Global Health and Nutrition

Global Burdens and Inequalities

Two main concerns of international public health research are generating knowledge on global burdens of nutritional illnesses and investigating the causes of these illnesses and their health and economic consequences. Burdens are traditionally monitored and documented globally as well as per world region and per country, sometimes down to a district level. Disparities and inequalities and their related excess morbidity and mortality are often observed, with comparisons of low- and middle-income countries versus high-income countries being particularly frequent. The poor, women of childbearing age, children younger than 5 years of age, minority groups, and the elderly are often found to be at increased risk of poor nutritional status, although the specific vulnerable population segments depend on the condition of concern. Reducing known sociodemographic disparities in nutritional illnesses and diseases is an important focus of investigation. One characterization of global nutrition research is that it revolves around concerns about global fairness and suffering and strives for global realization of the universal human rights to adequate food, freedom from hunger, and access to safe water. Such concerns underlie the United Nations Millennium Development Goals (MDG): For example, Goal #1 aims at reducing the proportion of hungry people by half between 1990 and 2015, and Goal #4 aims at reducing mortality rates in children younger than 5 years of age by two thirds during the same period.

The regular publication of global and country statistics on nutritional burdens and inequalities is itself a powerful tool to influence policy and to generate funding for further research on the mechanisms and consequences of disease and the development of prevention or alleviation strategies. Indeed, one of the ways in which the global community ensures progress toward improving nutritional outcomes is to monitor each other's successes and failures after reaching consensus on a joint set of targets. This watchdog mechanism also inspires many international agencies, research institutes, donors, and funders. Current trends in global malnutrition burdens are that Southeast Asia and Latin America have made considerable progress in the past decades, whereas sub-Saharan Africa and South Asia, despite some improvements, remain hotspots for nutrition problems. These regions are beset with an estimated prevalence of chronic malnutrition in children younger than 5 years of age of more than 40% and 36%, respectively, in 2010 (WHO and UNICEF, 2010). In the early 1990s, it was estimated that 50% of all deaths in children [Page 678]younger than 5 years of age worldwide were attributable to malnutrition. Recently, that estimate was updated to 33%, indicating the achievement of considerable progress while demonstrating that there is substantial room for improvement of this unacceptably high proportion.

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