Southeast Asia and Western Pacific Mortality and Physician Demographics


By Jiano Magdaraog

Good health and the means by which it can be maintained are fundamental human rights, as declared in Article 25 of the United Nations’ Universal Declaration of Human Rights. Most commonly associated with the pursuit of good health is the figure of the physician, from the friendly neighborhood pediatrician to the emergency room doctors burning the midnight oil to tend to the needs of those who require immediate attention. Physicians play an important role to human society, but one cold reality of this world is that there are some places where physicians are in far too short supply. With this in mind, it is reasonable to believe that there is a link between having a low presence of physicians and suffering from a high mortality rate.

In analyzing the correlation of mortality rates and physician populations, Asia provides opportunities for an interesting case study. Hyper-urbanized zones such as may be found in Japan, China and Singapore exist in stark contrast to the backwaters and hinterlands that still remain. Images of starving children in Africa tend to come to mind when considering the difficulties of life, but with its variety of dense jungles, arid steppes and nigh-inaccessible mountain settlements, the furthest reaches of Asia may be even more beleaguered.

The premise of this project is to collate data on the number and density of physicians in countries from the South-East Asia and Western Pacific regions of the World Health Organization (WHO) as well as the mortality rates of those same nations divided by cause of death. The WHO groups mortality into three categories, segregating rates according to whether they were the result of injury, communicable disease or non-communicable disease.

Data Used

Vector Data

The shapefile from which the vectors are derived was downloaded off of (http://thematicmapping.org) on recommendation from the author’s advisor. The countries listed by the WHO as belonging to the two regions stated above were isolated, along with three territories that belong to the vicinity but are not members of the WHO, namely the Republic of China (Taiwan), Hong Kong, and Macau. Latitude and longitude were also marked at 15º intervals, to help specify the locations of the countries involved.

Attribute Data

Data and statistics were made available by the WHO for public access on their online Global Health Repository at (http://apps.who.int/ghodata/). Figures on physicians were acquired by viewing aggregated health workforce data and taking absolute numbers and density of physicians per 1,000 people. Data regarding age-standardized mortality by cause was used directly and also used as a basis for combined mortality rates.

Method of Mapping

Two maps were created over the course of this project, one for data on physicians and the other for mortality rates by cause. Both make use of choropleth mapping; in the former, the number of physicians present per 100,000 people increases as the shade of colors goes from red to green, whereas in the latter overall mortality rates soar from green to red. The physician map also makes use of proportional symbols to represent the absolute number of physicians present in each country, while the latter employs pie charts to illustrate the distribution of mortality between the three cause categories.

The Mercator projection is used as the territories involved are merely being identified and need not be measured. Since all pertinent areas are sufficiently distant from the polar regions, any distortion of size is negligible. Both maps feature an inset using the Robinson projection, which the author found more aesthetically pleasing for a global map.

Challenges

The author had not originally intended to create more than one map. However, he realized soon after beginning work that the outcome would be far too cluttered to be of any use, given all the variables to be measured and the tables he wished to include. Wishing to keep the layout as direct and uncomplicated as possible, he decided that it would be best to split the data between multiple maps, eventually finding a way to keep the number down to two.

The author had also meant to make use of bar graphs in the mortality rate map to show the division of mortality by cause. Upon applying this method, he saw that this had caused an unwanted number to appear in the legend. Said number defied the author’s attempts to have it removed, even after requesting assistance from his advisor. Unable to remove the number by other means, the author found that it did not occur when pie charts were used and decided to use this symbol scheme instead.

Target Audience

Physicians are the central character of this map project, and as such those are one of them, work with them or aspire to become one of them are the primary audience. The maps point out places where they are most needed and would be of interest to doctors considering possibilities of employment in the area. Medical students stand to benefit from learning if their home countries are suffering from high mortality and/or low physician presence. The use of this map also extends to people associated with government work. They may be used to help determine if states should encourage the growth of the medical industry and set policies to mitigate deaths sustained due to whatever leading factor makes the most impact on their mortality rates.

Even though the subject of this project caters mainly to the medical field, this is no reason to preclude the general public from making use of the provided information. Indeed, this is a matter that concerns them greatly, being tied to their well-being. They stand to benefit from understanding how well equipped their society is to provide doctors to tend to their sick and injured, and they need to be aware of the greatest general threats that face their health. The maps are meant to be simple enough that even a person who is not well-versed in medical knowledge can interpret them.

Concluding Remarks

The maps presented here are simple and without glamour, but they are straightforward in their presentation. There is always some danger of losing the message in the medium when too much thought goes into pomp and frippery, and the author chose to err on the side of blandness rather than overlook what is essential. In the end, what matters most is that the point is made and action is taken.

Maps are tools whose ability to sway opinions and shape thought can be quite profound in their effects. Those given the means and the responsibility to create them must always remember this and strive to use their creations to promote the betterment of society. A well-made map in the right circumstances is capable of helping contribute to change for the better.

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