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In many Sub-Saharan African populations, in particular urban dwellers, there have been marked rises in the prevalences of obesity in women, hypertension, diabetes, and cerebral vascular disease. Yet there have been only slight rises in coronary heart disease. To learn more of the roles of the various influencing factors in the puzzling situations described, some aspects of the past and present occurrences of these diseases are described and discussed, with comparisons being made with corresponding situations in African Americans, as well as in certain white populations. Despite increases in the knowledge of influencing factors, such fail to explain fully the epidemiologic situations described. As to the future, judging from the experiences of other populations, despite continuing indigence, within the next generation significant rises in coronary heart disease in certain African populations seem to be inevitable. However, in many of those populations, in particular those in the South, the extent of changes, apart from those linked with level of socioeconomic state, will be strongly affected by the rising epidemic of human immunodeficiency virus and acquired immunodeficiency syndrome.

The subject of the future regarding nutritional status and food security, and of their ramifications in terms of nutrition-related disorders/diseases in Sub-Saharan African (SSA) populations, is a complex one. As well as social unrest, a country’s socioeconomic situation may affect food availability and, crucially, influence the generally low proportions of the Gross National Product devoted to health services. Additional determinants include changes in the roles of non-dietary adverse factors (i.e. smoking practice, alcohol consumption, physical inactivity) and of infections (i.e. gastroenteritis, malaria, tuberculosis and, particularly, HIV). As to future health in 2020, major increases in socioeconomic status are very unlikely; in fact, there has been a deterioration in some countries with food shortages affecting nutrition status and food security. However, with some measures of prosperity there are likely to be decreases in family size and falls in the proportions of children born with low birthweights or with protein-energy-malnutrition (PEM), and of children lying under the 5th percentile of growth reference standards. Simultaneously, though. there will be variable rises, especially in urban dwellers, in the occurrence of hypertension, diabetes, cardiovascular disease and certain cancers. Improvements in the health status of both children and adults are likely to be strongly affected by whether HIV infection can be controlled or whether it becomes rampant. [ABSTRACT FROM AUTHOR]

The article reflects on the several medical research projects that should be taken into consideration for South Africa. A research could be conducted to get accurate information on the causes of death in African population. A pragmatic assessment of malnutrition in schoolchildren is required in the nation. A research to get more information on the least degenerative sequelae of ageing is important.

The article focuses on the condition of public health in various countries. In the United States there is now 99% survival of infants, with life expectancy of 70-00 years and more, a far cry from the figure of 50 years in 1900. Funds for health have reached a high of 16% in the United States. The chief "killers", coronary heart disease (CHD) and stroke, have had their mortality rates almost halved, yet CHD incidence rate has not changed. Total mortality rate from cancer is stationary, or falling only slightly. The prevalence of obesity in women, and of hypertension and diabetes, already exceeds that in the white population. In most countries there is a tremendous health burden from infections, not only from malaria, but also from tuberculosis, and, more recently, from HIV infection. Rates of HIV infection in South Africa are the highest in the world; in parts, nearly 50% of antenatal African women are infected. In Spain, although mean serum cholesterol is rising, CHD mortality is falling. In Japan, although some risk factors are rising, inexplicably, mortality rates for breast and colon cancers are falling.