Can debates about poverty in developing countries enrich debates about health in developed countries, in International Perspectives on Equity and Health: as seen from the UK, (ed by A Oliver), The Nuffield Trust: London, 2002

This paper is written primarily for people working on health and health inequalities in the UK. Its main purpose is to suggest that the current debate about poverty reduction in developing countries can, as the title suggests, enrich the debate about health in developed countries (see also Maxwell and de Haan, 1998; Maxwell, 2000; Maxwell and Kenway, 2000). Partly, this is a question of delving into what I call the 'Smartie box', looking for interesting comparisons between experiences in North and South. More ambitiously, it involves looking for explanations of poverty and inequality, including in the field of health, which cut across an increasingly artificial geographical divide. Here, globalisation provides a convenient and informative analytical frame.

My own interest is in food and nutrition, rather than health obvious. Under-nutrition has an adverse impact on the survival, growth and the health of children, as well as on the intelligence and productivity of both children and adults (Box 1).

Foetal under-nutrition also has a direct connection with ill-health in later life, particularly obesity, late onset diabetes and hypertension. Over-nutrition, of course, has similar outcomes. This twin onslaught helps to explain the explosion of chronic dietary disease (CDD) among adults in developing countries, presenting a new 'double-burden' for health services, which are required to take on the new burden of CDDs as well as the old burden of high mortality and morbidity among children. The numbers are improving, but not fast enough, especially in Africa (Box 2)................. (see link in title for full article)