FIFTH REPORT - World Health Organization

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io FIFTH REPORT ON THE WORLD HEALTH SITUATION GRAPH 5. RANKING OF 16 CAUSES OF DEATH IN FIVE WHO REGIONS (1971 or 1972) 4 DYSENTERY AND ENTERITIS (B3 -4) TUBERCULOSIS MALIGNANT NEOPLASMS (B5 -6) (B 19) DIABETES (B 21) 6 8 10 12 14 16 18 20 AVITAMINOSES MALNUTRITION (8 22 ) HEART DISEASES (B27 -29) CEREBROVASCULAR DISEASE ( B 30 ) INFLUENZA (B31) 4 6 8 10 12 14 16 18 20 oc 2 4 PNEUMONIA (B 32) BRONCHITIS (B 33) CIRRHOSIS OF THE LIVER (B 37) NEPHRITIS (B 38) 6 8 10 12 14 16 18 20 2 4 6 8 10 12 OBSTETRIC AND SYMPTOMS AND PERINATAL ACCIDENTS ILL - DEFINED CONDITIONS (B41 -44) (B 45) ACCIDENTS (BE 47- 48) SUICIDE (BE 49 ) 14 16 18 20 A B C D E F uNO 40193 A= Africa B= Americas C= South East Asia D = Europe E= Eastern Mediterranean F= Western Pacific
DEMOGRAPHY, MORTALITY, AND MORBIDITY 11 either by a considerable difference or merely by a few units -but it does have the merit of drawing the attention of governments, grouped by WHO region, to the priority to be assigned to the leading causes of death. Communicable diseases, with the exception of tuberculosis and influenza, have not been taken into account as causes of death. The reason for this is that the lists communicated by governments rarely mention the common infectious diseases as causes of death, since the underlying cause is not often given. Thus measles or whooping -cough rarely appear as causes of death, since the death of the infected child is most frequently attributed to the terminal bronchopneumonia. The graph is based on the following numbers of deaths by region in 1971 or 1972: Africa (not available) Americas 871 795 South -East Asia . . . , 227 290 Europe 2 865 244 Eastern Mediterranean . 60 363 Western Pacific 372 836 Total 4 397 528 Clearly the ranking of causes for Europe is more likely to be correct than that for the Eastern Mediterranean, where only a minority of countries provided an analysis of causes of death. For the world as a whole the ranking of causes of death would obviously be influenced by the weight of the European figures and is therefore not given in the graph. This presentation has many faults but it is hoped that it will encourage governments to improve their health statistics by showing them that such statistics can be used for determining the major priorities for health action at the country, regional and worldwide level. Morbidity General morbidity statistics are either very incomplete or nonexistent in most countries. The morbidity statistics for hospital patients vary in value. They are fairly satisfactory when the diagnosis is made on the patient's discharge, less reliable when the diagnosis is made on admission; they ignore the private sector and reflect only morbidity that has led to admission to a public hospital bed, not general morbidity. Finally, the figures recorded depend to a great extent on the number of hospital beds. In countries where practically all requests for hospitalization are met, the statistics have a definite value and can be used to guide planning. On the other hand, where the hospital bed potential is notoriously inadequate the criteria for admission are based more on the severity of the case than on the nature or curability of the disease. The data used here are derived from information supplied to WHO by governments and used for preparing the World Health Statistics Annual. On the basis of these data, which are also reproduced in Part II, Graph 6 has been prepared by the same method as Graph 5, with the inclusion of the African Region. However, some changes have been made: typhoid and paratyphoid fevers have been grouped together, as have bacillary and amoebic dysentery and enteritis. Smallpox and cholera have not been taken into consideration. The graph covers the following populations, in thousands, by region, in 1971 or 1972: Africa 41 780 Americas 137 469 South -East Asia 46 337 Europe 343 570 Eastern Mediterranean 89 530 Western Pacific 89 426 Total 748 112 The differences between countries in the lists of diseases subject to compulsory notification, combined with the fact that more than half the countries failed to reply to the questionnaire for this report, make it impracticable to base a picture of morbidity in the world as a whole on these replies. Nevertheless, the position occupied by each of the 21 diseases in the ranking list in order of importance by region reflects the priority that national health authorities in each region might assign to those diseases in their programmes. The graph shows the universal nature of some diseases, such as tuberculosis, whooping - cough, infectious hepatitis, and gonorrhoea, which occupy high positions in all the regions. Other diseases, such as trachoma, trypanosomiasis, schistosomiasis, rabies, typhus, and relapsing fever, are notified or present in only a few regions. Finally, there are diseases which, although present in all regions, do not have high priority anywhere; examples are diphtheria, leprosy, and poliomyelitis. Graph 6 brings out the anomalies in the notification of diseases that are clearly universal, such as meningococcal infections, influenza, and measles, none of which has been reported from South -East Asia. The 21 communicable diseases and 16 leading causes of death selected for preparing Graphs 5 and 6 are by no means representative of general morbidity. Moreover, there are many countries, or areas of countries, where diseases that do not appear in the above analysis take first priority. Onchocerciasis, which affects more than half the inhabitants of the African savannas, and filarial infections, which cause disabling oedemas among 30 % of certain population groups in India, Sri Lanka, and Polynesia, represent the leading health hazard for those living in the affected areas and
Page 1 and 2: OFFICIAL RECORDS OF THE WORLD HEALT
Page 3 and 4: CONTENTS Page Preface VII PART I -
Page 5: European Region (continued) Page Ea
Page 8 and 9: personnel are not indispensable. Th
Page 11 and 12: CHAPTER 1 Two decades have passed s
Page 13 and 14: CHAPTER 2 DEMOGRAPHY, MORTALITY, AN
Page 15 and 16: DEMOGRAPHY, MORTALITY, AND MORBIDIT
Page 17: DEMOGRAPHY, MORTALITY, AND MORBIDIT
Page 27 and 28: CHAPTER 3 ECONOMIC DEVELOPMENT AND
Page 29 and 30: ECONOMIC DEVELOPMENT AND THE HEALTH
Page 31 and 32: CHAPTER 4 FACTORS INFLUENCING THE D
Page 33 and 34: CHAPTER 5 The main organizational p
Page 35 and 36: HEALTH ESTABLISHMENTS 27 TABLE 3. O
Page 37 and 38: HEALTH ESTABLISHMENTS 29 Several co
Page 39 and 40: HEALTH ESTABLISHMENTS 31 cases prov
Page 41 and 42: FAMILY HEALTH 33 report on the worl
Page 43 and 44: HEALTH PERSONNEL 35 duration of stu
Page 45 and 46: HEALTH PERSONNEL 37 few thousand in
Page 47 and 48: PROTECTION AND IMPROVEMENT OF THE E
Page 49 and 50: Country or territory Central Africa
Page 51 and 52: HEALTH PLANNING 43 and the local au
Page 53 and 54: PUBLIC HEALTH AND MEDICAL RESEARCH
Page 55 and 56: PUBLIC HEALTH AND MEDICAL RESEARCH
Page 57 and 58: Part II REVIEW BY COUNTRY AND TERRI
Page 59: AFRICAN RECTION
Page 62 and 63: 54 FIFTH REPORT ON THE WORLD HEALTH
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60 FIFTH REPORT ON THE WORLD HEALTH
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REGION OF THE AMERICAS
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INDIA Population and other statisti
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SOUTH -EAST ASIA REGION 143 Special
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SOUTH -EAST ASIA REGION 145 Physica
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SOUTH -EAST ASIA REGION 147 health.
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SOUTH-EAST ASIA REGION 149 improvem
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SOUTH -EAST ASIA REGION 151 filaria
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SOUTH -EAST ASIA REGION 153 centres
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SOUTH -EAST ASIA REGION 155 UNFPA:
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AUSTRIA Population and other statis
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EUROPEAN REGION 161 Poliomyelitis 7
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EUROPEAN REGION 163 The royal decre
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EUROPEAN REGION 165 BULGARIA Popula
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EUROPEAN REGION 167 Medical and pub
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EUROPEAN REGION 169 Dentists (unive
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EUROPEAN REGION 171 The 20 -year de
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EUROPEAN REGION 173 Expenditure on
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EUROPEAN REGION 175 Besides the var
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EUROPEAN REGION 177 Two new medical
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EUROPEAN REGION 179 FRANCE Populati
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EUROPEAN REGION 181 accounted for l
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EUROPEAN REGION 183 Government on t
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EUROPEAN REGION 185 result of impro
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EUROPEAN REGION 187 ing 3836 millio
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EUROPEAN REGION 189 The following p
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EUROPEAN REGION 191 expenditure and
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EUROPEAN REGION 193 special advisor
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EUROPEAN REGION 195 persons undergo
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EUROPEAN REGION 197 cases (27), pol
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EUROPEAN REGION 199 heart disease (
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EUROPEAN REGION 201 provincial comm
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EUROPEAN REGION 203 Medical researc
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EUROPEAN REGION 205 Category and ad
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EUROPEAN REGION 207 each of which h
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EUROPEAN REGION 209 ROMANIA Populat
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EUROPEAN REGION 211 Water and air p
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EUROPEAN REGION 213 better coordina
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EUROPEAN REGION 215 The bed /popula
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EUROPEAN REGION 217 million kronor
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EUROPEAN REGION 219 connected to wa
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EUROPEAN REGION 221 Category Durati
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EUROPEAN REGION 223 In the Union an
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EUROPEAN REGION 225 during the prec
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EUROPEAN REGION 227 Sanitary inspec
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EUROPEAN REGION 229 Category and ad
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EUROPEAN REGION 231 total of 28 654
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EUROPEAN REGION 233 absence from wo
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EUROPEAN REGION 235 Midwives 3 821
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EASTERN MEDITERRANEAN REGION
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WESTERN PACIFIC REGION
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INDEX TO COUNTRIES AND TERRITORIES
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FIFTH REPORT - World Health Organization

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