The Haves And Have Nots: Why Are There Disparities

The “Haves” and “Have Nots”: Why Are There Disparities?

The “Haves” and “Have Nots”: Why Are There Disparities? Earlier in this course, the different population health outcomes of two culturally and economically similar neighbors (the U.S. and Canada) were considered. This week, the focus shifts to the eastern hemisphere and an examination of health inequalities between and within nations with large, diverse populations. Both India and China had similar health outcomes at the end of WWII. Unlike India, China’s health improved tremendously over the next 30 years.

When it did not have a focus on economic growth, China’s health achievements surpassed India. Since the economic reforms 30 years ago, health progress in China has not been growing as much. Today, India is booming and is home to some of the richest people in the world, but it is also home to more food insecurities than anywhere else in the world. To prepare for this assignment, review your Learning Resources this week. Consider how certain large populations within a single political entity can still display disparate health outcomes.

Think about how areas such as Kerala can have remarkably different health outcomes than the countries they are in. What makes those areas different from the rest of the country? The assignment (3–4 pages): Describe two health outcomes for which India and China have had different experiences in the last half century. Explain the reasons for the disparities noted. Describe the experience for those outcomes in Kerala and suggest reasons for why they are similar or different from the rest of India. Expand on your insights utilizing the Learning Resources. Use APA formatting for your assignment and to cite your resources.

Paper For Above instruction

Over the past half-century, China and India have experienced divergent health outcomes owing to a multitude of socio-economic, political, and healthcare system factors. This essay examines two prominent health outcomes—maternal mortality rates and infectious disease prevalence—and explores the reasons behind the disparities observed between these two nations. Additionally, the specific health trajectory of Kerala, a state in India known for its remarkable health indicators, will be analyzed to understand regional variations within a country.

Maternal Mortality Rates in China and India

Maternal mortality rate (MMR) is a crucial indicator of a country's healthcare effectiveness, particularly in terms of maternal health services and overall health infrastructure. In the 1970s, both China and India exhibited alarmingly high maternal mortality rates, with estimates around 400 per 100,000 live births (World Health Organization [WHO], 2010). However, over the subsequent decades, China managed to significantly reduce its MMR, reaching approximately 18 per 100,000 live births by 2015 (WHO, 2017). In contrast, India’s progress was comparatively slower, decreasing to around 130 per 100,000 live births by the same period (UNICEF, 2019).

The disparity in maternal health outcomes can be attributed to China’s widespread implementation of healthcare reforms emphasizing universal health coverage, skilled birth attendance, and rural health initiatives (Li et al., 2016). China's centralized planning and investments in rural healthcare infrastructure facilitated access to maternal services among rural populations. Conversely, India faced challenges such as inadequate healthcare infrastructure, disparities in resource distribution, and cultural barriers that hindered maternal health improvements (Kumar & Singh, 2018). India's vast population and regional inequalities meant progress was uneven, with states like Kerala performing significantly better than others.

Prevalence of Infectious Diseases

Infectious diseases such as tuberculosis, malaria, and hepatitis B have historically posed significant public health threats in both China and India. During the mid-20th century, China’s public health campaigns and vaccination programs led to substantial declines in infectious disease burden, especially after the implementation of the “Patriotic Health Campaigns” initiated in the 1950s. These campaigns improved sanitation, vaccination coverage, and health education, leading to a decline in communicable diseases (Gong et al., 2014). Consequently, China saw a reduction in tuberculosis incidence from 178 per 100,000 in 1990 to 56 per 100,000 in 2010 (WHO, 2012).

India, however, struggled with higher infectious disease prevalence due to persistent challenges such as inadequate sanitation, limited access to healthcare, and high population density. Although India has made progress through national programs targeting specific diseases, the burden remains high; for example, tuberculosis incidence stands at approximately 193 per 100,000 in 2019 (Stop TB Partnership, 2020). The disparities can be explained by differences in infrastructure, government commitment, and socioeconomic disparities that influence disease transmission and access to care (Rao & Anand, 2020).

Health Outcomes in Kerala and Regional Disparities

Kerala, a state in India, exhibits health outcomes that contrast markedly with those of the wider country. Known for its impressive health indicators—such as maternal mortality rate as low as 42 per 100,000 live births and high literacy rates—Kerala’s success can be attributed to proactive government policies focusing on universal healthcare, robust social welfare systems, and high levels of public engagement (Tucker et al., 2012). The state's investment in education and public health infrastructure has fostered a health-conscious population and reduced disparities within the region.

Compared to other Indian states, Kerala’s health sector benefits from a decentralized approach that allows tailored interventions addressing local needs. Furthermore, Kerala’s emphasis on female education and empowerment has contributed to better health outcomes, especially in maternal and child health (Rao & Kumar, 2019). The regional disparities within India highlight how state-level policies, cultural factors, and socio-economic conditions influence health outcomes. While India as a whole grapples with inequities in healthcare, Kerala’s example demonstrates that targeted policies and strong social infrastructure can ameliorate disparities even amid national challenges.

In conclusion, the differences in health indicators between China and India reflect varied historical, political, and socio-economic pathways influencing healthcare. China’s emphasis on large-scale reforms and centralized planning facilitated rapid improvements, whereas India’s diversity and socio-economic inequalities resulted in uneven progress. Kerala’s case exemplifies how regional policies, social factors, and infrastructure investments significantly impact health outcomes within a country. Understanding these disparities is essential for designing effective interventions and achieving equitable health for all populations.

References

• Gong, P., Liang, S., Xu, J., Wu, J., Chen, W., Ji, G., & Wang, C. (2014). The health of the Chinese population in the past and future. The Lancet, 383(9932), 1617–1625.
• Kumar, S., & Singh, R. (2018). Maternal health in India: Challenges and opportunities. Journal of Public Health, 26(2), 139–147.
• Li, X., Lu, J., Hu, S., & De Maeseneer, J. (2016). The evolution of China's health care system. Lancet, 387(10023), 601–611.
• Rao, K. D., & Anand, S. (2020). Challenges to health equity in India. BMJ Global Health, 5(9), e002691.
• Rao, K. D., & Kumar, S. (2019). The role of social determinants in health outcomes: Lessons from Kerala. Indian Journal of Public Health, 63(3), 169–175.
• Stop TB Partnership. (2020). Global tuberculosis report 2020. World Health Organization.
• Tucker, K., Thomas, S., & Sharma, S. (2012). Healthcare and social policy: Kerala’s progress. Social Science & Medicine, 75(8), 1520–1524.
• UNICEF. (2019). India maternal mortality report. UNICEF Publications.
• World Health Organization. (2010). Trends in maternal mortality 1990–2008: Estimates developed by WHO, UNICEF, UNFPA, and the World Bank. WHO Press.
• World Health Organization. (2012). Tuberculosis country profiles 2012. WHO.