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PubMed2000

Economic development and traffic accident mortality in the industrialized world, 1962-1990.

BACKGROUND: We examined the association between prosperity and traffic accident mortality in the industrialized world in a long-term perspective. METHODS: We calculated traffic accident mortality, traffic mobility and the fatal injury rate of 21 industrialized countries from 1962 until 1990. We used mortality and population data of the World Health Organization (WHO), and figures on motor vehicle ownership of the International Road Federation (IRF). We examined cross-sectional and longitudinal associations of these traffic-related variables with the prosperity level per country, derived from data of the Organization for Economic Cooperation and Development (OECD). RESULTS: We found a reversal from a positive relation between prosperity and traffic accident mortality in the 1960s to a negative association currently. At a certain level of prosperity, the growth rate of traffic mobility decelerates and the fatal injury rate continues to decline at a similar rate to earlier phases. CONCLUSIONS: In a long-term perspective, the relation between prosperity and traffic accident mortality appears to be non-linear: economic development first leads to a growing number of traffic-related deaths, but later becomes protective. Prosperity growth is not only associated with growing numbers of motor vehicles in the population, but also seems to stimulate adaptation mechanisms, such as improvements in the traffic infrastructure and trauma care.

Accidents, Traffic↗
PubMed1995

Early-age mortality, socio-economic development and the health system in Mongolia.

Since the 1920s Mongolia has developed an extensive and well-staffed health care system that has made modern health technologies accessible to most of its population. In addition, the country experienced rapid economic and social development whose benefits were equitably distributed among the population. In spite of this progress, infant and child mortality levels are high by contemporary standards and during the past 20 years these rates have remained virtually constant. The modern health care delivery system, externally imposed, failed to take into account the specific characteristics of the Mongolian culture; this fact is identified as one of the major determinants of the unexpected levels of early-age mortality. The excessive orientation toward curative medicine, the lack of health prevention and promotion activities and the lack of community participation have resulted in the people continuing to believe in traditional therapeutic patterns and self-care. They perceive the modern system exclusively in curative terms and not with regard to health preservation and disease prevention. Most Mongolians do not fully understand the health care system, and use its services mainly because they have no alternative, or because of coercion rather than conviction based on the learning and internalization of its basic principles. In practices and ideas of child care, preservation of health and disease prevention, people seem to identify more with the traditional health care system. Like other former socialist countries, Mongolia is experiencing deep economic and social transformations, whose implications for the health care system are discussed. An economic crisis whose end is nowhere in sight, emergent social inequalities, a vague health insurance model with unclear financing sources, and lack of concern by most policy-makers in strengthening the preventive component of the health system, are not positive factors for substantial infant and child mortality decline in the near future. A clear advantage is, however, the fact that there is a wide space for major improvements with existing internal and external resources.

Child, Preschool↗
PubMed1992

Nutrition and socio-economic development in Southeast Asia.

While most Third World countries, particularly in Africa and Latin America, have experienced a deterioration in child welfare as a result of the severe economic downturn in the 1980s, Southeast Asia in general managed to sustain improvements in the situation of its children because it has maintained satisfactory rates of economic growth. However, there were exceptions within Southeast Asia. The Philippines, Vietnam, Dem. Kampuchea and Laos had unsatisfactory growth rates and, consequently, unsustained nutritional gains from the 1970s through the 1980s. Economic factors exerted a big impact on the Philippine nutrition situation, particularly on the dietary status of the households and the nutritional status of children. As a result of the economic dislocation occurring in the country, the nutritional gains of 1978-82 were not maintained in succeeding years. Unlike the case of Thailand, it has been estimated that the solution to nutritional problems in the Philippines is far from being achieved in the immediate future (Villavieja et al. 1989). On the other hand, the nutrition improvements in Thailand have been as remarkable as the economic growth over the last decade. Long-term investments in health, nutrition and other social services in Thailand (as well as in Indonesia) have paid off according to the assessment by the United Nations (1990). It appears, therefore, that the nutrition situation in developing countries is highly dependent on the economic situation, globally and nationally (Cornia et al. 1987), as well as on investment in social services. Adjustment policies should, therefore, consider their implications on distribution and poverty in order that they could positively contribute to the improvement of the nutrition of the people.

Asia, Southeastern↗