Most research on public health in the developing world has focused on children.  Relatively little is known about adult health.  (Adults are defined as 15-59 year olds.)

The Level of Adult Ill Health

• Many people believe that there is no “survival disadvantage” to living in a developing country if one survives the childhood years.  In fact, death rates in the adult (15-59) category are twice as high in the developing world compared to the developed world.
• ¾ of adult deaths are “avoidable”.  (“Avoidable” is not defined; I assume it means the deaths could be avoided with the aid of Western medicine.)  While men have a higher overall mortality risk, women are at more risk of dying from avoidable causes.
• Morbidity (sickness) is probably high in the developing world too, but it is difficult to measure.

Determinants and Causes of Adult Ill Health

• Poverty is usually associated with higher adult mortality, but there are exceptions.
• Childbirth, malnutrition and unhealthy home environments increase the risks of communicable disease.
• However, the leading causes of death in the developing world are noncommunicable diseases.  Causes include unhealthy behavior (smoking, drinking), pollution, workplace injuries, and vehicle accidents.
• Noncommunicable diseases cause higher death rates in poor countries, and among the poorer segments of a country’s population.  Further, rates of death from noncommunicable disease are declining in many countries.  All this contradicts the prevailing wisdom that noncommunicable diseases are concomitants of development.

The Impact of Adult Ill Health

• As child health improves and more children live past age 15, the relative incidence of adult health problems increases.
• Adult ill health hurts productivity, places demands on health services, and hurts families.