1POVERTY AND ILL-HEALTH: CHALLENGES, INITIATIVES AND ISSUES IN PAKISTAN

Poor people live without fundamental freedom of action and choice that the better off take for granted. They often lack adequate food and shelter, education and health, deprivations that keep them from leading the kind of life that everyone values. They also face extreme vulnerability to ill-health, economic dislocation, and natural disasters. And they are often exposed to ill treatment by institutions of the state and society and are powerless to influence key decisions affecting their lives. These are all dimensions of poverty. Huge disparities exist in health between the rich and poor in the world, and between the rich and poor within developing countries. Poor health is closely associated with poverty. Across and within countries, differences in income can account for as much as 70 % of variance in infant mortality. The poor are most vulnerable to ill-health and have the least means to combat it. The case for investing in health has been further strengthened by a growing body of evidence, which shows that better health contributes to greater economic security and growth. The complex relationship between poverty and ill-health is illustrated in Figure 1. Better health reduces poverty, and reduced poverty improves health. 1 Figure 1. Poverty and Ill-health: the Vicious Circle Some of the serious deprivations noted and where the poor people live in developing countries are detailed in Figure 2. and Table 1. poverty ill-health Increased personal and environmental risks Increased malnutrition Less access to acknowledge, information Diminished ability to access care Diminished quality of life Reduced productivity Lowered learning ability Diminished household savings, debt