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Fiona Chen
Sir Winston Churchill
IB Biology HL
Internal Assessment (Database)
Exam Session May 2020
Fiona Chen IB Biology HL May 2020
INTRODUCTION:
Anemia, one of the most common deficiencies, affecting 1.62 billion individuals worldwide, or
around 20% of the world’s population, is characterized by a shortage of red blood cells and/or
functioning hemoglobin (Figure 1) (World Health Organization). Hemoglobin is found in red blood cells
as its principal protein, with over 600 million molecules per red blood cell. Its function is to bind to and
carry oxygen around the body, and each red blood cell is able to transport 4 molecules of oxygen (Figure
2). As a result, the low amount of red blood cells and hemoglobin causes there to be insufficient oxygen
transported around the body. This can be detrimental to human body processes, since oxygen is a
critical reagent for the aerobic cellular respiration, a process in which ATP, the body’s universal form of
energy, is produced.
Figure 2:Diagram Comparison Between Normal
Figure 1: Diagram of Hemoglobin's Binding to Oxygen Diagram source?
and Anemic Red Blood Cell Count
Format is weird here. There are many causes of this deficiency. Although
anemia can be genetic and present in infants, it is generally caused by other ailments or lifestyle
conditions. The most prominent causes are active bleeding, iron deficiency, poor nutrition, and, sickle
cell anaemia. Iron deficiency anemia occurs when the affected individual does not consume sufficient
iron. Anemia develops in this case due to iron’s role as the central metal ion which binds to oxygen;
without iron present, binding of oxygen will not occur. As for sickle cell anemia, it is caused by a
mutation in the gene for hemoglobinBeta gene on chromosome 11, resulting in the production of a
faulty form of hemoglobin, hemoglobin S, which causes the red blood cell to become crescent shaped
and less efficient at transporting oxygen. General poor nutrition can lead to anemia as well, as many
essential amino acids and vitamins are required for the production of red blood cells and hemoglobin.
Active bleeding, or the loss of blood is the most common cause of anemia in women, who are shown to
be the most affected by anemia, due to their menstrual flows.
The signs and symptoms of anemia include, but are not limited to, fatigue, weakness, shortness
of breath, coldness, and paleness of the extremities of the body. Fatigue, weakness, and shortness of
breath are caused by the lack of adequate oxygen flow around the body for crucial bodily processes. The
coldness and paleness of the extremities is due to the flow or prioritization of blood to areas of the body
which are necessary for survival. There are many methods of anemia testing for anemia, where the
majority of which involve blood sampling. Tests may be used to search for the following: red blood cell
CITATIONS needed everywhere
(Kognity, Bio textbook, anything that gives you this background info)
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count, iron level, hemoglobin amount and bilirubin, a substance remaining after the destruction of red
blood cells. For instance, for hemoglobin tests, a hemoglobin value of less than 12.5g/dL in adults
classifies an individual as anemic. Treatments include changes to diet to include iron rich foods, the
consumption of iron supplements, intravenous iron therapy, or even blood transfusions.
Anemia, when left untreated can entail severe health and economic consequences. Due to the
insufficiency of oxygen, the heart works harder in order to transport oxygen rich blood around the body.
As a result, the heart may develop arrhythmias or irregular heartbeats, a heart murmur, or it may lead
to complete heart failure. Additionally, it can lead to delays in motor and cognitive development in
children, which also affects the child’s future education’s and economic success and in turn can
deteriorate their health, thus creating a vicious cycle of poverty and poor health.
The Human Development Index (HDI), developed by Mahbub ul Haq in 1990, is a measure of the
development of a country. It considers “four principal areas of interest: mean years of schooling,
expected years of schooling, life expectancy at birth, and gross national income per capita” (United
I chose to investigate the investigate the correlation between Human Development Index of
countries and their anaemia prevalence in nonpregnant women of reproductive age, because of my
personal experience with anemia as well as my interest in the connection between the humanities and
science. Therefore, I decided to combine the two areas of knowledge by investigating the effect of
country development on a medical ailment, especially from a global perspective. As for the age range, I
chose it, because it applies to my age range, and I want to see how this may add to the
disproportionality of gender equality (I will develop + edit this section (rationale) further in my final
copy, its really bare boned right now SORRY ITS just like brain vomit at this point ;; )
Yes, definitely need more on personal engagement
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Human development Index of countries was used as the independent variable for the
dependent variable, anemia prevalence, because of their possible relationship. As mentioned previously,
the HDI takes into account of longevity of the population which indicates level of healthcare, diet, and
nutrition. Additionally, it measures education of population and GNP, two factors that can greatly affect
the access to proper nutrition due to their effect on economic status, and meats, often costly, that are
rich in iron.
Research Question: Is there a correlation between the Human Development Index of countries and their
anaemia prevalence in nonpregnant women of reproductive age (age 15 to 49)?
Null Hypothesis: If the Human Development Index of countries and their respective anaemia prevalence
rates are associated there will be no correlation between the two values.
Alternate hypithesis
Hypothesis: If the Human Development Index of countries and their respective anaemia prevalence
rates are associated there will be a negative correlation between the two values due to availability or
access to improved healthcare (early intervention, better nutrition), education, and reduced poverty
effects on anemia.
VARIABLES
Independent Variable Controlled Variables
Human Development Index Diet of the country based on the dominant religion
MATERIALS:
APPARATUS:
• Microsoft Excel 2017
o Used for Data collection, processing, and statistical testing
PROCEDURE:
1. Access and obtain data from the Worldwide Prevalence of Anaemia 1993-2005 published by
the World Health Organization in 2008
2. Record only countries which have anaemia data that are stated to be nationally
representative
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This suggests that the gathering and estimation of data were executed with consideration of the entire
national population of nonpregnant for the select sample group. These studies have higher amounts of
subjects or larger sample sizes, ensuring superior validity. Additionally, seen that HDI values are
calculated with national statistics in mind, only nationally representative surveys were incorporated in
this investigation.
a. Record the value given for anaemia prevalence in nonpregnant women of
reproductive age including the value for the 95% Confidence Interval.
The 95% Confidence Interval provides the range of data in which the surveyors are 95% confident. This is
noted in so as to take account of the uncertainty in calculations and graphing.
3. Conduct research on the religious composition of recorded countries using
4. If more than 50% of the population is a believer of a religion where vegetarianism or veganism
is a principle value (ie Buddhism, Hinduism, and Mahayana), these countries will not be taken
into consideration for the correlation between HDI and anemia prevalence.
It is supported that partaking in a vegetarian or vegan diet can often lead to higher rates of anaemia due
to the lack of consumption of meat and/or animal products (Chai et al). Therefore, I decided to exclude
these countries from my sample group so as to reduce the effects of external factors unrelated to the
HDI that may affect the anaemia prevalence as well as the level of uncertainty.
Other external factors such as the prevalence of sickle cell mutations (which can be a cause of anemia)
in each country were considered, however, there was insufficient data regarding its prevalence,
therefore this factor could not be excluded.
5. Record the countries that remain after accounting for the strength of the study as well as
religious factors
6. Note each country’s Human Development Index from the HUMAN DEVELOPMENT REPORT
2002 Deepening democracy in a fragmented world published in 2002.
7. Log their range of HDI as indicated by the United Nations:
Low HDI: x < 0.510 Medium HDI: 0.511 < x < 0.798 High HDI: x > 0.799
a. If there are not 10 countries that satisfy the criteria, exclude this category from this
investigation.
Only categories containing 10 or more countries are included in this investigation to ensure an adequate
sample size.
After the selection of countries, there were 56 eligible countries remaining, with 14 countries in the low
HDI range, 32 in the medium range, and 10 in the high range. This was done so that there would be a
holistic representation of all ranges of HDI to investigate the issue of HDI inequalities and anaemia
prevalence through a global perspective.
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Table 1: Sample of Country Selection
RAW DATA
For complete raw data tables, as well as list of countries studied, please refer to appendix.
Put at least a SAMPLE of raw data here.
ANALYSIS
RESULTS
90
80
70
reproductive age (%)
60
50
40
30
20
10
0
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1
Human Development Index
Figure 4: Human Development Index vs Anaemia Prevalence in nonPregnant Women of Reproductive Age
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The data acquired was plotted on a scatter plot graph with the Human Development Index and
anaemia prevalence in nonpregnant women of reproductive age as the x (independent variable) and y
(dependent variable) respectively. The error bars represent the 95% confidence interval values as
presented in the Worldwide Prevalence of Anaemia 19932005 published by the World Health which
differ from study to study. As shown by the line of best fit, it can be observed that there is an evident
negative slope, which is later found to be 53.774. From it, we can deduce that there is a negative linear
correlation between the two variables. However, it is important to note the presence of certain outliers
from this graph, these include Uzbekistan, Bahrain, and Burundi. There are many possibilities which may
account for these outliers such as the availability of certain food groups like meat due to their
geography, differences in healthcare, differences in cuisine, or even ongoing conflicts that can affect
food supply and access to healthcare.
STATISTICAL TESTING
Pearson’s Correlation (r coefficient) was used to test for the strength of the correlation between the
Human Development Index and the prevalence of anaemia in their population of nonpregnant women
of reproductive age
𝑥𝑖𝑦𝑖
𝑥𝑖 𝑦 𝑖 − Where :
𝑛
𝑟 = 2 2
• n = sample size (amount of countries)
2 ( 𝑥𝑖) 2 ( 𝑦𝑖) • x = Human Development index value
𝑥𝑖 − 𝑦𝑖 − • y = Anaemia prevalence rate in non
𝑛 𝑛
pregnant women of reproductive age
Equation 1: Pearson's Correlation Coefficient Formula
Table 1: Calculations of Values
Equation/ Variable Inserted values Result
n 56
∑ 𝑥𝑖 0.939, 0.933, 0.928, 0.928, 0.917, 0.856,0.831, 0.831, 3.64 x 10
0.814, 0.813, 0.796, 0.787, 0.758, 0.755, 0.754, 0.754,
Sum of all Human
0.751, 0.75, 0.747, 0.743, 0.741, 0.727, 0.722 0.721,
Development
0.717 ,0.715, 0.712, 0.708, 0.706, 0.688, 0.667, 0.653,
Index values
0.642, 0.638, 0.635, 0.631, 0.602, 0.551, 0.548, 0.535,
0.513, 0.512, 0.499, 0.493, 0.469, 0.462, 0.444, 0.42,
0.414, 0.405, 0.4, 0.386, 0.375, 0.325, 0.322, 0.313
∑ 𝑥2 Identical to above 2.93 x 10
𝑖
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Index values
2 3.64 x 10 1.36 x 103
(∑ 𝑥𝑖 )
Square of sum of
all Human
Development
Index values
∑ 𝑥𝑖 6.9, 21.3, 9.1, 8.8, 10.2, 20.4, 51.3, 4.8, 18.9, 28.7, 20.8, 1.90 x 103
40.3, 31.8, 25.2, 12.4, 42.1, 34, 35.5, 40.4, 49.6, 40.2,
Sum of all Anaemia
64.8, 26.3, 33.2, 28.6, 19.7, 38, 53.9, 26.8, 24.3, 41.2,
Prevalence (%)
32.9, 27.6, 14.7, 9, 20.2, 32.6, 29.1, 43.1, 27.3, 46.4, 4.3,
27.9, 33.2, 45.6, 62, 43.9, 63.2, 50.4, 59.1, 43.9, 61,
49.8, 52, 48.2, 28,
∑ 𝑦2𝑖 Identical to above 7.82 x 104
36.4 ∗ 1900
1150 −
𝑟= 56
1360 3610000
(29.3 − ) ∗ (78200 − )
56 56
Equation 2: Complete Pearson's Coefficient Formula
The final value produced for the Pearson’s Correlation r coefficient is 0.597. The Pearson’s
correlation principle presents these guidelines as the ranges for the strength of correlation.
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The Pearson’s r coefficient of 0.597 falls within the high degree range. From this, we can
deduce that the correlation is of high strength and is a negative correlation. This means that the trend is
the higher the Human Development Index value, the lower the anaemia prevalence in countries.
CONCLUSION
The aim of this investigation was to determine if a correlation existed between the Human
Development Index of countries and their anaemia prevalence in nonpregnant women of reproductive
age (age 15 to 49). As such, data was collected from two scholarly sources: Worldwide Prevalence of
Anaemia 19932005 published by the World Health Organization in 2008 and HUMAN DEVELOPMENT
REPORT 2002: Deepening Democracy in A Fragmented World published in 2002 by the United Nations
Development Programme and Oxford Publishing Press. After data was gathered, criterion for countries
to be included in the sample group were selected. Then, the data was graphed to see if there was a
correlation between the two variables. After it was found that there was a correlation, the Pearson’s
correlation test was conducted to test the strength of the correlation. The result demonstrated that the
correlation was negative and of high strength, thus supporting my hypothesis. Therefore, I accepted my
hypothesis and rejected the null hypothesis.
EVALUATION
STRENGTHS
Strength Impact
Specific sex and age range In this correlation study, only the anemia prevalence of non
pregnant women of reproductive age were considered. As a result
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the sample group all have similar characteristics, thus causing a more
precise sample group with clearer sources of anemia.
Sample size 56 countries remained after the country selection process with set
criteria. The advantages of having such a large sample size include a
mean that is more precise, a more wholly representative result, less
error, and the possibility of identification of outliers.
Controlled for outside factors Countries in which 50% or more of their population believes in a
including a country’s dominant religion where veganism or vegetarianism is a principal doctrine
religion were omitted from the sample group. This was done to reduce the
impact of external factors specifically the lack of consumption of
meat/ animal products which is shown to increase the susceptibility
to anemia (Chai et al).
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All data in the The data represented in the anemia It is very difficult to have health
Anemia report are report published by the World Health statistics which are exact
educated estimates Organization and selected for this representations of the number of
investigation consist of extrapolations people who have anemia.
from data obtained from nationally Therefore, to lessen the effects of
representative studies. They are not an estimates, I could research the
exact representation of the number of background of every study included
individuals who suffer with anemia. and explore if they are reliable
studies based on their
methodology.
Elevation and I attempted to include elevation and I could consult more in print
availability of meat availability of meat as a criterion for the sources, which could include
selection of the countries. This factor geographical almanacs for these
was considered because elevation can statistics.
cause difficulty in the production of
agriculture and the transport of food.
Additionally, the availability of meat is a
great factor since it serves as a great
source of iron. However, there was
inadequate data and information on
these factors and therefore was not
included.
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Every country has a As each country’s anemia prevalence I could only select for countries
different sample size data was found through the respective with sample sizes that fit in a
countries, they each have different limited range to ensure control.
sample size and do not follow any
specific guidelines. As a result they have
varying precisions and error.
APPENDIX
Raw Data
Countries Nationally Vegetarian HDI Anaemia 95% 95% Negative Positive
representative Religion Prevalence % C.I. C.I. Error Error
Anaemia (low) (high)
study (N)
HIGH HDI
MEDIUM HDI
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LOW HDI
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Works Cited
Chai, Zi Fei, et al. “Factors Associated with Anemia among Female Adult Vegetarians in
Malaysia.” Nutrition Research and Practice, The Korean Nutrition Society and the Korean
Society of Community Nutrition, 31 Feb. 2019,
www.ncbi.nlm.nih.gov/pmc/articles/PMC6369109/.
Delgado, Christopher, and Henning Steinfield. “Livestock to 2020: The Next Food Revolution.”
Food and Agricultural Organization of the United Nations (FAO), 1999,
www.researchgate.net/publication/5055893_Livestock_to_2020_The_Next_Food_Revolu
tion.
United Nations Development Program, (UNDP). “Human Development Report 2002: Deepening
Democracy in a Fragmented World.” United Nations Development Programme HUman
Development Reports, Oxford University Press, 2002,
hdr.undp.org/sites/default/files/reports/263/hdr_2002_en_complete.pdf.
World Health Organization. “Iron Defiency Anaemia: Assessment, Prevention, and Control.”
Edited by Fernando Viteri and Ray Yip, World, 2001,
www.who.int/nutrition/publications/en/ida_assessment_prevention_control.pdf.
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This is pretty good Fiona! Remember, title page doesn't count for pages, nor appendix, so be
sure to include at lease SOME raw data.
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