Question
Briefly describe what is meant by “obesity”.[2]
Suggest why heart disease is considered a “disease of affluence”.[4]
With the aid of a diagram or diagrams, explain the spatial process of a disease spreading through “diffusion by relocation”.[4]
Examine the factors which have led to more food becoming available in some areas in recent years.[10]
▶️Answer/Explanation
Markscheme
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].
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.
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].
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.
Marks should be allocated according to the markbands.
Examiners report
Most candidates understood obesity as the result of excessive food intake but references to the BMI were less common.
Well-recognized factors were included but there was failure to elaborate sufficiently for all four marks.
A common error was the disease seemed to be travelling by plane to another country with no mention of the vector. Or people carrying malaria to another country and passing it on. Most candidates attempted a diagram of some sorts. Generally, the process of diffusion was not well understood and there were few diagrams that related well to the concept.
Answers tended to be superficial and were narrowly focused, with few candidates being able to refer to a range of factors other than those related to the Green Revolution, which is hardly a recent phenomenon. Failure to examine in depth was the main issue with this question. Many concentrated just on improved productivity, for example, mechanization, high yielding varieties, and did not really explain how they led to more food availability.
Question
Briefly describe what is meant by “diseases of affluence”.[2]
State two examples of diseases of affluence.[2]
Explain why health-adjusted life expectancy (HALE) is a better way to quantify the health of a community than infant mortality.[6]
To what extent have the management strategies for one named disease been successful? Refer to one country or region in your answer.[10]
▶️Answer/Explanation
Markscheme
Rich societies suffer [1 mark] (from health conditions not commonly found in poor societies). They include the degenerative diseases associated with different lifestyles and/or increased overall life expectancy [1 mark].
Coronary heart disease; cancer; asthma; type 2 diabetes; peripheral vascular disease; obesity; hypertension; some allergies. Some sources also include clinical depression and other mental health conditions. (Do not credit diseases of poverty: malaria, tuberculosis, measles, pneumonia, and diarrheal diseases. Do not credit AIDS.)
Infant mortality reflects health of mothers, nutrition, health care education and services. Many countries have reduced infant mortality with relatively small investments in health care services. Infant mortality is a “snap-shot”, reflecting a limited time period.
The HALE includes many more health-related issues, and all age-groups. It also reflects a longer time period, including infant mortality, but also including mortality of other age-groups, and more importantly, ill-health throughout the population. Award up to [3 marks] for the explanation of how each measure is used to quantify health. For full marks, HALE must be clearly shown to be the better measure.
The country or region must be clearly named and located. The disease should be identified. More than one management strategy should be examined. Strategies could involve prevention, treatment (palliative or curative), control/containment, public health measures. Each strategy should be clearly outlined in terms of its aims and methods, and the degree of success or failure should be evaluated.
To achieve band D the answer must describe relevant strategies to combat a named disease in a specific location.
To access bands E and F there should be some consideration of the merits of the strategies and a conclusion presented.
Marks should be allocated according to the markbands.
Examiners report
There were few problems.
There were few problems.
Generally well answered, with a good understanding of both terms and the benefits of HALE. Most failed to develop both indicators in sufficient depth. Weaker answers were descriptive and did not compare HALE with infant mortality rate.
Some very good responses with detailed case studies, a well-located region and disease and evaluation of the effectiveness of strategies. Responses tended to be on HIV/AIDS or malaria although there were a few less successful answers on swine flu. In some cases, the choice of a region or country was a problem, with vague answers being given about sub-Saharan Africa. A surprising number used cures from the last century.
Question
(i) Outline what is meant by the term “diseases of affluence”.
(ii) Briefly describe the global distribution of diseases of affluence.[4]
Referring to one named water-borne or vector-borne disease, distinguish between policies relating to its prevention and policies relating to its treatment.[6]
Examine the effects of transnational corporations (TNCs) and fair trade on the level of sustainability of agriculture.[10]
▶️Answer/Explanation
Markscheme
(i)
Award [1] for each valid point from the following:
- mainly affect wealthier people
- due to longevity/sedentary lifestyle/diet/lifestyle choices
- or an example, eg cancer.
(ii)
Primarily economically wealthy countries [1], but also in some socio-economic groups within less wealthy countries [1].
Award maximum [3] if no specific disease named, or disease is not either water-borne or vector-borne, eg HIV/AIDS, Ebola.
Award maximum [4] if policies only relate to either prevention or treatment.
For example:
Malaria is a vector-borne disease, carried by mosquitoes [1].
Policies related to malaria prevention include: Award [1] each.
- removing/covering open bodies of still water (ponds, buckets, puddles)
- eradicating mosquitoes (spraying)
- encouraging use of bednets, preferably pre-sprayed with mosquito pesticide
- encouraging use of anti-malarial tablets.
Policies related to malaria treatment include: Award [1] each.
- ensuring rapid diagnosis (provision of laboratories, training of medical staff, including doctors) ensuring easy access to medical attention and medicines needed to treat malaria (healthcare systems, education, purchase of stockpiles of malarial medicines)
- establishing a national database of malarial patients so that they might be treated more effectively and appropriately.
The relationship between TNCs and sustainability is complex. While some TNCs probably increase agricultural sustainability, others probably decrease it. Equally, the actions of some TNCs probably have no effect on sustainability whatsoever.
An example of how sustainability might be increased is when TNCs introduce/adopt more efficient irrigation techniques (such as drip feed instead of flood irrigation) to grow crops. However, sustainability is only increased if the pumping of water for the new irrigation system does not involve using large amounts of additional energy coming from non-renewable sources.
On the other hand, TNCs that introduce GM herbicide-resistant crops may decrease sustainability. For example, some TNCs have patented or otherwise protected their rights to certain types of seed, meaning that farmers have to purchase new seed every year and are no longer allowed to use seed from a previous crop, as is normally done in conventional farming. This may be economically unsustainable, especially over the long term. In other cases, for example where the seed of some hybrid crops will not germinate and grow new crops, the changes brought by TNCs may be ecologically unsustainable.
The adoption of fair trade is designed to increase sustainability, especially the social and economic aspects of sustainability. The discussion of fair trade might extend into considering the sustainability of marketing and supply chains. This should not be penalized but is likely to be self-limiting given the wording of the question.
TNCs and fair trade are not always mutually exclusive. One example of an overlap between TNCs and fair trade is Starbucks coffee. The firm is a TNC, but it advertises and commercializes fair trade products.
Candidates are expected to show some awareness that the concept of sustainability has several strands, including economic, environmental and social. It is also likely that many candidates will refer to ways in which sustainability can be measured/assessed. The strongest responses are likely to include references to food miles and/or energy efficiency as measures of sustainability.
It is not necessary for TNCs and fair trade to be discussed in equal depth for the award of full marks. A strong, evidenced discussion of TNCs may well offset a weaker discussion of fair trade, or vice versa.
Responses at band D are likely to describe some ways in which TNCs and/or fair trade affect sustainability of agriculture.
At band E, expect either greater explanation of how TNCs and fair trade affect sustainability of agriculture or some explicit examination of what is meant by sustainable agriculture.
At band F, expect both.
Marks should be allocated according to the markbands.
Examiners report
(i/ii) There were few problems with this. Relatively few candidates recognized that diseases of affluence can occur in less wealthy countries.
This was generally well answered. The question specifically required one named water-borne or vector-borne disease*; Ebola is neither, although some credit was given. Policies of prevention were often answered better than treatment. Unfortunately, some candidates wrote (erroneously) that there is a vaccination for malaria.
* The geography guide requires case studies of two diseases, chosen from two of the following three: vector-borne, water-borne, or sexually transmitted.
This question required an understanding of TNCs, fair trade and sustainability of agriculture. There were some very good, detailed responses, using examples. Others had an imperfect understanding of fair trade, confusing it with free trade. Many focused on environmental impacts and sustainability, with less consideration of social and economic aspects. Some recognized that TNCs and fair trade are not mutually exclusive.
Question
The graph shows the food miles for fruit and vegetables supplied to institutions in the state of Iowa, USA.
(i) Define the term food miles.
(ii) State the fruit or vegetable that ranks sixth in terms of the highest number of food miles.
(iii) Estimate the average (mean) food miles for the fruit and vegetables shown in the graph above.[4]
Suggest one advantage and two disadvantages of using food miles as an indicator of the environmental impacts associated with food production.[6]
To what extent are food availability, malnutrition and diseases of poverty connected with one another?[10]
▶️Answer/Explanation
Markscheme
(i) Food miles are a measure of the distance that food travels from its source (farm) to the consumer [1], either in units of actual distance or energy consumed during transport [1].
[2 marks]
(ii) garlic [1]
[1 mark]
(iii) 1500 miles (accept 1400–1600 inclusive) [1]
[1 mark]
Award [1] for each advantage/disadvantage and [1] for further development.
Advantages include:
- they are relatively easy to quantify [1], and therefore simple to state and explain [1]
- they provide an indication of the carbon footprint [1] from farm gate to retail location [1]
- they give consumers information about the origin of the food they consume [1] and the likely form of transportation used [1].
Disadvantages include:
- they do not take account of the carbon footprint of the food production methods used [1], or of the energy/water requirements [1] of different kinds of farming systems
- they do not give any indication of the farming system employed [1] , organic/free-range [1]
- they do not give a reliable indication of other environmental aspects [1], such as sustainability, the use of chemical fertilizers, pesticides and herbicides [1].
[6 marks]
There is a range of possible different approaches.
None of the three concepts is restricted to economically less wealthy countries.
In general, diseases of poverty and some forms of malnutrition (including under-nutrition) tend to overlap in distribution with areas where food may not always be readily available.
Malnutrition includes both under and over-nutrition and is therefore also found in many areas where diseases of poverty are absent and food is available.
Individuals suffering from under-nutrition, which may be due to poor food availability, may have weakened immune systems and less resistance to catching and suffering from diseases of poverty, such as malaria, tuberculosis and intestinal parasites. Equally, subsistence farmers and others suffering from diseases of poverty may be unable to work as productively as necessary to produce the food they need, thereby causing a lack of food availability and subsequent malnutrition.
Good answers may recognise the links between food availability, malnutrition and diseases of poverty, and provide a structured examination of these links. Diseases of poverty and some forms of malnutrition tend to overlap in distribution with areas where food may not be always readily available. There may be recognition that these areas may be in less economically wealthy countries, or in poorer sectors of the population within more wealthy countries. Another approach might be to challenge the links between food availability and the other concepts.
At band D, expect a description of two links/connections between the concepts/problems.
At band E, expect either a more detailed explanation of some simple linkages or a more thoughtful examination of more complicated connections/interrelations.
At band F, expect both.
Marks should be allocated according to the markbands.
[10 marks]
Question
Briefly outline what is meant by the term “food security”.[2]
Outline one way in which the health of a population can be affected by chronic hunger.[2]
Explain three geographic impacts at a national scale of one named water-borne or sexually transmitted disease.[6]
To what extent were physical factors responsible for one recent famine?[10]
▶️Answer/Explanation
Markscheme
Food security involves four basic concepts. Award [1] for the description of each of the following concepts, up to a maximum of [2]:
- access to food
- sufficient amount
- safety
- nutritional quality/diet.
Award [1] for the problem identified and [1] for further development.
Possibilities include:
- long-term under-nutrition [1] resulting in stunting/body weight loss [1]
- increased vulnerability to disease [1] due to weaker immune system [1]
- high maternal/infant mortality [1] due to lack of nutritious food [1].
Award [1] for recognition of a geographic impact and [1] for further development.
For example, HIV has impacted upon Swaziland’s GDP due to lost working hours / lower productivity [1]. The HIV prevalence rate in Swaziland is around 30% [1].
Impacts might include:
- high death rates/infant mortality rates
- cost of health care
- decrease in tourism
- cost of prevention policies.
Response should apply to one or more countries. If no example at a national scale is given, award a maximum of [5].
A famine may be defined as a widespread shortage of food in a region that leads to malnutrition and hunger and results in increased mortality rates. Famine may be caused by a variety of physical and human factors.
Physical factors might include:
- severe drought, caused by climatic factors
- soil exhaustion, caused by poor farming practices
- crop pests and diseases
- natural hazards, such as major earthquake
- climate change/global warming.
Human factors might include:
- civil war/conflict/refugees
- government policies/corruption
- poor infrastructure
- widespread poverty / high food prices
- rapid population growth/population pressure
- failure of response by outside agencies.
Reference should be made to a recent famine, preferably no earlier than the 1990s. Responses that do not focus on a specific recent famine are unlikely to progress beyond band D.
Good answers might provide a structured evaluation of the causes of a recent famine, and arrive at a considered view of the extent to which physical or human factors might matter most. Another approach might be to show how the factors are interrelated and interact with each other.
For band D, expect some description of physical and/or human factors that have caused a recent famine.
At band E, expect either a more detailed explanation of a range of physical and human factors (do not expect balance), or a structured evaluation of the extent to which particular factors (or the interrelationships between them) were responsible.
At band F, expect both.
Marks should be allocated according to the Paper 2 HL and SL markbands.