Briefly describe what is meant by “diseases of affluence”.

State two examples of diseases of affluence.

Explain why health-adjusted life expectancy (HALE) is a better way to quantify the health of a community than infant mortality.

To what extent have the management strategies for one named disease been successful? Refer to one country or region in your answer.

Rich societies suffer [1 mark] (from health conditions not commonly found in poor societies). They include the degenerative diseases associated with different lifestyles and/or increased overall life expectancy [1 mark].

Coronary heart disease; cancer; asthma; type 2 diabetes; peripheral vascular disease; obesity; hypertension; some allergies. Some sources also include clinical depression and other mental health conditions. (Do not credit diseases of poverty: malaria, tuberculosis, measles, pneumonia, and diarrheal diseases. Do not credit AIDS.)

Infant mortality reflects health of mothers, nutrition, health care education and services. Many countries have reduced infant mortality with relatively small investments in health care services. Infant mortality is a “snap-shot”, reflecting a limited time period.

The HALE includes many more health-related issues, and all age-groups. It also reflects a longer time period, including infant mortality, but also including mortality of other age-groups, and more importantly, ill-health throughout the population. Award up to [3 marks] for the explanation of how each measure is used to quantify health. For full marks, HALE must be clearly shown to be the better measure.

The country or region must be clearly named and located. The disease should be identified. More than one management strategy should be examined. Strategies could involve prevention, treatment (palliative or curative), control/containment, public health measures. Each strategy should be clearly outlined in terms of its aims and methods, and the degree of success or failure should be evaluated.

To achieve band D the answer must describe relevant strategies to combat a named disease in a specific location.

To access bands E and F there should be some consideration of the merits of the strategies and a conclusion presented.

Marks should be allocated according to the markbands.

There were few problems.

There were few problems.

Generally well answered, with a good understanding of both terms and the benefits of HALE. Most failed to develop both indicators in sufficient depth. Weaker answers were descriptive and did not compare HALE with infant mortality rate.

Some very good responses with detailed case studies, a well-located region and disease and evaluation of the effectiveness of strategies. Responses tended to be on HIV/AIDS or malaria although there were a few less successful answers on swine flu. In some cases, the choice of a region or country was a problem, with vague answers being given about sub-Saharan Africa. A surprising number used cures from the last century.