Diarrhoeal disease is a prominent cause of child mortality in developing nations (Green, Small, & Casman, 2009). This essay will explore how increased road and highway construction is one environmental determinant that is having a distally negative effect on individuals’ health in developing countries (Joseph et al., 2006). It will be argued that access to clean water and health education, regarding infectious contamination, as well as sanitation and hygiene, are significant resources for reducing diarrhoeal disease incidences (Green, Small, & Casman, 2009). Diarrhoeal disease is classified as the excessive passing, exceeding three, of loose or liquid stools daily; which is commonly a symptom of an intestinal tract infection, brought on by bacteria, parasites’ or virus’(Jamison, 2006). This disease is transmitted through the consumption of faeces contaminated food or water, as well as physical human contact, resulting from poor hygiene (Bain et al., 2014). There are 1.7 billion reported incidences annually of diarrhoeal disease across the world (World Health Organisation, 2013). Approximately 760,000 are morbidity cases of children under the age of five (World Health Organisation, 2013). Some key determinants of diarrhoeal disease are clean drinking water, sanitation and hygiene (Prüss-Ustün et al., 2014). Joseph, et al., (2006) states environmental changes, like road construction, exasperate the prevalence of diarrhoeal disease in developing nations.
Developing nations are experiencing the emergence of highways which facilitate the supply of goods, services and accessibility to remote communities; however there are negative consequences for population health (Joseph et al., 2006). Consequently, remote communities experience population density fluctuation as a result of increased accessibility. This commonly results in insufficient infrastructure, negatively affecting hygiene and sanitation levels (Joseph et al., 2006) .This poses a major health threat for individuals within developing counties as the probability of spreading infectious disease is significantly higher (Joseph et al., 2006). Joseph et al., (2006) conducted a field study that found a significant increase of malaria cases associated with the construction of the Transamazon Highway located in Brazil (Joseph et al., 2006). Additionally, the prevalence of dengue vectors in India and HIV positive woman in bar employment and male truck drivers in Uganda are all strongly associated with increased construction of roads and highways (Joseph et al., 2006).
Joseph et al., (2006) examined the relationship between community remoteness and prevalence of diarrheal disease across 150 villages. They found that incidence of diarrheal disease was negatively correlated to the proximity of major roads (Joseph et al., 2006). This relationship is significant for individuals’ health as building roads and connecting communities is becoming more common in developing nations (Miller, 2009). The endorsement of national policies regarding sanitation and available safe drinking water, in addition to increase research into the control and avoidance strategies, are options for developing countries in reducing incidences of diarrheal disease (Montgomery & Elimelech, 2007). Furthermore, the need for education of infectious transmission in conjunction with intervention programs such as water retrieval, treatment and storage could reduce prevalence of the illness (World Health Organisation, 2013).
By understanding the relationship between diarrheal disease and the emergence of new roads in developing nations it becomes clear that preventative change is possible. Although this relationship is complex it is clear that construction of new roads results in both distal and proximal negative health problems. With support and funding developing nations can control and prevent incidences of diarrheal disease, therefore dramatically reducing morbidity cases (Emch, 1998).

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