The Health of Adults in the Developing World.

• Author: Chasin, Steven H.

We have all seen the sorrowful news stories about and advertisements for children in developing countries suffering and dying from illnesses that developed countries conquered long ago. Rarely do these ads or stories mention the poor health of the adults in these countries yet these adults have a tremendous impact on their countries' economies. The Health of Adults in the Developing World begins to fill this void.

The authors' purpose is "to stimulate discussion, research and action on . . . adult health in developing countries". The writers are upbeat about children's health status by citing statistics that show almost all children reach maturity and use fewer health resources than adults. In contrast, boys who reach 15 years old, in general, have a 1 in 4 chance of dying before reaching 60 and in some countries this drops to 1 in 2 compared to 1 in 8 in developed nations. In addition, ailing adults in developing countries use "over half" of their countries' health assets. The authors cast a wide net by defining adult illness to encompass communicable and non-communicable diseases and injuries for people 15 to 59 years old.

The researchers provide an overview of adult mortality and conclude that the most "noteworthy" result is that deaths from noncommunicable diseases decline when total mortality drops. They point out that both sexes in developing countries are experiencing major decreases in digestive disorders and women, in particular, are experiencing less cardiovascular disease. One interesting relationship shows that men suffer higher mortality rates than women even after accounting for child birth. However, women suffer higher avoidable mortality rates than men from increasing breast cancer, motor vehicle injuries and intentional injuries. This implies there are ways to intervene to change women's rates significantly.

The book goes beyond just describing maladies and death rates by focusing on the results of adult illness. First they outline families' and communities' coping methods to deal with adult sickness. For instance, feeble individuals may shirk their household responsibilities to maintain their energy for work. Community members may substitute for the sick person but this means they forsake other productive activities. Finally, keeping children home from school to care for an adult or sending them to work to replace an adult's income hurts the country's human capital investment.

The authors then spend time discussing the...