| Country | IMR (per 1,000 live births, 2023 est.) | Context |
|---|---|---|
| Finland | 1.8 | Universal healthcare, excellent maternal support, comprehensive social welfare |
| Japan | 1.7 | Advanced neonatal care, universal access to prenatal services |
| UK | 3.5 | NHS provides universal access; slight rise in deprived areas |
| USA | 5.4 | High for a HIC — reflects inequality in healthcare access, particularly for Black and Hispanic populations |
| India | 25.5 | Improving rapidly but persistent rural-urban gap; 1 million infant deaths per year |
| Nigeria | 53.7 | Limited healthcare infrastructure in northern regions; high poverty |
| Sierra Leone | 78.5 | One of the world's highest; limited skilled birth attendants |
| Chad | 67.8 | Minimal healthcare infrastructure; fewer than 1 doctor per 20,000 population |
Global trend: The global IMR has fallen from 65 per 1,000 in 1990 to approximately 27 per 1,000 in 2023 — a decline of over 58%. This is one of the great achievements of modern public health, driven by:
The maternal mortality ratio measures the number of women who die from pregnancy-related causes per 100,000 live births. It is one of the starkest indicators of global health inequality.
The causes of maternal mortality are well understood — haemorrhage (27% of deaths), eclampsia/hypertensive disorders (14%), sepsis (11%), unsafe abortion (8%) and obstructed labour (9%) — and almost all maternal deaths are preventable with access to skilled birth attendants, emergency obstetric care and family planning services. The persistence of high maternal mortality in LICs reflects systemic failures in healthcare provision, not medical mysteries.
Exam Tip: Maternal mortality is an especially powerful indicator because it directly reflects multiple aspects of development: healthcare access, gender equality, education, income and governance. Use it to demonstrate synoptic understanding.
The epidemiological transition model, proposed by Abdel Omran in 1971, describes how the pattern of disease changes as countries develop. It identifies three (later expanded to four or five) stages:
graph LR
A["Stage 1:<br/>PESTILENCE<br/>AND FAMINE<br/>Infectious diseases,<br/>high mortality,<br/>LE < 30 years"] --> B["Stage 2:<br/>RECEDING<br/>PANDEMICS<br/>Declining infectious<br/>disease, improving<br/>sanitation, LE 30–50"]
B --> C["Stage 3:<br/>DEGENERATIVE<br/>DISEASES<br/>NCDs dominate,<br/>LE 50–75+"]
C --> D["Stage 4:<br/>DELAYED<br/>DEGENERATIVE<br/>Medical advances<br/>extend life,<br/>LE 75+"]
style A fill:#b71c1c,color:#fff
style B fill:#e65100,color:#fff
style C fill:#1565c0,color:#fff
style D fill:#2e7d32,color:#fff
Some scholars have proposed a Stage 5: the emergence of new and re-emerging infectious diseases (HIV/AIDS, Ebola, COVID-19, antibiotic-resistant bacteria), suggesting that the transition is not a simple linear progression from infectious to non-communicable diseases. The COVID-19 pandemic dramatically illustrated this — even the most advanced healthcare systems were overwhelmed by a novel infectious disease.
Communicable (infectious) diseases are spread between people through pathogens (bacteria, viruses, parasites). They include malaria, tuberculosis, HIV/AIDS, cholera, respiratory infections and neglected tropical diseases. They dominate the disease burden in LICs and LMICs, particularly in sub-Saharan Africa and South Asia.
Non-communicable diseases (NCDs) are not spread between people and are typically chronic. They include cardiovascular disease, cancer, diabetes, chronic respiratory disease and mental health conditions. NCDs are responsible for approximately 74% of all deaths globally (2023) and are the leading cause of death in every region including Africa.
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