Health and wellbeing in a global context
What you must be able to define and use
Learn the classifications used to compare countries: high-income, middle-income and low-income countries (World Bank classifications by gross national income per capita), and be careful to describe high-income versus low-income countries rather than using outdated language. Know the range of health status indicators used globally: life expectancy, under-five mortality rate, maternal mortality ratio, infant mortality rate, morbidity, incidence and prevalence, burden of disease, disability-adjusted life years (DALYs), self-assessed health status. Understand burden of disease as measured in DALYs - years of life lost to premature death plus years lived with disability - and know that it captures both fatal and non-fatal impact. Learn risk factors for global burden of disease (e.g. tobacco, high body mass index, alcohol, unsafe water and sanitation, air pollution, dietary risks) and the social, cultural, economic and environmental factors that explain differences between countries: income, education, healthcare access, safe water, sanitation, food security, political stability, geography and climate.
Traps that appear in questions
- Using incidence (new cases) when prevalence (all existing cases) is meant.
- Confusing mortality (deaths) with morbidity (illness).
- Describing DALYs as only years of life lost - it also includes years lived with disability.
- Assuming low-income countries have only communicable diseases; non-communicable diseases are rising everywhere.
- Listing factors without linking each to a specific indicator.
Rule of thumb
When asked to compare, always use data-style comparisons ('lower', 'higher', 'approximately') and then explain the reason with a factor, and finish with a consequence for health status.
Worked example: 'Why is under-five mortality higher in low-income countries?' Answer structure: state the difference, give factors (limited access to immunisation and healthcare, unsafe water and sanitation, malnutrition, lower maternal education), then link each to the outcome (more preventable child deaths).