FIFTH REPORT - World Health Organization

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12 <strong>FIFTH</strong> <strong>REPORT</strong> ON THE WORLD HEALTH SITUATION GRAPH 6. RANKING OF 21 NOTIFIED DISEASES IN THE SIX WHO REGIONS (1971 or 1972) TYPHOID AND PARATYPHOID FEVER (A2.3) 2 4 6 8 10 12 14 16 18 20 22 4 6 8 10 12 14 16 18 20 22 DIPHTHERIA (A 15) POLIOMYELITIS (A 22) DYSENTERIES AND ENTERITIS ) A4-5 ) TUBERCULOSIS (A6 -10) WHOOPING COUGH (A 161 STREPTOCOCCAL SORE THROAT AND SCARLET FEVER (A 17) INFECTIOUS HEPATITIS (A26) LEPROSY (A 14) MENINGOCOCCAL INFECTION (A 19) 4 6 8 10 12 14 16 18 20 22 z 2 4 6 8 10 12 14 16 18 20 22 %%A MALARIA (A 31) TRYPANOSOMIASIS RELAPSING FEVER SYPHILIS (A 35) A= Africa B= Americas C= South -East Asia D= Europe E= Eastern Mediterranean F= Western Pacific WHO 40200 GONOCOCCAL INFECTIONS (A 38) SCHISTOSOMIASIS (A39) INFLUENZA (A 90) TRACHOMA (076.077) 6 8 10 12 14 16 18 20 22 A B C D E F A B C D E F
DEMOGRAPHY, MORTALITY, AND MORBIDITY 13 the first priority for the health services that serve them. Although schistosomiasis appears in Graph 6, its position does not reflect the hazard it presents for some populations living alongside canals and watercourses infested by the snail vectors. These comments were called for in order to stress the gaps in the available information. The above analysis has two main objectives: to make it possible to direct country and WHO programmes towards the priority diseases, and to encourage the health services of countries to assess the causes of death and morbidity more accurately. Some of the leading causes of death and most frequently notified diseases, which have the most striking socioeconomic consequences and which WHO and governments have made special efforts to control, are discussed individually below. Cardiovascular and cerebrovascular diseases The major part of this group of severe diseases with serious social consequences is due to atherosclerosis, a disturbance in biochemical mechanisms probably at the cellular and molecular level. Arterial hypertension, the result of disturbed regulation of blood pressure, is another prominent causative factor of heart and vessel disease; its importance stems from its high rates of occurrence. The cardiovascular complications of rheumatic fever and of various infections, though in general regressing as a result of treatment and rising standards of living, still present important health problems in many countries. Basic research has not yet clarified the mechanisms of atherosclerosis and of essential hypertension. Fundamental laboratory research is being conducted in many countries; also, studies of entire populations using methods of active and not merely descriptive epidemiology are being carried out in practically all parts of the world. These investigations are also being extended to children, in whom the precursors of atherosclerosis are expected to be detected at an early stage. In recent years, working hypotheses have converged towards practical approaches to a better definition of risk factors and earlier diagnosis, and it is hoped that effective prevention of the major cardiovascular diseases will result. The principal risk factors are: high levels of cholesterol and other fats in the blood, indicating a disorder of lipid metabolism; high blood pressure; cigarette smoking and alcoholism; and diabetes. Though the presence of a single risk factor does not constitute immediate danger, the risk increases exponentially if several factors are associated. This viewpoint governs the planning of population surveys, health education of the public, and the training of health personnel. It makes it possible to base early diagnosis on the measurement of blood pressure, blood cholesterol, and comparative body weight, and on the interpretation of the electrocardiogram and of individual habits with regard to diet, tobacco and alcohol consumption, and physical activity. It is expected that efforts to advise on diet and the way of life, coupledif necessary -with drug treatment of hypertension, will exert a positive effect in the prevention of cardiovascular complications. It may therefore be hoped that community programmes can be applied to the most vulnerable groups: men aged 35 -65 and women aged 45 -65 with at least two risk factors should be kept under regular surveillance, and should receive therapy to control their hypertension. Primary prevention, however, should be started early in life. Cancer Research aimed at a better understanding of the factors liable to produce cancer has developed in great variety, both in countries, some of which have shouldered substantial financial burdens for such research, and at the international level. It would be unfair to compare the scope of these efforts with the modest results that have been obtained, since many studies will have to be carried out on a large number of subjects over many years before they bear fruit. It is also hoped that progress in basic research will be recognized as a prerequisite for advances in cancer control. The impressive efforts in the fields of early detection, surgery, radiotherapy, chemotherapy, hormonal therapy, and immunology must continue. At present the methods of treatment are generally combined, which means that treatment has to be carried out by a multidisciplinary team. Cures and long -term remission are becoming more frequent, and the period 1969 -1972 was associated with improvements in diagnostic and therapeutic methods and with the establishment of more clearly defined procedures. Mental diseases Mental health is referred to on many occasions in the country reports in Part II. Apart from the mental diseases and disorders associated with various pathogenic factors, there is a psychiatric component in criminality, delinquency, the education of children and adolescents, traffic and occupational accidents, the medical and occupational rehabilitation of the handicapped and the disabled, the abuse of narcotics and other drugs, alcoholism, and certain group phenomena. The governments of the developed countries spend substantial amounts on mental health services -onethird of the public health budget in the United States
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 19: 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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62 FIFTH REPORT ON THE WORLD HEALTH
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REGION OF THE AMERICAS
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100 FIFTH REPORT ON THE WORLD HEALT
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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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