The Impact Of Structural Adjustment Policies On Health

A typical characteristic of almost all the economies of the countries of the South over the last two decades has been the restrictions on the benefits and resources of the public sector. These limitations of means affected the public health sector completely, while the economic recession has not allowed the private sector to fill this gap. The dominant trend since the 1980s has been developmental policies of neo-liberal tinge materialized in structural adjustment programs of the economy, which has been aimed at reducing the role of the State, and with it the reduction of budgets for health, education and social welfare. This reduction in basic services has necessarily implied deterioration in the standard of living and health of a large part of the population, particularly vulnerable sectors such as children, the elderly and women.

Environmental Changes And Health

Development brings about various transformations and threats to the environment (such as pollution, land degradation, warming of the atmosphere or the proliferation of waste and toxic products), which have serious consequences for human health, the means of life and HUMAN SECURITY. Although it is the rich countries that contribute most to these impacts, it is the developing countries that suffer the most in the form of human losses, health risks and threats to livelihood systems. The latter contribute singularly to processes such as the degradation of soils, deforestation and the loss of biological diversity.

Vulnerable Groups And The Spiral Of Poverty

The adverse effects of precarious health are more serious in the poor, mainly because they get sick more frequently, but partly also because their income depends entirely on physical labor, so that the disease deprives them of their sources of income, and because they barely have savings to cushion the blow. Consequently, the disease surely implies progressive recapitalization of their assets and an erosion of their livelihood systems, which increases their level of vulnerability. Among the most vulnerable groups in developing countries, the following should be highlighted:

Children, because in the Third World the infant mortality rates due to malnutrition and infectious diseases, many of them preventable, are still very high.

Women, who have a particular vulnerability in the relationship between health and development, for reasons both physiological (risks associated with childbirth, a risk of contraction of sexually transmitted diseases and AIDS, etc.) and socioeconomic reasons (discrimination in the INTRA-FAMILY ALLOCATION OF RESOURCES, FEMINIZATION OF POVERTY, etc.). Also, in many cases, it has been found that girls, in particular, are discriminated against in access to food, health services and education concerning the rest of the family.

The ELDERLY , for whom different changes associated with development (urbanization, transformation of the family structure and attitudes of young people, dissemination of new labor relations) have led to a weakening of their roles and their weight in society and the family , that in the past gave them access to material resources, HEALTH care, emotional support and a respected social status. The consequence of this process is the generalized deterioration of their living conditions, nutrition, and health.

Health And Development

For its part, development can break the perfect circle of feedback between poverty and ill health. Economic growth makes it possible to have more resources to finance the improvement of ENVIRONMENTAL health, public health campaigns, and, above all, the establishment of a health system whose health services also cover the most vulnerable sectors, for example, by extending PRIMARY HEALTH CARE. Also, social development programs, such as education and literacy programs, have been instrumental in raising the level of health by facilitating improvements in nutrition, hygiene, and REPRODUCTIVE HEALTH. Socioeconomic development, particularly if it equitably reaches the population (although this is not usually the case), also allows improvements in housing conditions and other essential services.

Investments in health are justified not only because this is an essential element of well-being, but also because of purely economic arguments. Good health contributes to economic growth in four ways: it reduces workers’ production losses due to illness; allows the use of natural resources that, due to diseases, can be entirely or partially inaccessible and unexploited; increases the schooling of children and allows them a good learning, and frees for different uses those resources that otherwise would be necessary to allocate to the treatment of diseases.

The Impact Of Development Policies On Health

It is important to recognize that many development policies designed to improve the quality of life and economic conditions of communities can have unexpected health effects. Although development projects are currently paying more attention to their impact on health (for example, based on the objectives of HUMAN DEVELOPMENT and SUSTAINABLE DEVELOPMENT)), other projects and policies continue to threaten health. 

Uncontrolled urbanization and industrialization expose the population to new risks: work accidents; exposure to toxic substances; contaminated rivers; radiation; air pollution by transport and by industry; industrial noise, etc. Agricultural programs that at the macro level can help countries to feed locally can have harmful effects for the health of workers and residents in the area, such as those derived from the chemical pollution of fertilizers and pesticides (see GREEN REVOLUTION).They can also increase exposure to diseases such as malaria or sadomasochist, which is sometimes favored by poorly controlled irrigation practices. In short, these phenomena that are usually part of the development processes can lead to changes in the epidemiological profiles, that is, in the types of diseases that the population suffers.