In December 2016, Suchunya Aungkulanon and her dedicated research team conducted a groundbreaking study, which was published in the International Journal for Equity in Health. This extensive research explored Thailand’s mortality rates spanning from 2001 to 2014, offering crucial insights into regional disparities and the transformative impact of Universal Health Coverage (UHC).
A striking revelation from this study was the stark divergence in mortality rates across various regions of Thailand. Despite the nation’s overall decrease in mortality rates since the introduction of Universal Health Coverage in 2002, certain areas continued to grapple with significant health challenges. Notably, the northern region of Thailand emerged as a cause for concern, with almost all its provinces reporting alarmingly higher mortality rates for chronic diseases like asthma, lung cancer, and chronic obstructive pulmonary disease (COPD). Regions shaded in red or orange on the map starkly contrasted with the rest of the country.
The geographical distributions of cause-specific mortality for the 12 selected causes of death. The northern region had a higher rate of death from COPD, lung cancer, and asthma compared to the other regions.
Geographical distributions of average annual standardized mortality ratio by super-district, 2001-2014
While the study primarily focused on data until 2014, it shed light on enduring trends in northern Thailand, where mortality rates for specific health hazards remained distressingly high. Despite Thailand’s commendable progress in reducing mortality inequalities through UHC, challenges persisted, especially among children and in specific geographical areas.
Shifting our attention to the lower southern region, the study uncovered an alarming surge in asthma prevalence. This worrying trend appeared to be closely connected to the transboundary haze issue, primarily attributed to the expansion of palm oil plantations in neighboring Indonesia during the same period.
Although the study refrained from establishing direct causal links between respiratory diseases and air pollution in the northern and southern regions, it raised thought-provoking questions. When coupled with recent data on respiratory illness outbreaks during the haze season, it became increasingly evident that the burning practices in northern agricultural and forested areas had reached a critical level.
Since the 2014 study, the impact of haze from Indonesia on Singapore and the southern region of Thailand had diminished, thanks to stringent regulations implemented by the Singaporean government targeting the palm oil industry. However, in northern Thailand, this problem persisted and had even worsened. Addressing this issue required collaborative efforts. Calls for action had grown within Thailand and among neighboring regions as these challenges continued to affect the health and well-being of the people in northern Thailand.
Read the research: https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-016-0479-5/figures/1