PMC:7100305 / 28252-31339 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7100305","sourcedb":"PMC","sourceid":"7100305","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7100305","text":"The Socioeconomic Distribution of Disease\nEbola virus disease has been predominantly reported in low-income countries, with the last outbreak in 2014 reported to have caused 11,323 deaths worldwide and 4809 deaths in Liberia alone (Abramowitz et al. 2015). The most affected countries typically had poor health infrastructure (Arima and Shimada 2014; Burkle and Burkle 2015; McNamara 2016; Maras and Miranda 2016). It is only during the most recent outbreak that the virus spread to high-income countries (Burkle and Burkle 2015; Stanturf et al. 2015). Within these countries, and as was exemplified in Liberia, the outbreak mostly affected those populations that were very poor, remote, and lacked proper physical infrastructure, including roads, proper sanitation, and health facilities.\nThe burden of the Ebola epidemic fell disproportionately on the most disadvantaged Liberians, fundamentally politicizing the epidemic. The socioeconomic distribution of Ebola was political, as defined for the purposes of this review, in that many scholars attribute its emergence to the socioeconomic conditions of Liberia. For example, poverty, and subsequent limited investment into the health system led to weak public health infrastructure, insufficient information technologies, a lack of trained personnel, inadequate case reporting, was often cited as the key vulnerability of Liberia (Burkle and Burkle 2015; McNamara 2016; Maras and Miranda 2016; Scott et al. 2016). Additional challenges included mobility of particular populations, authority distrust (Fallah et al. 2015), economic instability, and a lack of governance (McNamara 2016). These challenges intersected with other stressors, such as climate change and food insecurity to intensify the effects of the Ebola epidemic (Scott et al. 2016). Many rural communities in Liberia were particularly vulnerable, extremely poor, and lacking secure access to food and health clinics (Scott et al. 2016).\nSimilar to the other epidemics, people living in poverty were most vulnerable to the effects of the Ebola epidemic. Poverty facilitated the spread of the Ebola virus; thus, interventions aimed at addressing poverty would be most effective in containing further transmission (Pellecchia et al. 2015). Socioeconomic inequality was additionally evident in the “inequitable management of the dead” (Pellecchia, Crestani, Decroo, Van en Bergh, Al-Kourdi, 2015, p. 1) (Garbuglia 2016). While cremation was a less acceptable cultural practice (Kobayashi et al. 2015), it was mandated to limit further Ebola transmission (Garbuglia 2016). The new practice seemed to have impacted the economically disadvantaged who could not afford to pay for private burial services instead of cremation, aggravating socioeconomic divides (Garbuglia 2016).\nThese issues frame the Ebola epidemic in Liberia as political as the operational processes at the local, national, and international organizations had a negative impact on the most vulnerable Liberians. Given this context of vulnerability, many scholars investigated the response pathways undertaken.","divisions":[{"label":"Title","span":{"begin":0,"end":41}}],"tracks":[{"project":"2_test","denotations":[{"id":"32226719-25856072-45162389","span":{"begin":250,"end":254},"obj":"25856072"},{"id":"32226719-25343493-45162390","span":{"begin":369,"end":373},"obj":"25343493"},{"id":"32226719-27389614-45162391","span":{"begin":384,"end":388},"obj":"27389614"},{"id":"32226719-25343493-45162392","span":{"begin":524,"end":528},"obj":"25343493"},{"id":"32226719-26325519-45162393","span":{"begin":546,"end":550},"obj":"26325519"},{"id":"32226719-25343493-45162394","span":{"begin":1401,"end":1405},"obj":"25343493"},{"id":"32226719-27389614-45162395","span":{"begin":1416,"end":1420},"obj":"27389614"},{"id":"32226719-27185252-45162396","span":{"begin":1459,"end":1463},"obj":"27185252"},{"id":"32226719-26720278-45162397","span":{"begin":1567,"end":1571},"obj":"26720278"},{"id":"32226719-27389614-45162398","span":{"begin":1631,"end":1635},"obj":"27389614"},{"id":"32226719-27185252-45162399","span":{"begin":1793,"end":1797},"obj":"27185252"},{"id":"32226719-27185252-45162400","span":{"begin":1947,"end":1951},"obj":"27185252"},{"id":"32226719-26650630-45162401","span":{"begin":2247,"end":2251},"obj":"26650630"},{"id":"32226719-26903474-45162402","span":{"begin":2427,"end":2431},"obj":"26903474"},{"id":"32226719-26903474-45162403","span":{"begin":2578,"end":2582},"obj":"26903474"},{"id":"32226719-26903474-45162404","span":{"begin":2780,"end":2784},"obj":"26903474"},{"id":"T58740","span":{"begin":250,"end":254},"obj":"25856072"},{"id":"T6094","span":{"begin":369,"end":373},"obj":"25343493"},{"id":"T65974","span":{"begin":384,"end":388},"obj":"27389614"},{"id":"T32439","span":{"begin":524,"end":528},"obj":"25343493"},{"id":"T1330","span":{"begin":546,"end":550},"obj":"26325519"},{"id":"T96512","span":{"begin":1401,"end":1405},"obj":"25343493"},{"id":"T58903","span":{"begin":1416,"end":1420},"obj":"27389614"},{"id":"T44199","span":{"begin":1459,"end":1463},"obj":"27185252"},{"id":"T83378","span":{"begin":1567,"end":1571},"obj":"26720278"},{"id":"T54851","span":{"begin":1631,"end":1635},"obj":"27389614"},{"id":"T80442","span":{"begin":1793,"end":1797},"obj":"27185252"},{"id":"T18781","span":{"begin":1947,"end":1951},"obj":"27185252"},{"id":"T28870","span":{"begin":2247,"end":2251},"obj":"26650630"},{"id":"T69960","span":{"begin":2427,"end":2431},"obj":"26903474"},{"id":"T93729","span":{"begin":2578,"end":2582},"obj":"26903474"},{"id":"T78308","span":{"begin":2780,"end":2784},"obj":"26903474"}],"attributes":[{"subj":"32226719-25856072-45162389","pred":"source","obj":"2_test"},{"subj":"32226719-25343493-45162390","pred":"source","obj":"2_test"},{"subj":"32226719-27389614-45162391","pred":"source","obj":"2_test"},{"subj":"32226719-25343493-45162392","pred":"source","obj":"2_test"},{"subj":"32226719-26325519-45162393","pred":"source","obj":"2_test"},{"subj":"32226719-25343493-45162394","pred":"source","obj":"2_test"},{"subj":"32226719-27389614-45162395","pred":"source","obj":"2_test"},{"subj":"32226719-27185252-45162396","pred":"source","obj":"2_test"},{"subj":"32226719-26720278-45162397","pred":"source","obj":"2_test"},{"subj":"32226719-27389614-45162398","pred":"source","obj":"2_test"},{"subj":"32226719-27185252-45162399","pred":"source","obj":"2_test"},{"subj":"32226719-27185252-45162400","pred":"source","obj":"2_test"},{"subj":"32226719-26650630-45162401","pred":"source","obj":"2_test"},{"subj":"32226719-26903474-45162402","pred":"source","obj":"2_test"},{"subj":"32226719-26903474-45162403","pred":"source","obj":"2_test"},{"subj":"32226719-26903474-45162404","pred":"source","obj":"2_test"},{"subj":"T58740","pred":"source","obj":"2_test"},{"subj":"T6094","pred":"source","obj":"2_test"},{"subj":"T65974","pred":"source","obj":"2_test"},{"subj":"T32439","pred":"source","obj":"2_test"},{"subj":"T1330","pred":"source","obj":"2_test"},{"subj":"T96512","pred":"source","obj":"2_test"},{"subj":"T58903","pred":"source","obj":"2_test"},{"subj":"T44199","pred":"source","obj":"2_test"},{"subj":"T83378","pred":"source","obj":"2_test"},{"subj":"T54851","pred":"source","obj":"2_test"},{"subj":"T80442","pred":"source","obj":"2_test"},{"subj":"T18781","pred":"source","obj":"2_test"},{"subj":"T28870","pred":"source","obj":"2_test"},{"subj":"T69960","pred":"source","obj":"2_test"},{"subj":"T93729","pred":"source","obj":"2_test"},{"subj":"T78308","pred":"source","obj":"2_test"}]}],"config":{"attribute types":[{"pred":"source","value type":"selection","values":[{"id":"2_test","color":"#93ecaa","default":true}]}]}}