Problems in measuring the influence of economic levels on morbidity.

Abstract

OF what importance is the relation of morbidity to economic levels? Why should we address attention to this problem? If we hope to convert the cycle of poverty, ignorance, malnutrition, and sickness to one of education, improved nutrition, improved health, and economic development, we must gain understanding of the interactions of these variables. Leona Baumgartner, in a recent editorial in this Journal, quoted from Kimball's book Tropical Africa: It is bad enough that a man should be ignorant, for this cuts him off from the commerce of other men's minds; it is perhaps worse that a man should be poor, for this condemns him to a life of stint and scheming, in which there is no time for dreams and no respite from weariness. But what surely is worse, is that a man should be unwell, for this prevents him from doing anything much about either his poverty or his ignorance.17 The problems of ignorance, sickness, and poverty are not restricted to tropical Africa. One finds these problems even in the cities of the United States. Some economists tell us that economic development per se will lead to better health. Educators claim that education will lead to both better health and economic development, while we as health workers often claim that without health, neither education nor economic development can succeed. To plan logically for improvement in all of these areas one must be able to evaluate effects of each, in order to establish priorities. This paper does not attempt to assess and evaluate the priorities of these factors. The difficulties and shortcomings of use of interview data in lieu of complete, standardized history and physical are not discussed.28 29'34 Discussion is limited to problems and pitfalls in the study of the interrelationships of economic level and morbidity as measured by household interview. Examples are drawn mainly from a year-long, nationwide study in Taiwan.