There is no other country in the world quite like Africa. It is home to some of the most indigenous populations of animals in the world. It is also home to over 1 billion people and still growing! In fact, “Africa is the second most populous continent with about 1.1 billion people or 16% of the world’s population. Over 50% of Africans are under the age of 25”(Boyes, Steve. 2013). Though Africa has many beautiful aspects about it, one sad reality still remains. “Over 25 million people are HIV-positive on the continent and over 17 million have died of the disease already”(Boyes, Steve. 2013). In looking over research about Africa I decided to focus on the country Ethiopia and the affects HIV/Aids has on its women and communities. “With one of the highest poverty levels in the world, Ethiopia is considered by many to be one of the most under-developed nations in the world. But within its African boundaries lies a nation filled with a rich culture and heritage. Bordered by Kenya, South Sudan, Sudan, Dijibouti, Eritrea, and Somalia, Ethiopia has an estimated 2015 population of 98.9 million, which ranks 13th in the world”(WPR. 2015). Ethiopia is the most populous landlocked country in the continent of Africa and the second-most populous country of Africa after Nigeria”(WPR. 2015). According to National Geographic, “most Ethiopians are farmers and herders. But deforestation, drought, and soil degradation have caused crop failures and famine during the past few decades; seven million people face starvation”(Ethiopia Facts, Ethiopia Flag. 2015). This is not a surprise, due to such large, land mass and such high population. One thing that I found to be very interesting about Ethiopian culture was the native’s life expectancy. In fact, “According to the latest WHO data published in April 2011 life expectancy in Ethiopian men is about 59.0 years old and female round 61.8 years old, with an average life expectancy around 60.4 years old. This places Ethiopia 152nd on the World Life Expectancy ranking(Life Expectancy in Ethiopia. 2011). This was astounding to me, because compared to the United States “Life expectancy for females is around 81.2 years old and for males it is around 76.4 years old (Copel, Larry. 2014). The question I was able to draw from this is “why do countries with large populations have such a low life expectancy rate”? I also wonder what keeps our country’s (United States) life expectancy so high compared to Ethiopia. I always wondered why couldn’t other countries get the same education as the United States. Lastly a huge factor on determining what country I chose was the fact that I had the pleasure of having an Ethiopian mentor in 8th grade who taught me a lot about his culture and prepared me for high school.
In studying the Sub-Saharan country Ethiopia, I found that the best way to research HIV/AIDS is to study it from an epidemiological theorist perspective. Sub-Saharan Africa is home to some of the most developing countries in the world, and is home to some of the highest HIV/AIDS victims in the world. According to the Africa Health Observatory (AHO) and the World Health Organization, “based on a single point estimate, there are nearly 1.2 million people living with HIV/AIDS in Ethiopia”(Ethiopia: Analytical summary – HIV/AIDS – AHO, 2014). Epidemiologists are at the forefront of collecting data and are masters at figuring out how diseases affect populations. Epidemiology is defined as “the study of the distribution and determinants of disease”(Trostle et al., 1996). According to the epidemiological theory, in finding out how to get rid of a problem, epidemiologist look at a countries culture and population to determine how specific diseases affect each culture and population. Epidemiologist ask questions such as how did this disease start and what can be done to limit the spread of the disease(Lecture: 1.2). They also look at ways to advocate and bring awareness to outbreaks to limit the spread. In the case of HIV/AIDS “Epidemiologic tools are essential to understanding patterns of risk and transmission, finding individuals and groups that need better access to care, and identifying key methods for interruption of transmission and control of the epidemic at the population level”(HIV/AIDS Epidemiology Research, 2015). I am currently studying in sociology at Michigan State University and I see epidemiological tools in my major everyday. For example in the case of HIV/AIDS In the United States “gay, bisexual, and other men who have sex with men, particularly young black/African Americans, are most seriously affected by HIV”(U.S. Statistics, 2014). Compared to Ethiopia where “the young populations, especially never-married sexually-active females, face the greatest risk of HIV infection in the country, with prevalence rates much higher than the average for both urban and rural areas as well as all women of reproductive age. This is associated with an early age of sexual debut and sexual mixing with high-risk older men, on top of their biological and gender-related vulnerability”(The Global HIV/AIDS Program: THE WORLD BANK, 2008). From a epidemiological theorist perspective, you would have to begin by dissecting each piece of information.
Epidemiological theorist present statements such as, “in order to find cures and ways to rid HIV/Aids we must first understand the social determinants that come behind the disease”. When I think of social determinants of health I imagine all the factors that influence health rather positive or negative in our day-to-day lives. It’s hard to first understand the concept of social determinants of health when you don’t know what determinants of health are. The center for disease control and prevention states, determinants of health are “factors that contribute to a person’s current state of health. These factors may be biological, socioeconomic, psychosocial, behavioral, or social in nature. Scientists generally recognize five determinants of health of a population, which are: biology and genetics, individual behavior, social environment, physical environment, and health services”(social determinants of health. 2014). This to me means all of the determining factors that control our everyday lives without us even knowing. Some are controlled actions, behaviors, and factors; adversely there are some actions, behaviors, and factors we cannot control. Nevertheless they are all factors that keep a population thriving. The center for disease control and prevention goes on to say, social determinants of health are “the complex, integrated, and overlapping social structures and economic systems that are responsible for most health inequities. These social structures and economic systems include the social environment, physical environment, health services, and structural and societal factors. Social determinants of health are shaped by the distribution of money, power, and resources throughout local communities, nations, and the world”(social determinants of health. 2014). Social determinants of health are what could be considered, beyond what a person can individually do to ones own health. They are the factors from society that correlate with health, because they ultimately cause stressors in our bodies. That is, they are influenced from culture not just individual behavior, which can have adverse affects on health. Inequalities are very common when looking at social determinants of health. Examples of social determinants of health include but are not limited to factors in educations, income, and even sex or gender. Though every country experiences social determinants of health, income seems to play the biggest role in societal growth. Compared to the United States where people are placed in classes based off of income, In Ethiopia, “The strongest determinants of adolescent health worldwide are structural factors such as national wealth, income inequality, and access to education”(Hurst, E. 2012). The journal of Pediatrics and Child Health says, “social determinants play a critical role in the early phases of conception, pregnancy and post-natal periods of children’s development. Sensitive periods in brain and biological development start prenatally and continue throughout childhood and adolescence. The extent to which these processes lead to healthy development depends upon the qualities of stimulation, support, and nurturance in the social environments in which children live, learn and grow”(The social determinants of early child development: An overview. 2010). In the United States there are services readily available for people to use, if they are in distress and or ill. Adversely in Ethiopia, the best way for young adolescents and even young adults moving into adulthood to deal with problems are “safe and supportive families, safe and supportive schools, together with positive and supportive peers are crucial to helping young people develop to their full potential and attain the best health in the transition to adulthood”(Hurst, E. 2012). This is very important to know, because most people I know live in the United States and don’t understand how privileged they are. Many people would kill to have what Americans have. We should all take these factors into consideration and be thankful for what we do have. Social determinants of health are not the only factors that can influence HIV/AIDS victims and other ill patients. Economic determinants also play a role in a person’s health dealing with the disease.
Health is of interest to economists, for many reasons. Not only is it an important element in society, but it is also a component of human capital, which means it is important for growth and development. In poor countries, where physical jobs tend to be more prevalent than industrialized countries, health may be more important than education in determining labor productivity. In the case of people affected with HIV/AIDS in Ethiopia, disclosing one’s HIV/AIDS test results to a sexual partner is an important factor in HIV/AIDS, because “disclosure of one’s HIV status enables for improved access to prevention and treatment programs provides increased opportunities for risk reduction and helps in planning for the future”(Kassaye. 2005). Through vast research methods, Advocacy and bringing awareness about HIV/AIDS is the only way to limit the spread of the disease. From an epidemiological prospective, you would examine what may or may not be causing HIV/AIDS victims in Ethiopia to not inform their partners of their illness. Questions from an epidemiological prospective that many arise are, “are economic factors playing a role on women admitting HIV/AIDS statuses?; or does HIV/AIDS victims have have trouble finding a way to continue life and fit in to an economic system who can not truly care for there needs? Does this make more women reluctant to admit their status? The epidemiological theoris prospective always questions this. The truth behind the matter is “HIV/AIDS- related stigma and discrimination directly hamper the effectiveness of Anti-HIV/AIDS responses. Stigma and concerns about discrimination constitute a major barrier to people seeking HIV testing and directly affect the initiation of protective behavior” (Kassaye. 2005). To many peoples surprise “69% of the women reported that they had shared their HIV test results with their partners. Among the women who did not disclose their HIV status 62.5% said that it was due to fear of partner’s reaction (fear of abandonment, rejection and accusation of infidelity).But 75.9 % of HIV positive women who disclosed their result reported positive partner’s reaction”(Kassaye. 2005). This would not be a surprise to anyone living with HIV/AIDS in the U.S, who also face stigmas because of the disease. However one thing that you do find more prevalent in the U.S., that is not so prevalent in Ethiopia are the available resources and clinics available to help those affected by HIV/AIDS. Often times the outside world ridicules people, because they could never understand what it would be like to live with the disease. Ethiopian women with HIV/AIDS have a tough task when it comes to disclosing information about the disease. Though disclosing status to partners allows more access to treatment programs and other methods of help, for women in Ethiopia “disclosure for HIV/AIDS infected women including loss of economic support, blame, abandonment, physical and emotional abuse, discrimination and stigma, as well as a loss of custody of children and property”(Kassaye. 2005). This tells me that HIV/AIDS stigma can add extra stressors to women health in Ethiopia. With such a negative image and pressure from media saying how death could be imminent, one could begin to understand why women are less likely to expose their status. Lastly in order to truly understand the affects of the HIV/AIDS virus on women in Ethiopia from an epidemiological theorist perspective, you must first start on the population level to figure out what social, economic, and political determinants control health.
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Copel, Larry. “Life Expectancy in the USA Hits a Record High.” USA Today. USA TODAY, 9 Oct. 2014. Web. 18 Aug. 2015. .
Trostle, James, and Johannes Sommerfeld. “Medical Anthropology and Epidemiology.” Annual Review of Anthropology. 25. no. 1 (1996): 253-274. http://www.annualreviews.org/doi/pdf/10.1146/annurev.anthro.25.1.253 (accessed August 6, 2015).
-Ethiopia:Analytical summary – HIV/AIDS – AHO. (2014). Retrieved August 6, 2015, from http://www.aho.afro.who.int/profiles_information/index.php/Ethiopia:Analytical_summary_-_HIV/AIDS
U.S. Statistics.” U.S. Statistics. U.S. Department of Health & Human Services, 2 Dec. 2014. Web. 6 Aug. 2015. .
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HIV/AIDS Epidemiology Research.” HIV/AIDS Epidemiology Research. U.S. Department of Health and Human Services, 31 July 2015. Web. 6 Aug. 2015.
Kassaye, Kebede Deribe, et al. (2005) “Determinants and Outcomes of Disclosing HIV-sero Positive Status to Sexual Partners among Women in Mettu and Gore Towns, Illubabor Zone Southwest Ethiopia.” Original Article. 2005. Web. 18 Aug. 2015. .
Lecture: 1.2. Introducing Theory 1: Epidemiological Theory
Boyes, Steve. “Getting to Know Africa: 50 Interesting Facts….” National Geographic. National Geographic Society, 13 Oct. 2013. Web. 18 Aug. 2015. .