AQA AS Geograp

CAse Studies

SIMON WARTNABY
CONTENTS

Areas With High Risks of Flooding.........................................................................................................................2

Indus Valley (Pakistan).......................................................................................................................................2

North Devon/Cornwall (UK)...............................................................................................................................2

Impacts of Flooding...............................................................................................................................................2

Lower Severn Floods, Gloucestershire and Worcestershire, 2007....................................................................2

Pakistan Floods, 2010........................................................................................................................................3

Coastal Erosion......................................................................................................................................................4

Coastal Erosion at Happisburge, Norfolk...........................................................................................................4

Sea Level Change...................................................................................................................................................4

Coastal Flooding in Eastern England..................................................................................................................4

Coastal Protection.................................................................................................................................................4

Hard Engineering at North Bay, Scarbrough......................................................................................................4

Soft Engineering at Freiston Shore, Lincolnshire...............................................................................................5

Managing Population Change................................................................................................................................6

China’s One-Child Policy....................................................................................................................................6

Immigration To The UK 2004-2007....................................................................................................................6

Inner-City & Suburban Areas in MEDC’s................................................................................................................7

Harehills – Inner-City Deprivation and Decay....................................................................................................7

Adel & Wharfedale – Suburban Prosperity........................................................................................................8

Morbidity...............................................................................................................................................................9

HIV/AIDS – An Infectious Disease......................................................................................................................9

Diabetes – ‘A Disease of Affluence’.................................................................................................................10

Healthcare Approaches.......................................................................................................................................10

Healthcare in Cuba..........................................................................................................................................10

Healthcare in Haiti...........................................................................................................................................11

Provision of Healthcare.......................................................................................................................................12

The Provision of Local Healthcare in South Lakelands.....................................................................................12

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RIVERS, FLOODING AND MANAGEMENT
AREAS WITH HIGH RISKS OF FLOODING

INDUS VALLEY (PAKISTAN)

The reasons for the severity of the Pakistan 2010 floods were:

 Much of central and southern Pakistan is lowland, comprising vast alluvial plains drained by the Indus
and its tributaries and occupied by millions of poor farmers.
 Heavy and prolonged rain fall in the monsoon season fill the rivers to bursting point.
 The Himalaya mountain range to the north increases perception intensity as meltwater from snow in
the mountains adds to discharge.
 Deforestation is wide spread, and has increased with rapid population growth.
 Flood management schemes such as dams and levees provide only limited protection from floods.

NORTH DEVON/CORNWALL (UK)

Several communities on the north coasts of Devon and Cornwall experience high flood risk. Major flash floods
occurred at Lynmouth in north Devon in 1953 and Boscastle in north Cornwall in 2004. The reasons for the
severity of the floods were:

 Onshore winds bring warm moisture-laden air from the Atlantic Ocean which is uplifted as it meets
the uplands of Exmoor and Bodmin Moor. This can trigger torrential downpours.
 The steep drainage basins on the Lyn, Valency and other rivers, together with their impermeable
geology and sparse tree cover result in rapid run off.
 Villages such as Lynmouth and Boscastle are vulnerable because they occupy the floors of steep,
narrow valleys down which the flood waters are funnelled.

IMPACTS OF FLOODING

LOWER SEVERN FLOODS, GLOUCESTERSHIRE AND WORCESTERSHIRE, 2007

Causes:

 The floods followed an extreme rainfall event on 20 July, when 135mm of rain fell at Pershore in
Worcestershire in just 16 hours.
 Heavy antecedent rainfall throughout the Severn basin meant soils were already saturated by record
rainfall in June
 Flash floods in several local tributary catchment areas raised the Severn at Worcester nearly 6 meters
above normal.

Impacts:

 By 21 July there was widespread flooding all along the River Severn from Upton to Gloucester. Floods
also hit towns and villages on the River Avon.
 At Tewkesbury flood waters entered the town’s ancient abbey for the first time in 247 years.

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  Near Gloucester flood waters shut down an electricity substation, leaving 50,000 households without
power for up to 2 days.
 A water treatment plant in Tewkesbury was flooded cutting water supplies to 140,000 households for
5 days.
 Some 10,000 motorists were left stranded on the M5 and surrounding roads and were forced to
abandon their cars because of flood waters and landslides.
 The total insurance loses were estimated between £1 billion and £1.5 billion.
 There was also large-scale damage to properties and disruption of businesses. Approximately 27,000
domestic insurance claims were made and 6,800 business claims.
 Crops were submerged and maize, potatoes and hay crops were destroyed.

PAKISTAN FLOODS, 2010

Causes:

 The floods of August and September were the worst to hit Pakistan in 80 years. The main cause was
extreme rainfall from the monsoon. At peak discharge the River Indus was 40 times above normal and
floods coved one-fifth of the country.

Impacts:

 A final death toll approximated 2,000.

 At least 1.2 million homes were destroyed and whole villages were swept away.
 Approximately 10 million people were displaced and 8 million needed emergency relief aid.
 Shortage of food and clean drinking water and inadequate sanitation were widespread.
 By September millions were at risk of water-borne disease such as cholera and diarrhoea.
 Economic costs of the flood were estimated between $3.5 billion and $5 billion and Pakistan’s GDP
was forecasted to fall 2%.
 Massive damage was inflicted on the counties physical infrastructure (e.g. roads, bridges, power
plants) and agriculture.
 3.2 million hectares of crops were either lost or badly damaged.
 Commercial crops such as cotton and sugar cane were seriously affected, and there was a 20-30%
decline in the output of food crops such as rice and wheat.
 Crop damage and lose was a major impact as agriculture contributes to one-fifth of Pakistan’s GDP
and employs 45% of the countries work force.
 Poor famers and landless labours with very few resources were worst affected.
 Despite a major international relief effort, 2 months after the disaster there was still the concerns of
the possible spread of disease and malnutrition during the winter.

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COASTAL ENVIRONMENTS
COASTAL EROSION

COASTAL EROSION AT HAPPISBURGE, NORFOLK

 Coastal erosion rates often exceed 5m a year.

 The coastline comprises of weak sands, gravel and soft clay, which is easily undercut by wave action.
 The long fetch to the north and northeast means wave energy is high along this coast.
 Erosion has accelerated considerably since 1990 when 300m of sea defences that protected
Happisburgh (revetments) were destroyed by a storm.
 The decision not to repair the revetments increased erosion and led to the loss of 6 cliff-top homes.
 Under the current governments “no active intervestion” the village of Happisburge could disappear
before the end of the century.

SEA LEVEL CHANGE

COASTAL FLOODING IN EASTERN ENGLAND

Causes:

 Low-pressure areas or depressions accompanied by gale force winds and high tides occasionally
present major flood hazards to the low-lying land coastal areas of eastern England.
 In 1953 a devastating surge was formed by a deep depression that generated hurricane-force winds
as it tacked south through the North Sea. As it moved south, the shallow funnel-shape of the southern
part of the North Sea amplified its height.
 The situation was made worse because the storm coincided with an exceptionally high tide.

Impact:

 Between 31 January and 1 February 1953, eastern England and the southern Netherlands we hit by
the greatest North Sea storm surge on record.
 Surge heights reached 3m at Kings Lynn and 3.36m in the Netherlands.
 Flood embankments were breached and sea walls crumbled.
 In east and southeast England 307 people died, 75,000 ha of farmland was flooded and 24,000 homes
were damaged.

COASTAL PROTECTION

HARD ENGINEERING AT NORTH BAY, SCARBROUGH

Strengthening hard defences:

 North Bay in Scarborough, surrounded by built-up urban environment is protected by hard defences.
 Concrete sea walls extend along the entire length of the Bay and protect the narrow promenade,
coastal road and the steep coastal slope.
 Between 2002 and 2005, the hard sea defences were strengthened in the southern part of the Bay.

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  Thousands of tonnes of riprap, at a cost of £26 million, were imported by barge and positioned at the
foot of the sea wall. The aim was to prevent waves overtopping, damage to infrastructure on the
promenade and landslips on the coast slope.

Issues:

 Hard defences are controversial: apart from their cost, they may have caused significant loss of
sediment in the Bay.
 The advanced line of the defence, and the highly reflective nature of sea walls have increased energy
levels over the remaining upper beach, resulting in sediment being removed offshore.
 Without hard defences, North Bay would have a boarder upper beach that would provide natural
protection for the coast.

SOFT ENGINEERING AT FREISTON SHORE, LINCOLNSHIRE

Background and issue:

 In 1983, 66ha of salt march at Freiston Shore was reclaimed by the sea. The reclaimed land was
protected by an earthen flood embankment and converted to arable farming.
 However, the costs of maintaining the sea defences, together with relativity low value of the
reclaimed land, made management more cost-effective, and a more sustainable alternative.

Responses and impacts:

 A partnership between the Environmental Agency, English Nature and the RSPB produced a more
sustainable realignment plan which involved the breaching of the flood embankment (2002) allowing
the area to return to a mix of salt marsh and saline lagoons.
 Within 13 months of the breaching of the inter-tidal area was colonised by 11 species of salt marsh
plants, 8 species of fish and numerous ducks and geese.
 Today, Freiston is an RSPB reserve and attracts nearly 60,000 visitors a year, brining £150,000 a year
to the local economy and creating 4 full-time jobs.

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POPULATION CHANGE
MANAGING POPULATION CHANGE

CHINA’S ONE-CHILD POLICY

Background:

 China’s anit-natalist population policy was a response to perceived over population in the 1970’s.
 Between 1950 and 1980 China’s population increased from 560 to 985 million.
 Such growth threatened shortage of food, fresh water, fossil fuels and other natural resources.
 As a communist country, China gives priority to state of interests over the rights and freedom of
individuals, therefore the government was able to impose an authorisation policy that would be
impossible in democratic societies.

The Policy:

 Introduced in 1979
 Women who opted to have more than one child incurred economic penalties.
 Legal age for marriage increase to 22 for men and 20 for women.
 The policy was applied with greater flexibility in rural than urban areas.
 Even in urban areas recently there has been some policy relaxation, for example, if a couple were
both themselves only children they can try for a second child 4 years after the first birth.

Impact:

 The policy had most success in towns and cities, where it was easy to enforce and small families were
acceptable.
 Rural areas the policy met more resistance: it was difficult to both enforce it and explain to poorly
educated farmers.
 China’s population increased by 73% between 1950 and 1979. However with the policy from 1979 to
2008 there was a 37% decrease.
 Today one-third of all Chinese families are single child families.
 It is claimed that the policy has been responsible for 400 million fewer births.
 The policy has caused the population of young people to fall rapidly, threatening labour shortages in
cities.
 Improvements in health care and living standards have caused an increase in proportion of elderly
people. By 2030 it is estimated that 25% of China’s population will be 60 and over, with little state
provision for pensions the burden of looking after old people will fall on today’s single child.
 The prevalence of male children has led to female infanticide and selective abortion of girls. Resulting
in a gender imbalance which will eventually leave a shortage of marriageable women, threatening the
tradition of universal marriage.

IMMIGRATION TO THE UK 2004-2007

Recent immigration trends:

 There was an annual net migration gain in the UK for most of the period 1990-2007.
 Before 2004 most immigrant s originated from Africa, the Middle East and south Asia.

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  Since the enlargement of the EU in 2004 the majority of immigrants have come from EU countries in
Eastern Europe.
 Between 2004 and 2006, 181,000 immigrants entered the UK from Eastern Europe.
 In 2007 the overall net migration was 237,000.
 Immigration reached record levels between 2000 and 2010 and is currently the main driver of
population growth.

Causes:

 Immigration has been driven by a combination of economical push and pull factors. In 2007 GNI for
the UK was US$40,660, compared with US$9,850 in Poland.
 In March 2007 Poland’s unemployment was twice as high as the UK and the UK’s minimum wage was
5 times greater than Poland’s. All citizens from other counties in the EU have a legal right to live and
work in the UK
 Successive UK governments have encouraged immigration because most in-migrants are young adults
and are economically active, providing a source of skilled and relatively cheap labour. They also help
to counter the problem of an aging populations and rising dependence.

Impacts

 A report by the Select Committee for Economic Affairs in 2008 suggested that the overall benefits of
immigrants to the UK economy had been exaggerated and the economic benefits depend on the skill
of the immigrants. For example immigrants with families can put a strain on housing and public
services such as schools and healthcare. There are also environmental concerns over rising population
pressure with ever-increasing demands for housing and loss of countryside.

INNER-CITY & SUBURBAN AREAS IN MEDC’S

HAREHILLS – INNER-CITY DEPRIVATION AND DECAY

Background:

 Harehills is an inner-city suburb in east Leeds, situated 1-2 km from the city centre, the suburbs grew
between 1870 and 1914.
 Much of the original housing (back-to-back terraces) still services today.
 Two-third of the housing is rented from the council, social landlords, and private landlords.
 Low-cost housing attracts low-income groups, especially Afro-Caribbean and south Asian ethnic
minorities.
 One-quarter of the ward’s population was born outside the UK.
 The population is relatively youthful, with 28% of residence aged 0-15 years.

Social and economical inequality:

 Harehills is among the poorest 5% of wards in England and a large proportion of its residents suffer
multiple deprivations.
 According to government assessment, the quality of life in Harehills is ‘poor’.
 Unemployment is twice the Leeds average and related to poor education and skills.
 45% of adult population have no qualifications and household incomes are less than half those of the
prosperous suburban wards.
 Life expectancy is 4 years below the average for Leeds and at the 2001 census 12 of residences
reported poor health.

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  Substandard housing and overcrowding contributes to poor health.
 Reported crime is four times the average for Leeds, with high levels of domestic burglary, vehicle
crime and criminal damage.
 Nearly half of all households qualify for council welfare benefits.

ADEL & WHARFEDALE – SUBURBAN PROSPERITY

Background:

 Dominated by low-density, high quality detached and semi-detached housing in north Leeds.
 High property prices and a lack of social and affordable housing excludes low income groups.
 Positive externalities include an attractive physical environment on the edge of the city, adjacent to
open countryside.
 Older population than Harehills with less than 19% of residents aged 15 years or less.
 Ethnically 95% of the population is white.

Social and economical inequality:

 Adel and Wharfedale ward is barley 4km from Harehills yet inequalities between the residents of the
two wards are extreme.
 In Harehills, every census super output area (SOA) is in the bottom 10% of SOA’s in England. In Adel
and Wharfedale the number is zero.
 Unemployment in Adel and Wharfedale is the lowest in Leeds while in Harehills is six times higher.
 Youth unemployment is closely related to qualifications, 82% of school leavers in Adel and
Wharfedale have 5 GCSEs, compared to 41% in Harehills.
 Crime rates are less than one-third of those in Harehills.
 The suburbs have some of the city’s most successful state schools.

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HEALTH ISSUES
MORBIDITY

HIV/AIDS – AN INFECTIOUS DISEASE

Epidemiology:

 HIV is transmitted by the exchange of body fluids (e.g. blood, semen) most often through sexual
contact.
 The virus damages the immune system, making the body susceptible to illness and infection.
 Worldwide, 33 million people were infected with HIV in 2009.
 In 2009, AIDS-related illnesses caused 1.8 million deaths.
 Since 1981, an estimated 25 million people have died from AIDS, most in sub-Saharan Africa.

Demographic impacts:

 Because of HIV/AIDS, life expectancy will continue to fall throughout southern Africa: in South Africa
from 65 to 50 years from 1990-2015.
 Meanwhile, high mortality among young adults has caused a decline in birth rate and an overall
slowdown of population (e.g. South Africa).
 Without the HIV/AIDS epidemic South Africa’s population in 2015 would have reached 54 million – 10
million more than is forecast.
 Changes in mortality and fertility have also affected age structure, with a large percentage shrinkage
by 2015 in the 0-15 and 30-65 group.

Economic impacts:

 The prevalence of HIV/AIDS has damaged the economy of several African countries and in some
reversed economic development.
 Most HIV/AIDS sufferers are adults 15-49 years old i.e. the most economically active and productive
part of the workforce.
 On an individual household level, HIV/AIDS has resulted in a loss of income, indebtedness and
increase in the likelihood of poverty.
 In sub-Saharan Africa the HIV/AIDS epidemic has reduced GDP by an average of 1.5% per year and in
east Africa time from work due to illness may have cut business profits by 6-8%.
 Premature deaths have reduced the labour supply and raised labour costs; while increased morbidity
has lowered productivity and profits.
 In rural areas HIV/AIDS has led to the neglect and abandonment of agricultural work, diminishing
food output and increasing food insecurity.

Social impacts:

 Premature mortality from AIDS has destroyed millions of families. Orphaned children often have to
assume family responsibilities in households with few if any savings or assets. Others have to leave
school to care for dying parents.
 AIDS in worst affected countries imposes huge financial burdens on health care services. In southern
Africa more than half of all hospital beds are occupied by AIDS sufferers.

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DIABETES – ‘A DISEASE OF AFFLUENCE’

Epidemiology:

 Diabetes is caused by a deficiency of insulin, a hormone secreted by the pancreas. Insulin enables
glucose to enter cells and provide energy. It also keeps blood sugar levels within safe limit. Globally
the disease affects nearly 250 million people.
 Type 2 diabetes, although found worldwide is often seen as a ‘disease of affluence’ associated with
lifestyles in the developed world.
 Diabetes is responsible for 3.8 million deaths a year – more than twice the number who dies from
AIDS.
 The disease is more concentrated in poorer communities and is closely linked to obesity, which in turn
is related to the consumption of low-cost, high calorie, convenience foods and drinks and lack of
physical exercise.

Distribution:

 Diabetes is widespread in the developed and les developed world, but most strongly concentrated in
North America, Europe and the Middle East.
 Originally diabetes was a disease of the elderly, but in recent decades it is becoming increasingly
common in younger adults of working age and even children.

The spread of the disease:

 By 2026, it is estimated that the disease will affect 380 million people. This is constant with rising
levels of obesity throughout the developing world.
 Currently in the USA 12.3% of 20-79 year olds are diabetic. Other countries include Saudi Arabia
(13.6%), Germany (12%), Ethiopia (2.8%) and Kenya (2.0%)

Economic impacts:

 The economic impact of diabetes include cost of health care and prevention (heart disease, blindness
and strokes), disabilities also reduce earnings for the individual.
 Currently the costs are spiralling. In 2007 the cost of the disease worldwide was US$290 billion. This is
expected to increase to US$380 billion by 2025.
 More than 80% of spending on medical care for diabetes is in MEDCs.
 Investment in diabetes is lowest in the poorest countries, however, with economic development and
rising obesity, a huge increase in the disease is likely to develop in the future in countries such as
China and India.

HEALTHCARE APPROACHES

HEALTHCARE IN CUBA

Background:

 Cuba is a lower-middle income country. In 2010 its GDP per capita was just below US$10,000, similar
to Tunisia and Peru, giving the world ranking of 109th.
 Its population was 11 million in 2011 and is expected to remain stable for the next 15-20 years.

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Healthcare system:

 Cuba’s modern healthcare system was established in 1970’s – the outcome of a socialist political
system where the government-funded healthcare is a right guaranteed to all citizens. Along with food,
clothing, housing and education, the delivery of healthcare has the highest priority.
 Primary healthcare is the foundation of the system, which employs 33,000 doctors. There are 498
polyclinics that each serve between 30,000 and 60,000 people. They are similar to outpatient
departments in small hospitals and provide specialist consultation and diagnostic procedures (e.g.
screening and ultrasounds).
 At the grassroots level, basic medical services are provided by neighbourhood-based family doctor
and nurses’ offices. They serve around 2,500 patients each and deliver the bulk of healthcare.
 Secondary healthcare comprises large city/regional hospitals.
 The emphasis of the Cuban healthcare system is on preventative medicine though primary care.

Achievements:

 Despite limited resources Cuba’s healthcare system in the past 40 years has been an outstanding
success.
 Average life expectancy (77 years) is comparable to many high-income countries.
 Child mortality rates for under 5s (6/1000), and maternal mortality rates (7/100,000) even exceed
those in Canada and Australia. TB rates are just 2/100,000 and malaria has been eradicated.

HEALTHCARE IN HAITI

Background:

 Haiti is a low-income country, the poorest in the western hemisphere – more like sub-Saharan Africa
than the Caribbean.
 GDP per capita in 2010 was US$717 and on the UN’s human development index its ranked 145th out of
169 countries.
 80% of the country lives in poverty. Haiti’s population is forecast to increase from 9.7 million on 2011
to nearly 12 million by 2030.

Healthcare system:

 Haiti has been an independent state since 1804, yet its healthcare system is rudimentary. This is not
only due to poverty but also long-term political instability and natural hazards (earthquakes and
hurricanes).
 The few health services that existed have declined over the past 2 decades.
 There are serious shortages of trained medical staff (only 1,000 doctors in the whole country),
medical supplies and poor management of clinics and hospitals.
 Spending on healthcare in 2008 was on US$85 per person.
 Increasingly, healthcare relies on charities and a patchwork of foreign agencies such as Medecins
which offer free clinics.
 The healthcare infrastructure of clinics and hospitals is totally inadequate to meet the population. In
the capital, Port au Prince, government healthcare services are practically non-existent, while privet
health care is beyond the means of all but a tiny minority.

Outcome:

 Poverty, political conflict and poor government have created appalling healthcare situation in Haiti.

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  Malnutrition is widespread and nearly 140,000 children die from preventable diseases (TB, malaria)
each year.
 Average life expectancy is 62 years; rates of mortality among children under 5 years are 12 times
greater than that of Cuba, whilst maternal mortality is nearly 100 times higher. TB rates are
290/100,000 and malaria causes nearly 37,000 deaths a year.

PROVISION OF HEALTHCARE

THE PROVISION OF LOCAL HEALTHCARE IN SOUTH LAKELANDS

Background:

 South Lakeland district covers the southern part of the Lake District, and Morecambe bay in Cumbria.
 It has a population of only 105,000, much of it scattered at low density in small rural communities.
With only one large town, Kendal.
 The region is relatively wealthy, with household income close to national average and few areas of
deprivation.
 Quality of life is high, with relatively low mortality rates and high life expectancy (79m, 83f).

Healthcare provision:

 Primary healthcare provided by 21 GP practices.

 Secondary healthcare is available at Westmoreland General Hospital in Kendal. For more specialist
hospital treatment residents must travel to Lancaster.

Age structure:

 23% of the population in South Lakelands are aged 65+ (well above the national average (16%)) and
this is highest in highest in Cumbria.
 The age structure is a result of out-migration by young people and large influxes of retirees in the past
30 years.

Health issues:

 Due to the high proportion of elderly people, the rates of degenerative illnesses such as cardio-
vascular disease and dementia are high by national standard.
 Access to healthcare for elderly patients living in isolated rural locations, and without access to privet
transport is a problem. Many villages are more than 8km from a GP surgery.
 Other health issues are common to other areas of the UK: excessive alcohol consumption, childhood
obesity, low uptake levels for flu and MMR vaccines and responses to screening programmes (e.g. for
types of cancer).

Health implications:

 Ageing of the population will continue. By 2031, over one-third of the population will be aged 65+.
 Large numbers of elderly people will live alone (as spouse die) increasing loneliness and the risk of
depression.
 As the population is relatively affluent and life expectancy is well above the UK average old people are
more likely to suffer from mental illness and dementia in future.
 Already rates of dementia are higher than national average, and a 60% increase is forecasted by 2025.
This has implications for healthcare, and could place considerable burdens on the local NHS trust.

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