Development and health: The need for integrated approaches in South Africa

The impact of development policies on health are outlined within the context of epidemiological and demographic transition. Macroeconomic policies have a major impact on the nutritional status of the population; agricultural policy and particularly changing patterns of land use have in the past resulted in forced resettlement with concomitant health effects, while the development of new irrigation schemes has increased the risk of vector‐borne disease. Industrial and energy policies increase the risk of the population for a range of environmental and occupational pollutants. Several adverse health impacts associated with urbanisation include poverty‐related disease (measles, nutritional diseases); all forms of trauma (from motor vehicle accidents to interpersonal violence); behaviour injurious to health (associated with tobacco, alcohol and sugar consumption); and sexually transmitted diseases. Aids could well become a major impediment to all aspects of future development. The article concludes by recommending greater interaction between epidemiologists and economists so as to ensure that an integrated approach to development will result in enhancement of the health of people.