The geography of food and health

➔ Assessing the health of a country or population through indicators:

◆ Infant/child mortality rate​:
● IMR= Under five years old.
● Reflects social (especially health), economic, and environmental
conditions.
● MDG.
● Measured in "per thousand".
● World average: 44.
○ Pros:
◆ Reflects household income, nutrition, maternal age and
education, housing condition and sanitation.
○ Cons:
◆ Data may be unreliable if collected by household
surveys, or national birth/death registrations.
◆ Calculations have to account for death in epidemics,
civil wars and migrations.
◆ Life expectancy​:
● Spatial variation within countries (urban X rural), between them
(sub-Saharan Africa X Canada/Japan), and between social and ethnic
groups (in the US black minority groups live 5 years fewer than white
people).
● Male life expectancy is shorter.
○ Higher incidence of degenerative illness.
◆ Smoking, alcohol, more exposure to pollutants.
○ Violence, road accidents and suicide, especially between
19-24 years of age.
● Increased significantly since 1950.
○ Greater food production.
○ Cleaner water.
○ Better living conditions and health care.
● AIDS in Africa made it fall.
○ Pros:
◆ Social, economic, medical advancements and living
conditions.
○ Cons:
◆ Only length of life, and disconsiders the years which
are spent in ill state.
◆ Disconsiders age-specific mortality rates.
◆ Data may be unreliable. Since some countries may not
measure from birth.
◆ Calorie intake​:
● Newly industrialized countries-- rising calorie intake.
● Shows access to food.
○ Cons:
 ◆ Doesn't take nutrient consumption into account.
◆ Not everyone needs the same calorie intake (cold X
warm), so you can't compare countries.
◆ Access to safe water:
● Directly related to poverty and sanitation.
● Lack of water leads to:
○ Health problems.
○ Excessive use of labor to obtain water.
○ Limitations for economic development.
● Has been increasing, will reach MDG if trend continues.
○ Low income countries need to double their increase to reach
the target.
● Gap between rural and urban in some countries.
● Slowest improvement in Africa.
● Inadequate sewage, which is a consequence of lack of water, leads to
infections (cholera, hepatitis).
● To improve:
○ Provision of water.
○ Education on hygiene and non-wastefulness.
● Affects child mortality a lot.
◆ Access to health services​:
● Measured as number of doctors etc... per 10000 people.
● Less than 23 physicians, nurses... per 10000= failure to achieve
coverage rates prioritized by MDG.
◆ Health-adjusted life expectancy (HALE)​:
● Overall health of a population.
● Shows the life expectancy spent in full health.
● Provides a deeper insight into health than life expectancy, as it asses
not only quantity, but quality of life.
● Calculated using official mortality and disability data, adjusting the
severity of disabilities.
○ Cons:
◆ Lack of reliable data (especially from low-income
countries) on mortality and morbidity.
◆ Prevention relative to treatment:
● Reflection of public funds and priorities.
● Three key aspects, to which patients may vary in access.
○ Health professionals.
○ Medication.
○ Therapies.
● Access may depend on ability to pay and accessibility.
○ Developing countries:
◆ Tend to exclude poorer sectors of population, which
makes them more susceptible to disease etc.
◆ Hence, much more difficult to cure once illness is
established.
 ● Therefore, prevention:
○ Minimize spread of infection.
◆ Hygiene.
● Needs water supply and sanitation...
◆ Health education.
◆ Contraception to avoid HIV.
◆ Education and public awareness of diseases.
◆ Better access to food, will increase resistance and limit
transmission.

➔ Global availability of food:

◆ Food security​= All people, at all times, have access to sufficient, safe and
nutritious food to meet their dietary needs and food preferences for an active
and healthy life.
◆ Food availability deficit​-- food deficiencies are caused by local shortages
due to physical factors.
◆ However, hunger was seen in areas with food and production.
◆ Hence, ​food entitlement deficit​-- food deficiency due to lack of access, due
to rising cost for example.

➔ Areas of food sufficiency:

◆ World food has managed to keep pace with population growth-- due to
technology. (Green revolution).
◆ Green revolution:
● Science and technology to increase food production.
○ Pros:
◆ Yields are better and higher.
◆ Less hunger.
○ Cons:
◆ Rural unemployment.
◆ Decrease in soil fertility (unsustainable).
◆ Dependence of developing countries.
◆ Increasing food output:
● Genetically engineered, ​high-yielding varieties​ (HYVs).
● Artificial ​fertilizers​ and pesticides.
● Irrigation​ maximizes yields, and allows for agriculture in arid
locations.
● Increasing ​scale of operations​.
● Biotechnology​:
○ Carried out mostly in developed countries.
● Markets/human productivity​:
○ Guaranteed prices and markets lead to bigger production from
farmers.
○ Pay farmers properly, to keep more educated, hard-working
and skilled workforce.
➔ Areas of food deficiency:
◆ Food shortages are caused by: remember to consider long, short, medium
terms.
● Soaring oil and energy prices​, which increase cost of food
production.
● Rising demand​ from global population growth or emerging
economies.
● Farming may be inefficient.
● Natural hazards​ may disrupt production.
○ In the 2010 decade, South Sudan, Somallia, and eastern Africa
suffered droughts which caused crop failure and led to hunger.
● Biofuels​ competing for arable land.
● Underinvestment in agriculture.
● Speculative trading in agricultural commodities:
○ Fluctuations in market prices which do not follow demand and
supply. May lead to increased cost.
● Climate change​:
○ Changing rain patterns.
○ Water shortages.

➔ Food production and markets:

◆ Political/economical factors which affect the production and availability of
food.
● Trading blocs and farm subsidies:
○ Trading bloc= arrangement between countries to allow free
trade amongst themselves.
○ To stimulate production= farm subsidies (guaranteed prices
and markets).
◆ Led to overproduction.
● Free trade​:
○ Countries trade competitively and fairly amongst themselves.
◆ Leads to imports and exports, which is usually good for
commerce.
◆ May not be beneficial for some farmers.
◆ May increase price in short term, due to the end of
subsidizes.
◆ May decrease price in long term, due to competition.
○ Protectionism is the contrary, restrictions to trade.
● Multilateral arrangements:
○ Arrangements between countries to imports goods from other
countries.
◆ Bad for local farmers.
● Bilateral arrangements:
○ Arrangements between two countries to import goods.
◆ Bad for local farmers.
➔ Alleviating food shortages:
◆ Solutions to food insecurity:
● Technical solutions:
○ GM crops.
◆ More present in MEDCs.
○ Expanding irrigation.
◆ Needs a lot of water.
○ Appropriate technology.
○ Seeds and fertilizers.
○ Sustainable practices:
◆ Using technology and avoiding pollution to conserve
resources.
● Socio-economic solutions:
○ Agricultural investment:
◆ Increased yields given more investment.
○ Better credit​:
◆ More money for equipment.
○ Food aid.
◆ Good in short term, bad in long. "Give a man a fish...".
○ Land reform:
◆ Spread land amongst farmers to increase productivity.
○ Improved infrastructure.
○ Trade reform:
◆ Free trade, which'll likely lower prices.
○ Fair trade:
◆ Socially, economically and environmentally responsible
trade.
◆ Fairer prices for products.

➔ Sustainable agriculture:
◆ Ability to produce food without causing irreversible damage to ecosystems.
◆ Prevents degradation.
◆ Ensures profitability.
◆ The environmental costs of increasing food production (unsustainable):
● Dependence on​ fertilizers and pesticides, as well as energy
subsidies​ (those not obtained by the sun).
● See dependence on energy subsidies via ​energy efficiency ratio.
○ Shows sustainability.
● Production through ​profit maximization​ has often put profit before
environmental issues, due to economies of scale.
○ Produce more with less, so no one cares about the
environment.
● Increasing crop yield​.
○ Genetically modified​ seeds and fertilizers.
○ Modifying micro-climate.
● Increasing livestock yield​:
 ○ Selective breeding​ to "create" the best animals. (factory
farming).
◆ Low priority to animal welfare.
● Eliminating competitors (pests).
○ Harmful ​insecticides​.
◆ Damage environment and ecosystem.
◆ May affect humans.
● Modifying landscape and reducing biodiversity:
○ Intensive commercial farming:
◆ Leads to ​microclimatic modifications.
● Deforestation...
● Food miles:
○ Distance food travels from producer to consumer​.
○ Lesser, better, cheaper.
○ Food industry dependant on crude oil due to transportation.
◆ Unreliable, inefficient, vulnerable.
◆ Energy efficiency ratios:
● Energy input/energy output.
● Related to use of energy subsidies.
◆ Sustainable yield:
● Amount of food which can be taken from land, without reducing its
productive abilities.
○ If all fish are removed, next year there will be no fish, since
none reproduced.
◆ Organic farming:
● Manure ​rather than inorganic fertilizers.
● Crop rotation ​to maintain soil fertility.
● Reducing energy subsidies.
● Free roam of livestock.

➔ Global patterns of disease:

◆ Infectious diseases prevail in LEDCs.
◆ Degenerative diseases prevail in MEDCs.
◆ Infectious or communicable diseases:
● Diseases of poverty.
● Close human contact or vectors.
● Spread rapidly in overcrowded and unsanitary locations.
● Malaria, schistosomiasis, HIV-AIDS.
◆ Non-communicable, chronic or degenerative diseases:
● Diseases of affluence.
● Associated with old age, but now impact young people too.
○ Smoking, high-energy diet, low levels of physical activity,
and high alcohol consumption.
● Exposure to pollution in cities.
● Radiation leads to cancer.
● Heart disease, stroke, chronic respiratory failure and cancer.
 ◆ Epidemiological transition:
● When countries become more urbanized, their population suffers from
lifestyle changes which generate chronic disease.
● Life expectancy may be rising, but HALE may not be.
● Can push families into poverty due to high treatment costs.
● Healthcare costs to the state as well.
○ China loses a lot of money due to this.
➔ The spread of disease.
◆ Disease diffusion= spread of disease into new locations.
● Areas closer to the initial source as more impacted.
● Types of diffusion:
○ Expansion​ diffusion:
◆ Diffuses from initial source into new areas.
○ Relocation​ diffusion:
◆ Diffusion into new areas, leaving old one behind.
◆ Person with HIV migrates elsewhere, for example.
○ Contagious​ diffusion:
◆ Spread through direct contact with infected people.
○ Hierarchical​ diffusion:
◆ Diffusion through ordered sequence of classes or
places.
◆ From urban to rural areas.
◆ From poorer classes to more affluent ones.
○ Network diffusion​:
◆ Diffusion through transportation and social networks.
◆ HIV in southern Africa amongst transfer routes.
○ Mixed diffusion​:
◆ Both contagious and hierarchical diffusion.
◆ Pandemic risk index:
● Measured by:
○ Risk of a disease emerging in a country.
○ Risk of disease spreading to and within a country.
○ Capacity of a country to contain a disease.
● High indexes may be both in low and high income countries.
○ International travel in MEDCs, poor medical infrastructure in
LEDCs.
● Mexico:
○ Swine flu originated from Mexico, and spread out of it due to
international travel.
● Extreme risk in China.

➔ Geographic factors and impacts: malaria: (infectious disease of poverty).

◆ 40% of the world's population is at risk of catching.
◆ Kills up to 3 million people annually.
◆ 80% in sub saharan africa.
◆ Infected mosquitoes.
 ◆ Symptoms:
● Fever.
● Headache.
● Vomit.
● Appear after 10-15 days.
● Disrupts blood supply to vital organs.
◆ Humid locations.
◆ Stagnant water.
◆ Human enhancements to Malaria:
● Conflicts and war.
● Agricultural projects.
● Dams.
● Mining.
◆ 80% of children in southern Tanzania are infected before six months.
◆ Costs:
● Medication.
● Doctors.
● Unable to work.
● Preventive measures.
● Public health costs.
● Loss of productivity for employers.
◆ Control:
● Protect humans from mosquito bites.
○ Drug treatment.
◆ Must beat resistance of mosquitoes.
○ Bed nets.
● Reduce population of mosquitoes.
○ Killing mosquito larvae.

➔ Geographic factors and impacts: HIV and AIDS: (infectious disease of poverty,
mostly in subsaharian Africa).

➔ Geographic factors and impacts: measles: (infectious disease of poverty).

◆ Leading causes of death among young children.
◆ Low-income countries​ with underdeveloped health services (Some parts of
Asia and Africa).
◆ 20 million people infected per year.
◆ Low immune system and children are the biggest victims.
◆ Spread by coughing and sneezing. ​Personal contact.
◆ Flu-like symptoms and a rash.
◆ Blindness, brain swelling, dehydration...
◆ 10% end in death among populations with malnutrition.
◆ Prevention:
● Good nutrition and adequate fluid oral rehydration.
● Vaccination.
○ Safe, cost-effective and inexpensive.
 ○ Some don't develop immunity, therefore 2 shots.
○ Globally recognized as extremely important.

➔ Geographic factors and impacts: diseases of affluence: consequences of smoking,

obesity, diabetes.
◆ Risk factors for degenerative diseases:
● Age:
○ More prevalent among the ​elderly​.
● Wealth:
○ Changes in lifestyles which leads to less activity and health
(​the epidemiological transition​).
● Urban residence.
○ Easy access to transport and services.
○ Worstened diet with more fat.
◆ Smoking:
● Main causes of death in the 20th century, in rich countries.
○ By 2010, most of the deaths were in low-middle income
countries.
○ Anti-smoking campaigns.
◆ More successful in MEDCs than LEDCs.
○ Income on tobacco instead of food etc..
○ Cancer and malnutrition.
○ Bangladesh.
○ A quarter of smokers die, and many become ill.
◆ Loss of productivity.
◆ Global obesity:
● 65% of countries have more overweight and obesity deaths kill more
people than underweight.
○ Bothin middle and high income countries.
● Generates diabetes, heart disease and cancer.
● Low activity patterns lead to obesity.
● More common in MEDCs.
○ Need to have food to have obese people.
● Childhood obesity.
● USA.
◆ Diabetes:
● Incurable.
● Increasing numbers of people.
● Most deaths in low and middle income countries.
● Deaths are likely to double.
● Cardiovascular disease and blindness are examples of consequences.
● Economic impact on families and the government.
● India​,​ Mexico.
● Prevention:
○ Monitoring of blood sugar levels.
○ Insulin shots. (type 1)
○ Medication.
○ Healthy body weight.
○ Physical activity.
○ Healthy diet.
○ Avoid tobacco.