Here is a clear, exam-oriented but concept-deep explanation of the image, as if I am your Community Medicine professor.
Socio-Economic Indicators of Health
The mnemonic given is:
H – FLAGGED
Each letter stands for one major socio-economic indicator.
1. H – Housing (Number of persons per room)
Why it matters:
- Overcrowding increases respiratory infections (TB, ARI), diarrheal diseases, mental stress.
- Poor housing → poor ventilation, damp walls → higher vector breeding, mold, asthma.
- Housing is a classic marker of poverty and living standards.
What we measure:
- Persons per room
- Quality of house (pucca/kutcha)
- Ventilation, lighting, sanitation facilities
- Overcrowding index
2. F – Family Size
Why it matters:
- Large family size indicates high fertility, low use of contraception, low female autonomy.
- More dependents → poorer resource distribution → malnutrition, poor schooling, poor health-seeking behavior.
- Smaller family → better per-capita spending on health and education.
3. L – Literacy Rate (especially female literacy)
WHY female literacy?
Female literacy is the single most powerful socio-economic determinant of health because:
- Educated mothers → better nutrition, child care, hygiene, and health-seeking behavior
- Better uptake of immunization, family planning, sanitation practices
- Reduced infant and maternal mortality
- Improved decision-making and autonomy
Thus, literacy is strongly correlated with life expectancy and lower mortality.
4. A – Availability of Per Capita “Calorie”
Why this matters:
- Direct measure of nutrition adequacy in a population
- Low per capita calorie availability → protein-energy malnutrition, stunting, anemia
- Also reflects the economic ability to access safe, sufficient food.
This is a major indicator used in poverty estimation (Tendulkar, Lakdawala committees).
5. G – GNP Per Capita (Gross National Product per capita)
Why?
- Most widely used economic indicator of a nation’s health.
- Higher income → higher spending on healthcare, education, and better living conditions.
- It correlates strongly with:
- Life expectancy ↑
- Infant mortality ↓
- Maternal mortality ↓
- But: GNP alone does not reflect distribution of wealth (inequality).
So we often supplement it with HDI (Human Development Index).
6. G – Growth Rate of Population
Why important?
- High growth rate → burden on resources → poverty, unemployment, malnutrition
- Indicates inadequate family planning services
- Also reflects socioeconomic stress in the population.
A stable or declining growth rate is a marker of demographic transition and improved living standards.
7. E – UnEmployment Level
(Here the mnemonic uses “E” from “UnEmployment”)
Why unemployment affects health:
- Unemployment causes poverty, mental stress, depression
- Poor access to healthcare → delayed treatment
- Increased risk of alcoholism, substance abuse
- Affects purchasing power for food, housing, sanitation.
Thus unemployment is a sensitive indicator of economic stability and community well-being.
8. D – Dependency Ratio
Definition:
Ratio of dependents (children <15 + elderly >60) to the working-age population (15–59 years).
Why it is important:
- High dependency ratio → more economic burden on each earning member
- Indicates poorer resources for health, schooling, nutrition
- Elderly dependents increase need for healthcare services
- Child dependents reflect high fertility and poor family planning uptake.
Lower dependency ratio → healthier and economically stable society.
Summary Table (Quick Revision)
| Indicator | What it Reflects |
|---|---|
| Housing | Overcrowding, hygiene, living conditions |
| Family size | Fertility, resource strain |
| Literacy | Knowledge, health behavior, empowerment |
| Calories per capita | Nutritional adequacy |
| GNP per capita | Economic strength |
| Growth rate | Demographic transition |
| Unemployment | Economic security |
| Dependency ratio | Economic burden |
Why are these important in Community Medicine?
Because these indicators help us:
- Assess root causes of disease
- Plan health programs
- Allocate resources
- Measure impact of social welfare schemes
- Understand health inequalities
They complement mortality and morbidity indicators to give a holistic picture of health.
If you want, I can also explain HDI, Physical Quality Life Index, or Social Indicators vs Economic Indicators with diagrams.
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