ANSC 148 Midterm

Generally speaking, a health disparity refers to a difference in health status between groups of people. Singer differentiates between health disparity and inequality by defining health inequality as a difference in health outcome rooted in a social factor/inequality, while health disparity is a difference in health outcome between two groups that is not necessarily of social origin. For example, a health disparity would be rates of breast cancer among women versus men - women are more likely to get breast cancer because of biological rather than social origins. An example of a health inequality is how black women have higher rates of mortality from breast cancer than white women, as this is rooted in access to care and poverty.

It is a critique of blaming cultural practices as the reason why disease spreads or is higher in certain communities, as this focuses on behaviors attributed to one's culture instead of focusing on social inequalities or social position that could lead to heightened risk for disease.

One example of this is that poor people are often blamed for obesity, when they may live in areas with poor education and didn't learn about nutrition (or live in an area with food deserts/cannot afford healthy food).

Another example is that Haitians are blamed for having HIV/AIDS because they would spread the disease with voodoo rituals, as opposed to a lack of access to preventative measures and education about the disease.

An epidemiological transition describes a variety of population and ecological factors that explain major trends of disease. It discusses the relationship between diseases and with other health trends to find causes.

Omran originally proposed that the first transition was following the industrial revolution in the US and Western Europe, a transition from infectious disease to chronic and non-communicable diseases. With this model, Omran wanted to capture the changes in cause-specific mortality following Industrial Revolution in these regions.

Zuckerman modifies this to point out the transition is ongoing in many developing low- and middle-income countries, which have high rates of mortality from infectious diseases and NCDs. Zuckerman also expands the timeline to include a first transition during the Neolithic period/agricultural revolution, and a third (current) transition of emerging/reemerging infectious diseases. These modifications help broaden our understanding of the complex dimensions of health over time, revealing ultimate causes and prevention strategies and predictions of epidemiological trends to improve population health overall.

Population density and new sedentary lifestyle provided conditions for epidemic infections of disease, also living in close quarters with domesticated animals made people more susceptible to diseases like the flu

Social hierarchies developed reservoirs for disease in impoverished communities living in close quarters with poor sanitation, wealthy elites could also withhold needed resources (water, food) from them

Diet concentrated on staple crops reduced diversity of nutrition, especially for lower classes who couldn't afford more more items (imported or scarce)

Culture: A complex idea that includes knowledge, belief, art, law, morals, customs; any other capabilities or habits acquired by man or woman in a society.

Reliance on traditional culture may not account for history, social structure, or cultural change over time - it also doesn't acknowledge the perspective of the observer, who would be inclined to use their own culture as the gold standard, and therefore may not recognize attributes of culture in another community if they differ from one's own. According to Douglas, traditional culture does not exist because no culture is definable and recognizable, but instead is unpredictable, changing, and complex.

Structural violence is harm is done through systematic procedures to everyone belongs to a certain order. This means it is violence exerted systematically, so while no individual is at fault, everyone is complicit in this oppression. It causes harm to those affected, and constricts their agency.

Farmer's 2-pronged approach to help stop this is to 1)
remove structural conditions that perpetuate structural violence, or essentially decrease the environment for risk (a preventative measure) and 2) increase access to treatment for disease

Structural violence is harm is done through systematic procedures to everyone belongs to a certain order. This means it is violence exerted systematically, so while no individual is at fault, everyone is complicit in this oppression. It causes harm to those affected, and constricts their agency.

Behavioral risk focuses on individual actions and choices, and thus blames the individual for their condition, whereas social vulnerability focuses on population level of the sociocultural environment, and therefore blames the systematic failures that led to these conditions rather than the affected individuals themselves. For example, someone with diabetes could be considered to have been taking behavioral risks by always eating fast food, or socially vulnerable for not being able to afford or access healthy, fresh food. So behavioral risk stresses the level of individual action, while social vulnerability stresses the social level of disease vulnerability.

By shifting the focus to social vulnerability, we reveal the true causes of these issues, and can find appropriate prevention and treatment. We can study the conditions that expose people to health outcomes and diseases, rather than assuming it is their own fault and refusing to help.

The importance of the transition from reproductive health to sexual health was that it stopped viewing sex as only for procreation, and understanding recreational sex also needs to be address in global health programs. This is a more holistic and inclusive view, and acknowledges that people have different needs.

Reproductive health previously focused largely on ultrasounds, prenatal care, and family planning.

Now, sexual health focuses more on STIs and birth control, and also discusses sexual orientation, gender identity, and sexual freedom from coercion or violence, as well as pleasure for all partners. This is especially important for LGBT communities and women.

An example is the feminist movement has expanded the focus of pregnancy to the health of the woman, not just fetus, and has changed the nature of political advocacy in health care.

A syndemic is a group of two or more diseases that synergistically produce bad outcomes like morbidity/mortality. They are diseases that come together because they share the same roots, which are often health conditions induced by health inequality (poverty, stress, structural violence, or social stigma).

A syndemic is different from co-/multi-morbidity because it refers to biocultural, sociocultural, or sociopolitical interactions. Comorbidity refers more specifically to the diseases, not other factors, and they don't necessarily interact or have underlying factors that lead to both/all of them.

An example of a syndemic with infectious diseases is AIDS and TB, as they interact with each other, and can both originate from the same social conditions.

A syndemic with non-communicable diseases is VIDDA (violence, immigration, depression, diabetes, abuse), where depression and diabetes can be caused by the other social factors, and can feed off of each other.

The market focuses on profit and not care being provided. Businesses have no vested interest in making people healthier, only making money. These go against individuals in terms of their needs for protecting their health, because it is more beneficial to them for you to be worse so often they work in conflict with your best interests.

Neglected tropical diseases are diseases affecting a developing nation or nations that are neglected in terms of research funding and care because they are not profitable, as many of those affected can not afford to purchase the necessary medication, as the population affected is generally poorer and from developing "tropical" countries.
Examples of NTDs are hookworm infection, dengue fever, river blindness, and leprosy.

The 90-10 gap is that 90% of the disease burden in the world receives 10% of research funding.

A privileged lifestyle drug that is not essential but profitable, like Viagra or Rogaine.

An example of a lost cost NTD drug that is not profitable is Ivermectin, which treats for parasites for 10 cents.