Microkhan by Brendan I. Koerner

The Reaper Runs Roughshod

December 11th, 2009 · 2 Comments

Marshall Islands
One of the happier trends these days is the general improvement in human life expectancy, even in nations that are suffering through armed conflict, natural disasters, or other great misfortunes. Believe it or not, for example, the average life expectancy in Afghanistan has actually increased steadily in recent years, as has the hallowed figure in such tough locales as Burkina Faso, Haiti, and Timor-Leste. (You can graph any nation’s life expectancy over time with this handy Google tool.)

But the picture is not universally rosy. In most cases, the dips in life expectancy have been temporary, and easy to ascribe to factors such as war or internal turmoil. Many of the former Soviet republics, for example, experienced huge declines in life expectancy in the mid-1990s, primarily because their health-care sectors disintegrated overnight. (The excess vodka probably didn’t help, either.)

Much tougher to explain away, however, is the slow, steady, and long-term decline of life expectancy in several South Pacific nations. Most notable among these cases is that of the Marshall Islands, where the average life expectancy has declined about five years since 1987. Strangely, this decline has taken place even as the nation’s infant mortality rates have improved.

So what gives out there just west of the International Date Line? We thought the legacy of 1950s nuclear testing might factor into the equation, but the authors of this 2004 study from the International Journal of Epidemiology have a different hyopthesis regarding the mortality enigma in the South Pacific:

Pacific Island countries show highly variable patterns of mortality. Whereas high-mortality populations are affected particularly by infectious diseases and undernutrition (especially in children), low-mortality countries are afflicted with noncommunicable diseases and injuries in adults. However, even the least developed, high-mortality countries show urban–rural differentials, with noncommunicable diseases emerging as health problems in urban areas. In Nauru, noncommunicable diseases and accidents, particularly for males, are sufficiently problematic to greatly increase adult mortality and reduce life expectancy. This cause-structure of mortality also explains wide sex differentials in death rates, with much higher death rates in males.

The layman’s interpretation here might be that shifts in the population’s diet have increased the number of heart-disease deaths, while agricultural workers too rarely receive immediate medical treatment for life-threatening injuries. Both of these mortality factors could be easily addressed, given the political will and sufficient (albeit relatively paltry) outside funding. Maybe it’s time for the Marshall Islands government to call in the marker it’s earned by supporting Taiwan all these years.

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2 Comments so far ↓

  • Captured Shadow

    Accidents for Urban populations sound like car and motorcycle accidents to me. I imagine those could be a big factor.

  • Brendan I. Koerner

    Yeah, I thought road fatalities would play a big role, too. But if this list is to be believed, then the Marshall Islands actually have some of the safest roads in the world:

    http://en.wikipedia.org/wiki/List_of_countries_by_traffic-related_death_rate

    I’m going to keep digging on this one, as the paper I cite isn’t too conclusive. I have heard anecdotal evidence about the increasingly poor diet in these South Pacific nations, often due to the fact that so much of their food is heavily caloric fare imported from the U.S. Combine that with poor health care–esp. trauma care involved with saving heart-attack victims–and you can see how the adult morality rate would steadily go up over time.

    But I need to find some hard evidence to support that theory. Next week, perhaps…

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