Online Geography Resources


Variations in Health

IB DP Geography
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Base Knowledge and Understanding

Base knowledge and understanding


Video Clip
Data Visualization
Definition life expectancy
health adjusted life expectancy
infant mortality rate
maternity services
degenerative disease
congenital disease
News Article
Words to be defined
Base Level



The aim of this lesson:

  • To be able to describe variations in health as reflected by changes in life expectancy at global scales since 1950.
  • To be able to describe variations in health as reflected by changes in life expectancy at national scales since 1950.
  • To be able to explain the patterns and trends in variations in health in terms of differences in income and lifestyle.
  • To evaluate life expectancy, infant mortality rate (IMR) and child mortality, HALE (health-adjusted life expectancy), calorie intake, access to safe water and access to health services as indicators of health.
Geography Activities

Defining 'health'

World Health Organization definition of health

"Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."

Source: Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.

The International Baccalaureate Organization states that the health of a population is:

"The direct consequence of having enough food, a balanced diet and reduced susceptibility to disease."
Geography Activities


Geography Activities

Describe variations in health as reflected by changes in life expectancy at global scales since 1950

Make a statement: what has the global average life expectancy done since 1950?
Geography Activities

Describe variations in health as reflected by changes in life expectancy at national scales since 1950


Go to the Gapminder World website by clicking on the following link:

‘Watch’ the animation through, and complete the table below:

Life Expectancy trends observed
Examples: Figure / Date
United States of America
Geography Activities

Explain the patterns and trends in variations in health in terms of differences in income and lifestyle

This is a complex geographical topic and at the core of a lot of the IB DP Geography syllabus. Use the resources below to start to brainstorm why life expectancy has increased since 1950.
  The Jakarta Post - UN: Global life expectancy up sharply since 1950 [10 April 2010]
  National Geographic - Secrets of Living Longer
Geography Activities

Evaluate life expectancy, infant mortality rate and child mortality rate, HALE, calorie intake, access to safe water and access to health services as indicators of health

Geography Resource

You should be able to define each of these terms and outline their value as indicators of overall health. Some of these factors will be explored in more detail in the next section(s) of this Food and Health Unit.

Life Expectancy
Infant Mortality Rate (IMR)
Health Adjusted Life Expectancy (HALE)
Calorie Intake
Access to safe water
Access to health services
The IB Five
Life Expectancy
Infant Mortality Rate (IMR)
Health Adjusted Life Expectancy (HALE)
Calorie Intake
Access to safe water
Access to health services

Life Expectancy

This can be defined as the average length of time that a person can expect to live, based on key demographic indicators.

How effective do you think it is as a measure of overall health? There are large variations in values between those countries where people live the longest, and those with the shortest life expectancy.

Are people who live to an old age necessarily ‘healthy’?

Age-specific mortality data is needed to fully explore regional variations within a country. Life expectancy figures can be affected by a high Infant Mortality Rate. If people survive infancy they could live much longer than the life expectancy figures suggest. There may also be differences between cohorts (age groups) in the population which relates to improvements over time. It is important to remember that a low life expectancy may be the result of factors that aren’t health related, including conflict, air pollution, natural hazards, sanitation and the locations where people live. There are also ethnic variations within countries. Male life expectancy is generally lower than female life expectancy, so the demographics of an area also play a part. There are various reasons for this, which include lifestyle, increased suicide rate among young men and greater chance of a road traffic accident.

It is also worth remembering that before the Industrial Revolution, many cities in the United Kingdom had a lower life expectancy than the worst-performing countries today. Life expectancy is improved by vaccination programmes, particularly those on a large scale. However, the HIV/AIDS epidemic has dramatically lowered the life expectancy in sub-Saharan Africa.

"Although estimates of life expectancy reflect how many years a person might be expected to live given the current mortality rates in specific settings, they say nothing about health status during life. Mortality statistics alone are insufficient in fully describing and comparing the health status of different populations because they underestimate the burden of ill-health caused by chronic conditions and provide no information on non-fatal health outcomes." Part II Global Health Indicators - World Health Statistics 2010


Infant Mortality Rate (IMR)

This relates particularly to the proportion of babies who die before they reach their first birthday, per 1000 of the population.

It is generally recognised that the early years are a dangerous time, particular in the immediate post-natal period, where access to proper pediatric services may be limited in some regions or countries. These deaths are often easily preventable, if appropriate medical support was available. It is affected by the age of the mother, the nature of the household the child is born into, education and sanitation. Because of this, the indicator is a good measure of the level of development of a country.

This could be an area to focus on for a statistical improvement, but the scale of births in some countries such as India, means that there is unlikely to be sufficient budget to implement all the measures. There may also be issues with registering births and deaths in some areas which may affect the reliability of figures used in calculations. Large scale migrations, such as the ones caused by the 2011 famine in Somalia which we will return to later in the unit, also complicate the accurate measurement of deaths.

There are also countries, where a significant proportion of the population is under the age of 15. Where countries have a high proportion of young people (or old people) many of the indicators become less reliable.

Infant Mortality
© Copyright SASI Group (University of Sheffield) and Mark Newman (University of Michigan)
Territory size shows the proportion of infant deaths worldwide that occurred there in 2002 | PDF version

Health Adjusted Life Expectancy (HALE)

Health-adjusted life expectancy is a variation on the life expectancy featured above. It is a general indicator of the overall health of a population, but is also related to quality of life. There is an adjustment to the average figure for the time that is spent in ill health.

HALE may also be affected by endogenetic factors (from inside) – these include congenital diseases (from birth), and degenerative diseases resulting from old age. A person may be alive, but not in full health for periods of time at various stages during their life.

In addition to the average life expectancy values, it includes some additional statistical data. This works out the equivalent number of years in full health that a newborn child can expect to live based on the current mortality and morbidity rates for the country.

  • Disability-adjusted life years (DALYs) measures number of years of potential or productive life, which are lost to poor health or disability.
  • YLDs are years lived with a disability

HALE is therefore a measure of quality as well as quantity of life, which perhaps makes it a more effective measure.

"“Healthy life expectancy” (HALE) at birth represents the average number of years that a person could expect to live in “good health” by taking into account years lived in less than full health due to disease and/or injury. As a result, it captures both fatal and non-fatal health outcomes and disabilities, of which the most common worldwide are hearing loss, visual impairment and mental disorders." Part II Global Health Indicators - World Health Statistics 2010


Calorie Intake

Calorie intake relates to the energy that is contained in the food that people eat. Although there are minimum recommended calorie intake figures, the ‘type’ of food that is eaten is also significant. Someone who eats a lot of calories from fried fatty foods would potentially be more unhealthy than someone who ate lots of fruit and vegetables and had a lower daily calorie intake. The current recommended calorie intake per day is 2000 for women, and 2500 for men. There are certain areas such as Japan and the Mediterranean which are famed for their ‘healthy’ diet, but which aren’t necessarily high in calories.

Identify countries which are well above and below the average for per capita calorie consumption

Some countries which have high calorie averages also hide inequalities. People in the USA eat an average of around 3800 calories per day, but a significant proportion of the population receive ‘food stamps’ (welfare payments for food). There will also be differences in calorie requirements. A cyclist competing in the Tour de France will need to consume up to 10 000 calories per day during the race.

Access to safe water

Clean water is an essential element of health as not only are diseases spread by drinking contaminated water, but water is also a method of disease transmission for a range of insects and other organisms (some diseases don’t involve drinking water to become ill). Some of these are exogenetic (from outside), which means they are caused by environmental conditions, social habits and hazards.

Over 85% of the world’s population are thought to have access to safe water. Improvements in access to safe water is included in the Millennium Development Goals. There should be access to water that is affordable, in sufficient quantity for people’s needs and available without excessive effort and time required to collect it.

This immediately creates issues for many millions of people. Generally the water supply should be improved i.e. water is available from a tap, or pipe or pumped from a well. One issue with water is that it is not always possible to tell whether it is contaminated and dangerous to drink. When people are forced to drink dirty water, their chances of poor health increase dramatically, and their ability to recover is reduced substantially, as rehydration is required for diseases such as diarrhoea. Water is also involved in the transmission of certain diseases.

  World Health Organization - Water and sanitation related diseases fact sheets

Access to health services

There is uneven access to health care on a local, regional, national and international level. Some countries have free health care for all the population, but an increasing number have insurance based schemes, or require payment for treatment.

A raw figure is the number of people per doctor, or health worker or hospitals, or hospital beds. There may also be the use of figures relating to the number of doctors per 10 000 of the population. It is worth noting that the age structure of an area can impact on the accuracy of the figure.

Some countries are understood to have lower coverage than is required for adequate health care. An additional figure is health expenditure per capita.

Health services that are referred to here can include:

  • Maternity services
  • Pediatric care (young people)
  • Geriatric care (an increasing issue for countries with ageing populations)
  • Promotion of family planning measures, including contraception
  • HIV AIDS treatments
Geography Review



Describe the trend in global life expectancy since 1950 [3 Marks]

Evaluate two indicators of health [3+3 Marks]

Use examples to explain how lifestyle can impact life expectancy [3 Marks]

Use examples to explain how income can impact life expectancy [3 Marks] on facebook
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