Health in hand with education

by Cesar Chelala

Special To The Japan Times

Better education, particularly among mothers, is widely associated with better health. Experiences in several countries have shown the power of education to increase the nutritional levels and the health status of the poor.

Girls’ education is one of the most effective investments a nation can make toward development and better health.

In urban India, for example, it has been found that the mortality rate among the children of educated women is almost half that of children of uneducated women.

In the Philippines, primary education among mothers has reduced the risks of child mortality by half, and secondary education by a factor of three.

A study in rural Ghana on health-protective behaviors related to HIV/AIDS infection among adults found that more educated individuals practiced more protective health behavior, thus decreasing the risk of contracting infection.

In addition, those living in poverty and suffering from malnutrition show a higher propensity for contracting a host of diseases, a lower learning capacity, and an increased exposure and vulnerability to environmental risks. Poor children frequently lack stimuli critical to growth and development.

Poverty cannot be defined solely in terms of lack of income. Little or no access to health services, lack of access to safe water and adequate nutrition, illiteracy or low educational level and a distorted perception of rights and needs are also essential components of poverty.

Poverty is one of the most influential factors for ill health, and ill health — in a vicious cycle — can lead to poverty. Education has proven to be critical to breaking this cycle.

Poverty and health are linked. Illness impairs learning ability and quality of life, has a negative impact on productivity, and drains family savings. Poor people are more exposed to environmental risks (poor sanitation, unhealthy food, violence,and natural disasters) and less prepared to cope with them.

Because they are also less informed about the benefits of healthy lifestyles and have less access to them as well as to quality health care, the poor are at greater risk of illness and disability. It is estimated that one-third of deaths worldwide — some 18 million people a year or 50,000 a day — are due to poverty-related causes.

More than 1.5 billion people in the world live in extreme poverty, 80 percent in developing countries. Poor people have little or no access to qualified health services and education, and do not participate in the decisions critical to their day-to-day lives.

Those who live in extreme poverty are five times more likely to die before age 5, and 2½ times more likely to die between 15 and 59 than those in higher income groups. The same dramatic differences can be found with respect to maternal mortality levels and incidence of preventable diseases.

The level of education in relation to health is particularly important among women. In addition, education for women is closely associated with later marriage and smaller family size.

Increased income alone cannot guarantee better nutrition and health because of the impact of other factors, notably education, environmental hygiene and access to health care services, which cannot necessarily be bought with increased income in the developing world.

Several strategies can be used to improve the access of mothers and children to educational opportunities as a way of improving their health status. National governments, particularly in developing countries, have to establish education — including the education of the parents — as a priority, and provide necessary resources and support. Interventions should be targeted to vulnerable groups such as those with lower income or with less access to adequate food.

At the international level, lending institutions have to implement debt-reduction policies for those countries willing to provide increased resources for basic education.

Although an important goal is to reduce economic inequity to improve the health status of populations, emphasis on education can provide substantial benefits in the health of populations even before reducing the economic gap between the rich and the poor.

Cesar Chelala, M.D., is a public health consultant for several international organizations.