The Bristol-Meyers Squibb Foundation has found that cancer is the second most common cause of death in Europe. Health disparities exist in the incidence and mortality rates for all cancers within Europe, with better survival rates for every type of cancer in Western Europe.

The assumed reason for this disparity is because Eastern Europe has inadequate health prevention measures, including delay in early diagnosis and use of innovative treatments and lack of quality care, may account for differences in survival. In addition, public education and awareness campaigns around cancer and its prevention are fragmented or relatively rare.

There is also a higher use of tobacco and alcohol in the east along with worse dietary habits, pollution, hepatitis B, as well as inadequate screening, diagnosis and treatment.

In Europe’s case I feel that the political geography is very different between the West and the more communist East are so very different, which worsens the disparities.

According to Stanford University’s Asian Liver Center, Worldwide, there are about 350 million people who are infected with chronic hepatitis B virus. About 78 percent, or 275 million people, of those individuals reside in Asia or the Pacific Islands.

Lifelong infection with hepatitis B can lead to liver cirrhosis, liver failure and liver cancer. About one million people die each year from liver cancer or liver failure caused by hepatitis B. That’s the equivalent of 2,800 deaths per day.

According to the Bristol-Meyers Squibb Foundation, China has the highest incidence of the disease, with an estimated 170 million people with lifelong infections. With only about four percent of those affected reportedly receiving treatment, each year about 300,000 Chinese die from hepatitis B.

This is a large worldwide health disparity since incidents of Hepatitis B is much lower in all other parts of the world.  But there is something being done to advocate for these Asian people.  The Shanghai Charity Foundation, working with the Shanghai Center for Disease Control, will use a $371,000 Bristol-Myers Squibb Foundation grant to develop awareness programs for 200,000 people, including migrant workers, high risk groups in both urban and factory areas, school children and teachers, and hepatitis patients and their families.

The entrance to Wockhardt hospital in Bangalore, India

There was an article posted by the New York Times in 2008 about contrasting two different hospitals in  Bangalore, India.  Wockhardt is a state-of-the-art private hospital that provides 5-Star service. Patients have private rooms overlooking gardens, cable TV, computers, and ice cream in a mini fridge at easy reach.  The next hospital is Bowring, the government run hospital.  This hospital lacks dialysis machines, ventilators, an ICU, and nutritional meals.

In the article Bowring hospital says, “one of the young doctors, named Harish, said a ventilator and a dialysis machine would have allowed him to keep half of his patients alive. The most severe case, Mohammed Amin, was breathing with the aid of a hand pump that his wife squeezed silently.

Harish sent the relative of one man to get blood tests done at the nearest private hospital; there was no equipment to do the test here.”

These health disparities are caused by a government unwilling to spend money on improving their medical systems and many people unable to afford the care of a private hospital.  The government has more money to give to its government hospitals but they  refuse because there are private hospitals and feel that they are able to allocate their budget else were.  This creates even larger problems because the poor majority are unable to afford the care that they need.

Miracles in Africa is a program of LDS Charities as a part of the church of Jesus Christ of Latter-Day Saints (LDS).  This program deals with villagers in small African tribal communities working with Latter-day Saint Charities to improve their health and quality of life.

One of the wells in Sierra Leone

In central Sierra Leone, there is a village named Bo that LDS Charities are focusing their efforts toward.  In this village there are more than 130,000 people and there are no paved roads, no electricity, and no water systems.  Because of their lack of resources, about 50 people walk miles to a river or the next village every day for water.

LDS Charities has come to Bo in order to build a well in their village.  Before they build they form a “water committee” with in the village and train them in maintenance and how to keep the water clean and safe for the community.  Each committee member must go through training classes and Matthew Heaps, the clean water initiative manager for Humanitarian Services explains why this training is so important by explaining that, “ This training allows families to discover the importance of hygiene, how to keep their hands clean, and how to properly care for water once it has been obtained from the well. Our goal in each community is for them to feel complete ownership so they will maintain the well and take responsibility for their health.”

I feel that this program is so completely efficient because of how thoroughly it is planned through.  They do not just build them a well and leave.  They train the people of weeks before construction even begins so that the people are able to maintain the well on their own and take responsibility for their own health.

In the United States racial and ethnic minorities suffer from worse health compared to their white counterparts. The CDC and FamiliesUSA state that the statistics as of 2008 for minority health disparities are:

• American Indians are 638 percent more likely to suffer from alcoholism, 400 percent more likely to contract tuberculosis, 67 percent more likely to have pneumonia or influenza, and 20 percent more likely to suffer from heart disease then whites.

• African-American men are 50 percent more likely to suffer from prostate cancer than white men, and they are more than twice as likely as white men to die as a result of the cancer.

• American Indians are more than twice as likely to suffer from diabetes as whites.

• Although they made up only 26 percent of the U.S. population, African Americans and Latinos accounted for 67 percent of newly reported AIDS cases.

• The maternal mortality rate for African-American women is nearly five times the maternal mortality rate for white women

• Private health insurance coverage among persons under age 65 was only 40% for Hispanics/Latinos, compared to 75.6% for non-Hispanic whites

Franklin Delano Roosevelt stated, “the success or failure of any government in the final analysis must be measured by the well-being of its citizens. Nothing can be more important to a state than its public health; the state’s paramount concern should be the health of its people.” Now my question is, are we succeeding or failing?

A garbage dump in Manila with scavengers at work

The slum of Bagong Silangan in Quezon City, Manila, is centered around a vast garbage tip on which many of the residents survive through scavenging.  In this particular slum men, women and children are knee deep in slime every day looking for articles which they can sell for their recycling value. They inhabit miserable makeshift huts on the perimeter of the dump and scavenge the dump as almost a career since they have no money.  Not only do these people not have access to health care because of their poverty, but they live in a very unhealthy environment because there are no laws to protect their health.

A young child working in a dump in Tondo

To paint a better picture, the dumps in the Philippines are huge mountains of garbage some even piled as high as seven stories.  The scavengers are mostly women and children, many without shoes, walking in the trash to find things to sell.  Many of them have bare feet that are just waiting to be protruded with broken glass, rusty nails, used syringes, and anything else that gets thrown away.  In Tondo, Philippines Adults carry bags of trash into an abandoned warehouse. They sift through the garbage for food or recyclables, leaving the leftovers of others’ leftovers to rot while flies swarm, rats scurry about and their children play nearby.

The slums of the Philippines are some of the worst in the world and many things can and need to be done in order to protect the health of all of the individuals living in the slums consumed with garbage dumps.  There are some church groups that allow Filipino women to use their kitchens in order to make things to sell, which replaces the need to scavenge. Also, some church groups provide free clinics once a year in order to improve the health of the slum residents, but large efforts need occur in order to make a significant impact on health improvement which are not in place.

Tondo Slum, residents are practically living on top of the garbage dump that is right next door

Women advocating for women's health around the world at the 2009 conference for International Women's Day

Since gender is one of the contributors to health disparities, the WHO (World Health Organization) is doing all that they can to promote healthy lifestyles for women by providing opportunities for them to receive health care and health education. The WHO has created an international women’s day, which falls on March 8^th every year.  The theme for International Women’s Day this year is “Equal rights, equal opportunities: progress for all” which re-emphasizes that equal rights and opportunities lead to improved health outcomes for women and girls.

Gender norms and values give rise to gender inequalities. The fact that, throughout the world, women on average have lower cash incomes than men is an example of a gender inequality.  Both gender differences and gender inequalities can give rise to inequities between men and women in health status and access to health care. For example, a woman cannot receive needed health care because norms in her community prevent her from travelling alone to a clinic. A married woman contracts HIV because societal standards encourage her husband’s promiscuity while simultaneously preventing her from insisting on condom use.

This is a typical home in the slums of Guatemala

This is a typical style of home in the wealthy areas of Guatemala

Health disparities are almost directly correlated with economic disparities within a country and between countries.  It is very common for health disparities to exist within a country when there are extreme gaps in wealth.    For example, Guatemala is a country in Central America and is one of the poorest countries in Latin America.  The distribution of income remains highly unequal with more than half of the population below the national poverty line and just over 400,000 (3.2%) unemployed. The CIA World Fact Book considers 56.2% of the population of Guatemala to be living in poverty.  Therefore, in this country there is extreme wealth and extreme poverty.  The wealthy people of the population can afford medical care which can prevent and treat diseases.   They also have the education necessary to live healthy lives.  The poorer areas do not have the means to provide their families with sanitation let alone having access to medical care and good education.  The government runs a number of public elementary and secondary-level schools. These schools are free, though the cost of uniforms, books, supplies, and transportation makes them less accessible to the poorer segments of society and significant numbers of poor children do not attend school. Many middle and upper-class children go to private schools.  This education availability or lack thereof increases the economic gap even further.

Since these economic gaps make a significant impact on health disparities around the world today, there have been successful interventions to aid this problem.  One of these interventions is Microfinance which is a banking system which allows people in poorer areas to receive loans in order to sustain a business and allows people the opportunity to get out of poverty and provide their families an education, which leads to better health.  Certain areas in India and Africa are places where this banking system has been the most successful.

These children are orphans because their parents were killed by the AIDS epidemic in Southern Africa

Health People 2010 states that a lack of education is one of the major reasons for health disparities. Disease occurs when people do not know how to prevent or treat a disease.  Health disparities researcher Dr. Dana Goldman says, “Better-educated people are healthier, but the magnitude of the relationship between health and education varies substantially across groups and over time.”  There needs to be a closing of the gap in health knowledge.  In fact, CHAPS is an organization who is trying to bridge the gap because they have a goal to promote health and to eliminate health disparities at a global scale.

Southern Africa is an excellent example of a health disparity due to education problems.  Because of the lack of education in Sothern Africa, their occurrence of AIDS is astronomical.  In 2008 there were an estimated 22.4 million adults and children in Sub-Sahara and Africa living with HIV compared to the 1 million in the United States.  Also, 1.4 million of those African people died from AIDS in that same year.   The African people are not aware that many of them have AIDS and do not know how to prevent contracting the disease.  Because of this lack of education some businesses in Southern Africa are now providing worksite AIDS/HIV education classes while providing free testing and counseling for their employees.

Since the recent earthquake in January, 2010 there have been various countries providing aid to Haiti because of the vast amount of devastation.  A group called Global Relief Technologies (GRT) was featured in a Fox News story about how GRT has sent a crew to Haiti to help the growing amputee population.  They are collecting data and sending it via PDA to their offices in New Hampshire where they create prosthetic limbs to properly fit each individual for each person that they receive information for.  The data being collected includes the person’s name, age, date of amputation, type of amputation, location, and a picture of the injury.  The patient in turn receives a bracelet with a barcode that identifies the person.  This identification bracelet will make the process of distributing the prosthetics much more efficient.  I think that this is a really wonderful idea to help the Haitians and it appears to be really organized.  I just hope that they have a plan in order to help the people who receive these prosthetics with physical therapy or at least train them a little bit on how to use a prosthetic limb.

These are the researchers using their PDA in order to send information back to the United States