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Poor nutrition intake among adults, leading to either underweight or overweight, is closely associated with ill health. More than one-third of all deaths worldwide are due to ten main risk factors, and seven of these are related to nutrition (WHO, 2002b).

Persistent and growing inequities in health are increasingly evident, both between and within countries. Inequities in access to essential health services result in a poorer health status of underserved populations and increase health inequities. Inequities in health outcomes are observed for children (see Infant mortality and Under-5 mortality) and access to family planning and skilled birth attendants is unequal (see Reproductive health and  Pregnancy and birth). Inequities also exist in access to health services during and after pregnancies, prevention and also treatment in several countries in the Asia/Pacific region, but degrees of disparities are different by types of services.

Diabetes is a chronic metabolic disease, characterised by high levels of glucose in the blood. It occurs either because the pancreas stops producing the hormone insulin (type-1 diabetes), which regulates blood sugar, or through a reduced ability to produce insulin (type-2 diabetes). People with diabetes are at a greater risk of developing cardiovascular diseases such as heart attack and stroke. They also have elevated risks for sight loss, foot and leg amputation due to damage to nerves and blood vessels, and renal failure requiring dialysis or transplantation.

The health burden related to harmful alcohol consumption, both in terms of morbidity and mortality, is considerable in most parts of the world (Rehm et al., 2009; WHO, 2014j). Alcohol use is associated with numerous harmful health and social consequences, including an increased risk of a range of cancers, stroke, and liver cirrhosis, among others. Foetal exposure to alcohol increases the risk of birth defects and intellectual impairment. Alcohol misuse is also associated with a range of mental health problems, including depressive and anxiety disorders, obesity and unintentional injury (Currie et al., 2012). Alcohol also contributes to death and disability through injuries, assault, violence, homicide and suicide, and is estimated to cause more than 2.5 million deaths worldwide per year (WHO, 2014j). While many countries set age limits for purchasing or drinking alcohol, lack of enforcement and no age limits in some countries allow young people to access alcohol easily, increasing their consumption and risk of harmful consequences.

Injuries are a leading cause of death and disability for all age groups and took 2.7 million lives in 2012 in the Asia/Pacific region, accounting for 9% of all deaths. Injuries can result from traffic collisions, drowning, poisoning, falls or burns, and violence from assault, self-inflicted or acts or war. The magnitude of the problem varies considerably across countries by cause, age, sex, and income group. But deaths from injury, both intentional and unintentional, are largely preventable events.

Optimal feeding practices of infants and young children can increase their chances of survival. They play an important role for healthy growth and development, decrease rates of stunting and obesity and stimulate intellectual development.

Access to high-quality health services depends crucially on the size, skill-mix, geographic distribution and productivity of the health workforce. Health workers, and in particular doctors and nurses, are the cornerstone of health systems.

Population ageing is characterised by a rise in the share of the older people resulting from longer life expectancy (see Life expectancy at birth) and declining fertility rates (OECD, 2011b; UN ESCAP, 2013). In Asian countries, since 1990, life expectancy has increased by about seven years and fertility has decreased from 3.4 children per woman of reproductive age, to slightly below the population replacement level of 2.1. This has been mainly due to better access to reproductive health care, primarily a wider use of contraceptives (see Reproductive health). Population ageing reflects the success of health and development policies over the last few decades.

The descriptive analyses presented in this chapter are based on available data for 24 Asia/Pacific countries and economies. Much variation in health spending levels can be observed in Asia-Pacific countries in 2012 (), ranging from Myanmar’s total health spending per capita of only 25 USD PPP to Australia’s 3 985 USD PPP. The average OECD health spending per capita in 2012 was around five times that of the Asian economies (3 514 versus 738).

Medical technologies are improving diagnosis and treatment. Access to these technologies is improving, while also increasing health spending. Computed tomography (CT) scanners and magnetic resonance imaging (MRI) units help physicians diagnose a range of conditions by producing images of internal organs and structures of the body. MRI exams do not expose patients to ionising radiation, unlike conventional radiography and CT scanning. Mammography is used to diagnose breast cancer, and radiation therapy units are used for cancer treatment. But such equipment is expensive.

Despite the commitment to a national medicines policy in many countries in the Asia/Pacific region, progress on the implementation of these policies has been slow (Asia Pacific Conference on national medicine policies, 2012). For millions of people in those countries, problems of access to essential medicines remain. Medicines are often not available or affordable and they may be low quality products which may also be inappropriately used in practice. Consumer out-of-pocket expenses on medicines account for a substantial proportion of total health care expenditures, and for many people on lower incomes, these out-of-pocket expenses push them below the poverty line with major consequences.

Evidence suggests that certain socially excluded groups tend to use health services less, although these groups may need health services more. This phenomenon, sometimes referred to as inverse care law, can partly be explained by the fact that excluded groups typically face multiple barriers to access to services. This includes financial barriers, such as direct and indirect costs of accessing services.

Malaria is a tropical disease caused by a parasite transmitted by the bites of infected female Anopheles mosquitoes. After a period spent in the liver, malaria parasites multiply within red blood cells, causing symptoms such as fever, headache and vomiting. Malaria is preventable and curable, although no vaccine currently exists. But if left untreated, malaria can become life-threatening by disrupting the blood supply to vital organs.

Preterm birth (i.e. before 37 completed weeks of gestation) is the single most important determinant of neonatal deaths (i.e. during the first four weeks of life) and the second leading cause of death in children under 5 (see Under-5 mortality). Many survivors of preterm births also face a lifetime of disability, including learning disabilities and visual and hearing problems. But preterm birth can be largely prevented. Three-quarters of deaths associated with preterm birth can be saved even without intensive care facilities. Current cost-effective interventions include warmth (skin to skin contact within the first minute of birth) and early initiation of breastfeeding (within the first hour of birth) and basic care for infections and breathing difficulties (WHO, 2013f; see Indicator 1.2 Infant mortality). Preterm birth rates can be also reduced if women, particularly adolescents, have better access to family planning and increased empowerment, as well as improved care during pregnancies (see Reproductive health).

Health at a Glance: Asia/Pacific 2014 presents key indicators on health status, determinants of health, health care resources and utilisation, health expenditure and financing, and quality of care for 27 Asia/Pacific countries and economies. Countries in the Asia/Pacific region are diverse, and their health issues and health systems often differ. However, these indicators provide a concise overview of the progress of countries towards achieving universal health coverage for their population.

Childhood vaccination continues to be one of the most cost-effective health policy interventions. Nearly all countries and economies have established vaccination programmes based on their interpretation of the risks and benefits of each vaccine. Coverage of these programmes can be considered as a quality of care indicator. Pertussis, measles and hepatitis B are taken here as examples as they represent, in timing and frequency of vaccination, the full spectrum of organisational challenges related to childhood vaccination.

Tuberculosis (TB) is the leading cause of death from an infectious disease in the Asia/Pacific region. In 2012, there were 5.5 million new TB cases in the region, out of 8.6 million new cases worldwide, 1.3 million including people with HIV died of TB globally. Most of these TB cases and deaths occur disproportionately among men, but the burden of disease among women is also high as it remains among the top three killers for them in the world. Most cases of TB are preventable if diagnosed and the right treatment is provided. The internationally recommended Stop TB Strategy is recognised as being efficient and cost-effective.

Basic care for infants and children includes promoting and supporting early and exclusive breastfeeding (see Infant and young child feeding), identifying conditions requiring additional care and counselling on when to take an infant and young child to a health facility. There are several cost-effective preventive and curative services for leading causes of childhood morbidity and mortality worldwide. These include vitamin A supplementation, measles vaccination, oral rehydration therapy (ORT) for diarrhoea, and antibiotic treatment for acute respiratory infection (ARI). Access to these services leads to better infant and child health.