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Transformation of the Developing
World: Socioeconomic Matrix1
Dennis Carroll,* Pierce Gardner,† Bradford A. Kay‡, Michael Osterholm,§
and Edward T. Ryan¶
*U.S. Agency for International Development, Washington, DC, USA; †National
Institutes of Health, Bethesda, Maryland, USA; ‡World Health Organization,
Lyon, France; §University of Minnesota, Minneapolis, Minnesota, USA; and
¶Harvard Medical School, Boston, Massachusetts, USA
Suggested
citation for this article
Economic disparity affects the health of persons around the world, and
various societal, environmental, and economic factors influence the emergence
of infectious diseases. Similarly, emerging infectious diseases have a
social and economic impact, including diminished economic productivity,
increased expenditures on public heath, deferred external investment and
development, and reduced travel and retail sales.
The thriving consumer demand for exotic and rare animals as "tonic"
food in China, especially in the southern regions, raises concern for
the risk for animal-human cross-infections through contact with live and
recently slaughtered animals. The increased demand for civet cat, suspected
as the source of severe acute respiratory syndrome, is one such example.
The demand for tonic food has risen with improving economic conditions
in post-1978 China and is a form of conspicuous consumption that expresses
economic and social distinction and prestige. A Chinese medical paradigm
based on "humors" inherent in the concept of tonic food, combined
with the well-understood cultural symbolism of distinction and prestige
associated with conspicuous consumption, has lent weight to the demand
for rare and exotic animals perceived to be "pure," "safe,"
and "virile." Since this rising demand is not likely to be suppressible,
regulated production of these animals is needed to make them safe.
Additional contemporary issues in China include the effect of migration
and urbanization on the spread of sexually transmitted diseases. The forces
driving this effect can be divided into three overlapping categories:
the dismantling of the organizational and spatial structures that helped
keep order in China’s cities during the Maoist era (from 1949 to 1978);
a dramatic increase in the overall fluidity of urban societies in China
(accompanied by the erosion of traditional moral and behavioral boundaries);
and a new set of cultural values that has encouraged more urban Chinese
to think of themselves as actors with individual agency. These overlapping
forces, which are geographic, socioeconomic, and cultural, are interwoven
with and thoroughly implicated in the emergence of new behavior and lifestyles
that have put a growing number of Chinese at risk for infectious diseases.
More broadly, climate can also affect public health and emerging infectious
diseases. Factors affecting emergence can also be examined in an eco-epidemiologic
framework that can often drive epidemics. Examples include the effects
of rains and flooding on vector-borne and diarrheal diseases and the effect
of heat and fires on respiratory infections.
1Presented at the International Conference
on Emerging Infectious Diseases, Atlanta, Georgia, February 29 –
March 3, 2004, by Christopher Smith, University of New York; Gerry Keusch,
National Institutes of Health; Paul Epstein, Harvard University Medical
School; and Josephine Smart, University of Calgary.
Suggested citation
for this article:
Carroll D, Gardner
P, Kay BA, Osterholm M, Ryan ET. Transformation of the developing world:
socioeconomic matrix. Emerg Infect Dis [serial on the Internet]. 2004
Nov [date cited]. Available from http://www.cdc.gov/ncidod/EID/vol10no11/04-0797_03.htm
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