Nav: Home

Deaths from chronic diseases now hitting poorest households hard in Bangladesh

October 22, 2015

The number of people in Bangladesh dying from chronic diseases such as cancer, diabetes and hypertension--long considered diseases of the wealthy because the poor didn't tend to live long enough to develop them--increased dramatically among the nation's poorest households over a 24-year period, suggests new research from the Johns Hopkins Bloomberg School of Public Health.

The study, published Oct. 13 in the International Journal of Epidemiology, found that the rate of people dying from chronic conditions between 1982 and 2005 fell among the richest 20 percent while rising dramatically among the poorest 20 percent. The shift underscores how chronic diseases, once referred to as "diseases of affluence," have become diseases of poverty, as lower-income people live longer but often lack the resources to prevent and treat these illnesses.

This research, believed to be the first long-term study of its kind, also finds that chronic disease can worsen poverty, underscoring the importance of including chronic disease prevention and management in strategies to alleviate poverty. Instead of dying from infectious diseases at a young age or dying soon after birth, many more children are instead living far longer than before. As life expectancy increases around the world, other countries will likely experience a shifting burden of chronic diseases, with poorer households spending a disproportionate amount of their income on health care costs than better-off households.

"Our study is the first moving picture of the epidemiologic transition that is occurring in low- and middle-income countries. Instead of a single snapshot, we were able to track the changes in the same population over the course of two decades," says study leader David Peters, MD, MPH, DrPH, professor and chair of the Department of International Health at the Bloomberg School. "While the proportions of people dying from chronic diseases are rising across all groups, the poor are suffering disproportionately."

Peters and his colleagues analyzed data collected in a health and demographic surveillance system in Matlab, Bangladesh, which is maintained by the International Centre for Diarrhoeal Disease Research. The study site is located in a rural area of the country and covers a population of about 225,000 people. The survey routinely collected demographic information such as births, deaths, marriages and migration. Socioeconomic censuses were conducted in 1982, 1996 and 2005.

Between 1982 and 2005, results show that chronic disease mortality rates rose overall from 646 to 670 per 100,000 people. The rate, however, fell among the richest 20 percent, from 697 to 615 per 100,000, a decline of 12 percent. At the same time, the rate rose dramatically among the poorest 20 percent, from 546 to 752 per 100,000, an increase of 38 percent. For the poorest 60 percent, chronic disease mortality rates also rose, but they decreased slightly for the upper 40 percent.

Researchers also looked at the change in socioeconomic status over time in relation to chronic disease mortality. They found economic status more likely to drop if there had been a death in the household caused by a chronic disease. In 1996, for instance, a household was one-third more likely to be in poverty if there had been a death from a chronic disease in the household in 1982.

These findings, Peters says, are reminders that special attention should be paid to the poor when addressing the rising rates of chronic disease mortality. Chronic diseases are not only beginning to affect the poor disproportionately, they are also dragging more people into poverty.
-end-
"Distribution of chronic disease mortality and deterioration in household socioeconomic status in rural Bangladesh: an analysis over a 24-year period" was written by Jahangir A.M. Khan, Antonio J. Trujillo, Sayem Ahmed, Ali Tanweer Siddiquee, Nurul Alam, Andrew J. Mirelman, Tracey Perez Koehlmoos, Louis Wilhelmus Niessen and David H. Peters.

This project has been funded by Federal funds from the United States National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Department of Health and Human Services, under Contract No. HHSN268200900032C.

Johns Hopkins University Bloomberg School of Public Health

Related Public Health Articles:

COVID-19 and the decolonization of Indigenous public health
Indigenous self-determination, leadership and knowledge have helped protect Indigenous communities in Canada during the coronavirus disease 2019 (COVID-19) pandemic, and these principles should be incorporated into public health in future, argue the authors of a commentary in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200852.
Public health consequences of policing homelessness
In a new study examining homelessness, researchers find that policy such a lifestyle has massive public health implications, making sleeping on the street even MORE unhealthy.
Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.
Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.
The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.
The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.
The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.
BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.
The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.
Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.
More Public Health News and Public Health Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Warped Reality
False information on the internet makes it harder and harder to know what's true, and the consequences have been devastating. This hour, TED speakers explore ideas around technology and deception. Guests include law professor Danielle Citron, journalist Andrew Marantz, and computer scientist Joy Buolamwini.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at Radiolab.org/donate.     You can read The Transition Integrity Project's report here.