3. Leading Causes of Death According to WHO 2004 By broad income group A) Low Income Countries Is this expected? Why might it be so high? Traditional health risks associated with lower income countries.

4. Leading Causes of Death According to WHO 2004 By broad income group B) High Income Countries A lower number of deaths than in Low Income Countries Why? What are the %age differences? Which of these diseases are directly linked to income / lifestyle choices?

5. Adult mortality rates by major cause group and region, 2004

6. Age distribution of burden of disease by income group, 2004

8. The Complex Causes of Human Health Risk The main environmental factors. Factor Comment WATER Dirty Water = main causes of disease in developing world. Improving sanitation and water supply shown to cut infant mortality rate by average of 55%. Standing pools of water are esp. significant in disease transmission as they harbour vectors and parasites. GEOLOGY UK has approx 2 000 deaths each year attributed to lung cancer caused by radon gas produced from the decay of uranium. It is naturally present in many rocks. ECOLOGY If an ecosystem is placed under stress their ability to support a healthy population can be compromised INSECT AND ANIMAL VECTORS Both natural and human-induced changes in the habitats of disease carrying insects will alter the disease incidence pattern.

14. Circular graph showing main determinants of health (health map)

15. Health Risks and Pollution. Sources of Pollution linked to Health Risks 1. Air pollution kills an estimated 2.7 million to 3.0 million people every year. Air Pollution hanging over the city of Bogota Colombia 2. Water pollution: globally 2.3 billion people suffer from diseases linked to water. 3. Pollution from Heavy Metals Metals most dangerous to health include lead, mercury, cadmium, arsenic, copper, zinc, and chromium. Mercury can cause mutations and genetic damage, while copper, lead, and mercury can cause brain and bone damage 4. Persistent Organic Pollutants (POP’s) Human exposure to persistent organic pollutants (POPs) occurs in several ways—in foods, mostly as pesticide residues; occupationally, among farm workers who spray pesticides on crops; & through accidents, e.g. leaks in indoor storage areas. POPs are organic compounds that have long lives in the environment and undergo physical, chemical, and biological changes over time.

16. Investigating the different causes of health risk: Case Study : John Snow and the Broad Street Pump – The Case of Cholera, London 1800’s. Key Words Epidemiology is the study of the distribution, occurrence and spread of disease. Cholera: A water-borne disease caused by a bacterium which leads to severe and often fatal diarrhoea. Epidemic(s) An infection rate which has reached a certain predetermined level in relation to the total population. miasmas Poisonous gases and vapours thought to infect the air. The first comprehensive epidemiological study was undertaken by Dr John Snow, who analysed fatalities in the London cholera outbreak of 1854.