The mortality rate of anemia is quite high in children the thirteenth leading cause of death of children under 15 years old. The prevalence ranged from 5.9% to 5.9% in a study conducted by the second National Health and nutrition Examination survey. A side from infants 1-2 year, girls 15 -17 years old are having the highest prevalence rate of anemia. The high prevalence in infant is due the high demand and low supply of iron (milk is poor in iron).The high prevalence of anemia in young girl due to heavy menstruation. Boys Men 12 to 44 years of age had the lowest prevalence rate. Elderly Men are having a high prevalence due to decrease in the androgen stimulation of erthropoiesis that began during puberty.

Economical aspect of Anemia:

• Severe deficits in the delivery and use of oxygen increase Fatigability
• Decrease work capacity
• impair brain function
• Lessen ability to maintain body temperature
• Less productivity...bad economy

The prevention and the treatment to many types of anemia is quite easy and inexpensive. The prevalence of anemia is quite high specially among children and young age group. From the above we can see the importance of the economic aspects influencing anemia. Loss of productivity, the coast of treating the advanced complications, and the irreversible body and brain growth impairment far more expensive than the appropriate health measures necessary to prevent, early diagnosis and treat anemia and its underlying causes.

Anemia and The Environment:

• Areas with low resources; Malnutrition
• Parasitic related
• Toxic; lead & Cooper
• Occupational related: Aplastic anemia; Benzene, DDT, ionized radiation, Arsenic & TNT
• Due to endemic of infectious and chronic diseases

Occupational and Environmental background have a major role in causing certain type of anemia:

Benzene exposure can cause aplastic anemia and acute leukemia. Lead exposure (battery factory work, gasoline sniffing ) will cause lead poisoning. Pure vegetarian might cause B12 and iron deficiency. Increase alcohol intake will cause folate deficiency, toxic effect on hematopoiesis, sideroplastic anemia. Unusual cravings (pica) will cause iron deficiency (eats ice) or lead poisoning (eats paint or plaster). Travel history; parasites (iron deficiency from hookworm, mixed deficiencies from malabsorption due to Giardia), Malaria can cause hemolytic anemia.

Exposure to a very cold temperatures will cause IgM cold agglutinin, IgM antibodies. The release of histamine from mast cell after warm shower in vulnerable people will cause myeloproliferative disease manifesting itself with itching and autoimune hemolytic anemia.

Epidemiological Transition Omran:

• Shifts in health and disease patterns"
• "Social economic and medical developments"
• Three Stages:
  1- "The age of pestilence and famine"
  2- "The age of receding pandemics"
  3- "The age of degenerative and man-made diseases"

• "Fertility decline is expected to follow these gains against mortality but with varying speed and varying reasons"

The classical model of epidemiological transition is proposed to occur in areas where mortality decline began gradually as a result of the social, economic and environmental improvements. Associated with industrialization These elements were later joined by medical advancements as factors influencing mortality decline. Anemia is a good example about epidemiological transition theory. Anemia of dietary deficiency and anemia due to occupational and environmental illnesses is more prevalent in developing countries. On the other hand anemia due to chronic diseases and surgical surgeries is more prevalent in developed countries.