DP Exam Questions on Food and Health

Optional Theme F — The geography of food and health

May 2011

The graph shows the percentage of farm income from agricultural subsidies in 1990 and 2006 for 11 countries and the European Union (EU).
11. (a) (i) Describe the pattern of agricultural subsidies in 2006. [2 marks]
1mark for any valid general statement, such as agriculture subsidies are higher in the Northern hemisphere than the Southern hemisphere, or agricultural subsidies are higher in European nations than in North America or Australasia, with an additional mark for any supporting quantification. No credit given for a simple list.

(ii) State two reasons why agricultural subsidies have declined in most countries since 1990. [2 marks]
1 mark each for any two valid reasons. These reasons include the reallocation of government resources since 1990 into other sectors of the economy; and the influence of the role of civil society or international trade organizations and their attempts to regulate subsidies.

(b) Explain how the actions of TNCs can reduce the availability of food. [6 marks]
There are numerous possible ways in which TNCs can reduce food availability. They may encourage an emphasis on the growing of non-food cash crops rather than food crops. They may gain control of the supply of seed for one or more basic crops; this seed may then be priced beyond the means of the average farmer or the seed may require higher than affordable investments in infrastructure or equipment in order for high yields to be obtained.
At least two actions must be explained for the full 6 marks.
1 mark for each valid action, plus an additional mark for explaining it, and a final 1 mark for an example, quantification or further detail.

(c) To what extent were human factors responsible for a recent famine? [10 marks]
You are expected to consider a range of human factors and other factors (such as physical/environmental, economic and political) in their responses. You need to clarify how each factor affected the occurrence, severity and outcome of a particular famine.
Possible human factors include: age and education of agricultural workforce; extent to which population is concentrated in a few large cities, or dispersed across a wide area; migration flows.
Economic factors include: ability to purchase food supplies from outside the area or country; deficiencies in the transport system reducing the effectiveness of food distribution; lack of capital to replant or restock farms.
Political factors might include: war and refugee movements; refusal to accept international food aid.
Possible physical/environmental factors include: soil degradation; climate change; natural hazard events such as hurricanes or earthquakes.
While most are likely to conclude that human factors are not the main cause of famine, all conclusions should be judged strictly on the merits of the arguments presented and the example chosen.
Answers arriving at a clear conclusion about the relevance of human factors to a specific recent famine are likely to be credited at band D and above.
If you refer to more than one famine event in different countries, only the best one should be credited.

12. The graph shows the rates of disease in a city in India between 1991 and 2001.
(a) (i) Describe the trend in diseases spread by diffusion between 1991 and 2001. [2 marks]
1 mark for the recognition that the number of cases of diseases spread by diffusion fell between 1991 and 2001, and an additional mark for some quantification or recognition of anomaly.

(ii) Describe what is meant by “diffusion by relocation” with reference to a disease. [2 marks]
Diffusion by relocation occurs when individuals infected with a disease move [1 mark] to a new, perhaps distant location and the disease spreads [1 mark].

(b) Explain the global distribution of diseases of poverty. [6 marks]
Diseases of poverty include many infectious and parasitic diseases, as well as diseases related to vitamin and/or calorie deficiencies. The global distribution is related to economic and social development, though pockets of diseases of poverty can also exist in developed nations. Factors include lack of access to adequate medical care because of costs and/or poor availability; poor quality of water supply; high levels of environmental pollution; poor levels of sanitation. At least two distinct factors must be treated in detail for the award of the full 6 marks. Alternatively, a greater number of factors can be explained in less detail for the award of full marks. If you only describe the distribution your mark will be limited to a maximum of 3 marks.
Alternative approaches should be considered on their merits.
No credit may be given for any explanations that relate directly to diseases of affluence (degenerative diseases, cancers, heart disease).
Referring to one or more diseases, discuss the factors that determine the relative importance of policies of disease prevention as opposed to policies of treatment.
Numerous factors are relevant to this response, depending on the particular disease or diseases chosen. They include: relative costs per patient of treatment compared with prevention; cost, effectiveness and availability of disease-specific preventative measures such as vaccinations; whether or not the disease in question spreads by diffusion, and if so by which type of diffusion; potential long-term health or economic impacts of an outbreak of the disease in question; pressure from disease-specific non-governmental organisations.
Responses which show a good knowledge of one or more diseases and which discuss both prevention and treatment policies are likely to be credited at band D or above.

November 2011
(a) (i) State one other indicator besides infection rates which could be used to map the health of people in this city. [1 mark]
1 mark for any valid indicator that might produce a spatial pattern. Possible answers include the number of people per doctor (or per clinic/hospital) in each zone; life expectancy or infant mortality rate in different districts. Other valid responses accepted.

(ii) Referring to the map, describe the pattern of this disease in the city. [3 marks]
This disease is concentrated in the north-eastern sector of the city (Gajrawadi, Fatepura, City and Panigate) [1 mark]. Rates are low in the west of the city (Belbaug, Subhanpura and Sayajigunj) [1 mark]. Some responses may also identify the mid-range concentration forming a north- south belt (Raopura, Shiyabaug and Sindhvaimata Road). 2 marks for the recognition of the general pattern with another mark reserved for specific reference to the map.

(b)  Explain three possible reasons, one environmental, one social and one economic, for this pattern. [3×2 marks]
Examples of possible reasons include:
Environmental: high rate areas may be at lower altitude, where water collects, or may be on unstable ground where water pipes frequently rupture, contaminating the water supply.
Social: people living in overcrowded conditions may be more likely to share contaminated water sources and catch the disease; different ethnic groups may have differing views about drinking untreated water.
Economic: people living in high-rate areas may be less affluent, and therefore unable to afford preventative measures such as water purification or vaccination, and may have to work even during an epidemic, increasing their chances of catching the disease.
1 mark for each valid reason, and a further mark in each case for any valid development or detail.

(c) “Poverty is the main cause of food insecurity.” Discuss this statement. [10 marks]
Answers are expected to consider both sides of this question. Poverty may cause or exacerbate food insecurity because families in poverty may be unable to afford food even though supplies are (physically) available. Poverty makes it unlikely that families can retain a reserve of food to tide them over bad times, or guarantee them seeds for planting the following year. On the other hand, food insecurity may also be caused by natural hazards, such as droughts, reducing food availability, or by earthquakes and hurricanes disrupting food supply chains and normal distribution channels. Food insecurity may also result from wars, conflicts, and from external forces such as the actions of NGOs and effects of government subsidies.
While it is likely that most will conclude by agreeing with the statement, this is by no means the only possible conclusion. All responses judged strictly on their own merits.
Responses that discuss both sides of the question and arrive at a conclusion in line with the evidence selected are likely to be credited at bands E/F.

12. The graph shows the total food production and food production per person in Country A, 1962–2010.
(a) (i) State the year when the index of total food production was greatest. [1 mark]
Either 1996 or 1997 accepted [1 mark].

(ii) State the value of the food index per person in 1970. [1 mark]
Any answer accepted within range 140–150 inclusive [1 mark].
(b) Describe the trend in total food production shown on the graph. [2 marks]
Total food production is rising [1 mark] with another [1 mark] for quantification or recognition of any anomaly.

(c) Suggest reasons for the trends in total food production and in food production per person from 1962 to 2010. [6 marks]
1 mark for a brief description of each valid reason, and a further mark for developing it by means of example, explanation or detail. Both total food production and food production per person must be covered, though not necessarily in equal depth for the awarding of the full [6 marks].
Possible reasons for the increase in total food production include: a greater area of land under cultivation due to land improvement (drainage, irrigation) or land clearance; higher crop yields due to better agricultural techniques; the application of fertilizers, biotechnology or improved seeds; higher productivity due to effective pest control measures or application of improved technology.
The main reason for the decline in food production per person is an increase in population, which in turn may be due to either natural increase or in-migration.
Some may refer to the anomalies which is also acceptable, but reasons for anomalies such as natural hazards, wars and plagues, should not receive more than 2 marks out of the total 6 marks available.

(d) Examine the geographic connections between food availability and health. [10 marks]
There are many links between food availability and health. Health is generally better in areas of higher food availability: vitamin and calorie-deficiency diseases would be less likely; immune systems would be more robust; recovery from disease faster. On the other hand, too much food being available can lead to other health issues related to being overweight or obese. Greater food availability is often linked to economic development. Assuming this link is made explicit, responses may legitimately include reference to related aspects such as improved medical care, vaccinations and preventative measures.
Some may subdivide food availability into different categories, such as economic food availability and physical food availability. However, this is not necessary for the awarding of full marks.
To reach bands E and F, you need to look at health issues in relation to shortage and excess food availability.

May 2012

11. (a) (i) Define the term health-adjusted life expectancy. [2 marks]
Health-adjusted life expectancy (HALE) is the life expectancy [1 mark] adjusted for time spent in poor health due to disease and/or injury [1 mark].
It can also be defined as the equivalent number of years of full health [1 mark] that a newborn can expect to live [1 mark], based on current rates of mortality and ill-health.

(ii) State one reason why this is a better measure of the health of a population than child mortality. [2 marks]
There are many possibilities. Child mortality reflects the health of mothers and young children, whereas HALE reflects the entire population, including the elderly. The costs and policies associated with the provision of health services in a society are probably better judged by HALE than by child mortality. Award [1 mark] for a valid reason with an additional [1 mark] for further development, such as quantification or exemplification.

(b) Referring to one or more diseases, explain how three geographic factors influence the spread of disease. [2+2+2 marks]
Depending on the disease(s) chosen, many different geographic factors may be relevant, including climate, relief, transport lines and connections, incidence of hazards such as flooding, availability and access to methods of prevention (e.g. vaccination) or cure, population density, mobility, religion, politics, poverty. Award [1 mark] for each valid factor, with an additional [1 mark] for further development, clearly linked to the spatial diffusion/spread of the disease. Award a maximum of [2 marks] if no diseases are named.

(c) “Affluent societies are less affected by disease than those with a high level of poverty.” Discuss this statement. [10 marks]
There are few simple relationships between poverty/affluence and the incidence of disease. At a global level, a distinction is recognized between the so-called “diseases of affluence” (type 2 diabetes, heart disease, cardiovascular disease, some forms of cancer, asthma, allergies, depression, some psychiatric illnesses) and the “diseases of poverty” (AIDS, malaria, tuberculosis, pneumonia, measles, cholera, typhoid, malnutritional diseases, dysentery, diarrhoeal diseases). In practice, both groups of disease often co-exist in any one society, with their incidence depending on income levels and other socio-economic characteristics.
Higher life expectancies in affluent societies may explain the higher incidence of diseases of affluence, most of which are degenerative, chronic and non-communicable. Diseases of poverty tend to be linked to infections, inadequate environmental health regulations or poor hygiene; they are often communicable. Rapidly developing countries may have relatively high levels of both groups.
Candidates should discuss the statement not only in terms of the distribution or incidence of disease, but should also look at other effects. These include the financial costs associated with disease prevention, treatment options and public health facilities, the possible economic consequences of disease in terms of reduced workforce productivity, the social costs of any disease linked especially to a particular age-group, such as women of child-bearing age.
Answers with developed examples or case studies are likely to be credited at bands E/F.

12. The map shows the energy efficiency ratios for agriculture in selected provinces in Canada.
(a)   Identify the province with the most efficient energy ratio. [1 mark]

(b) Describe the pattern of energy efficiency ratios shown on the map. [3 marks]
The lowest (least efficient) energy efficiency ratio is in British Columbia; the highest (most efficient) ratio is in Saskatchewan. Larger provinces (in area) tend to have lower ratios than smaller provinces, but overall there is not a very clear pattern. The Eastern seaboard has medium to high values; the lowest value is on the West coast.
The overall pattern is of distance decay from Saskatchewan with the provinces in eastern Canada representing an anomaly. 1 mark each for any valid statements.

(c) Suggest three reasons why energy efficiency ratios vary within a country or region. [2+2+2 marks]
Energy ratios depend on numerous factors, including the technology employed in agriculture (e.g. glasshouses are much less efficient than open field farming); methods of cultivation (generally, subsistence farming is more energy-efficient than commercial farming); the precise crop(s) grown (e.g. growing peas has a lower energy ratio than growing wheat or maize); the climate (energy ratios are often more efficient in warmer, wetter areas, than in cooler, drier areas, because of differences in biological productivity); the soil type (which also results in different yields or levels of productivity).
Award [1 mark] for each reason stated (provided it links to energy efficiency) and [1 mark] for further development.

(d) Examine recent changes in agricultural systems that have led to increased food availability in some areas. [10 marks]
Candidates may interpret the term “agricultural systems” in its narrowest sense, or may adopt a more inclusive definition, to include technological innovations and changes to the area being farmed.
In general, recent changes have tended to increase crop yields, and improve the availability of food. However, these changes may be at the cost of decreasing the sustainability of farming (since they may cause a decline in energy efficiency), or of higher expenditures on other inputs, such as fertilizers.
Food availability is not only a function of how much food is produced or enters the marketplace. It is also related to political factors and economies, and in particular to the relationship between income levels in a society and food prices. Even in an affluent society, some low income groups may not have access to sufficient food. In other areas, the changes in agricultural systems may be focused on raising the production of non-food cash crops at the possible expense of local food crops.
Answers accessing markbands E and F are likely to examine a number of changes in some detail, and refer to examples and case studies.

November 2012

11. (a) Describe the difference between malnutrition and low calorie intake. [2 marks]
Malnutrition means an inadequate/unbalanced supply of energy, vitamins or other food-based nutrients (malnutrition includes both under- and over-nutrition) [1 mark]. Low calorie intake is a subset of malnutrition and is therefore a condition where people receive insufficient calories to maintain a healthy weight [1 mark].

The map shows part of the global pattern of low calorie intake (undernourishment).

(b) Describe the pattern of undernourishment shown on the map. [2 marks]
The highest rate/prevalence of undernourishment (over 50 %) is in central Africa [1 mark], especially the DRC [1 mark]. South/southeast Asia is generally lower than Africa but higher than Europe/Russia/Australia [1 mark].
Other important features that may be awarded [1 mark] include: low levels in north Africa and south Africa; lower levels in the Middle East; higher value (may describe as anomaly) in Mongolia/central Asia.
For the award of full marks some quantification is necessary.
N.B. country names are not essential for the award of the full [4 marks].

(c) Explain two economic causes of food deficiency.  [2+2 marks]
The economic causes of food deficiency include: price increases in staple food items (regardless of why or how they arise, whether from local changes or changes in other regions or countries); transition from food-based agriculture to non-food commercial or export agriculture; inadequate transport infrastructure for food (including food aid) to be supplied and/or distributed efficiently; failure to invest in irrigation projects meaning that the area is unable to cope in times of low rainfall or drought. Credit other valid causes.
Award [1 mark] for each valid cause, with a further [1 mark] for its development.

(d) With reference to any one vector-borne, water-borne or sexually transmitted disease, compare its geographic impacts at the local and international scales.  [10 marks]
The response will depend on the disease selected. The relative importance of local and international scales will differ depending on the disease selected.
Some diseases, such as river blindness, have a serious local impact (and some national impacts) but relatively few or no international impacts. Other diseases, such as SARS and A-H1N1 influenza have the potential to impact all scales. Knowledge of the biology/pathology of the chosen disease is not expected, except in so far as it determines specific impacts of geographic importance.
Responses accessing band D and above should refer to both scales, though the amount of depth for each scale need not be equal. Credit should only be awarded for a single disease. In the case of responses which consider more than one disease, the disease scoring most marks should be credited.
Responses reaching bands E/F are expected to show accurate knowledge of a disease, and to consider a range of impacts before concluding whether or not the impacts are similar at the two scales.
Marks should be allocated according to the markbands.

12. (a) Briefly describe what is meant by “obesity”.   [2 marks]
BMI (Body Mass Index) over a certain number / a form of malnutrition [1 mark], usually resulting from energy (calorie) intake exceeding the amount required [1 mark].

(b) Suggest why heart disease is considered a “disease of affluence”.  [4 marks]
Rates of heart disease are lower in poorer countries than in richer/wealthier/more developed countries [1 mark]. Award [1 mark] for each factor that is explained. These may include dietary factors e.g. a high fat intake (especially high saturated fat), high levels of “bad” cholesterol, and obesity. Lifestyle factors include insufficient physical exercise, stress levels, preference for sedentary occupations, reliance on powered forms of movement such as motor vehicles rather than walking, and decision to spend discretionary income on particular kinds of food.
For [4 marks] both dietary factors and lifestyle factors should be addressed. A wide range of suggested factors may compensate for depth of explanation.

(c) With the aid of a diagram or diagrams, explain the spatial process of a disease spreading through “diffusion by relocation”. [4 marks]
Relocation diffusion involves the movement of individuals [1 mark], taking the disease with them to new locations [1 mark] where it continues to spread through contact with then more people (e.g. airline passengers) [1 mark]. Credit other valid points, including an example of a disease such as SARS for [1 mark]. Responses which do not include a diagram may not be awarded more than [3 marks].

(d) Examine the factors which have led to more food becoming available in some areas in recent years.  [10 marks]
Numerous factors can result in more food becoming available.
The first major group of factors is those related to the improved productivity and/or total production of food-related agriculture. These factors include: increased area under cultivation as a result of land clearance and/or irrigation; higher yields due to better technology (e.g. drip irrigation instead of flood irrigation), mechanization, improved varieties (including GM crops and livestock).
Distribution and storage is also important. More food may become available because less is lost or damaged in transit as a result of improvements in the distribution network (highways, rail, planes) or in the vehicles used (e.g. refrigeration). Improved packing methods may also be important. Subsidies to local farmers for food crops, and reductions in food exports may also raise the amount of food available locally. Equally, a rise in income may also increase the availability of food within some sectors of society.
Increased food imports also play a part, and this means that increased availability of food may depend on the success of harvests a long way away from their eventual destination.
While changes of climate may bear some responsibility for increased food availability in some areas, this will normally be restricted to those areas which were previously suffering from a prolonged condition such as an extreme drought.
It is expected that responses reaching markbands E/F will consider a variety of factors, and support their ideas with accurate examples.