Community Health Problems in the Gulf Countries
F. M. SHATTOCK
The epidemiological pattern in the Gulf countries is of special interest in that it reflects the stage between a less developed country and a fully developed one. In the less developed countries, underlying the community health problems are poor socioeconomic circumstances, a small governmental budget and a large child population with high mortality from poor sanitation, malnutrition and infectious diseases. In a developed country the problems are those of the chronic diseases, most of which are due to life-style, the increasing number of elderly and a limited budget in relation to high-technology medical care.
The Gulf countries have a considerable burden of childhood infectious disease, though with a considerably smaller mortality rate, a high proportion of children under the age of fifteen who account for 32 to 45% of the population and a community health problem of subnutrition but very little serious malnutrition. In addition, there is the increasing burden of obesity, diabetes, heart disease, cardiovascular accidents and carcinomas reflecting the epidemiological pattern of a developed country.
In Qater there were 392 deaths in 1980. The first five causes of death were heart disease (18.2 percent), perinatal conditions (19.4 percent), senility (11.2 percent), neoplasms (8.7 percent) and pneumonia (6.9 percent). 1 A total of 20.5 percent of the deaths involved children under the age of five years. (In lesser developed countries, deaths in that age group usually account for 40 to 50 percent of total deaths.)
In most parts of the Eastern Mediterranean region, the climate is arid; where there is no irrigated land, food availability and farmers' income are heavily dependent on rainfall. In many of the countries there is a very low investment