BBH 305 Midterm

trading for goods and then ended up being land colonized too because the europeans killed so many native american's with the diseases that the natives were not immune to but the europeans were (their animals also supplied the natives with diseases their bodies didn't know). the diseases wiped out the native population which made it easier to colonize the land. at one point spreading diseases and killing natives was intentionally by supplying natives with smallpox infected blankets. they also supplied them opium so they became dependent on it when the europeans would stop supplying it. at this point the medical knowledge was bloodletting for smallpox treatment

sewage contaminated water in london leading to widespread cholera which no one knew where from until john snow discovered that the cholera was coming from infected water in this one well because those who were infected used that well (determined the cause and thus began epidemiology). this also led to advent of germ theory in which louis pasteur determined that diseases could be caused by small particles: germs/bacteria

successes in small countries and regions helped worldwide successes and the ability to gather results and information. since a vaccine was previously invented it was advancements such as the bifurcated needles which didn't require refrigeration for the vaccine that helped widespread immunization. the WHOs smallpox eradication unit helped gather research and widely distribute the vaccine via the bifurcated needle around the world. smallpox was declared fully eradicated in 1980

helps us address and assess health issues and concerns that transcend national boundaries so it promotes health between countries and worldwide to reduce health emergencies and disparities of low-income countries

women dying of pregnancy in low income regions,
large amount of undernutrition among children (especially in africa and south asia),
burden of communicable and noncommunicable diseases world wide and how to control them,
effects of environment and natural disasters on health,
and how countries organize and manage their health care systems

the determinants and social determinants of health,
key risk factors for different health conditions,
global burden of disease,
measurement of health status,
the demographic and epidemiologic transitions,
organization and function of health systems
links among health, education, development, poverty and equity

GNI per capita of $995 or less (haiti, ehtiopia, chad, zimbabwe)

GNI per capital between $996 and $3895 (india, morocco, egypt, bolivia, bandladesh)

GNI per capital between $3896 and $12,055 (costa rica, jamaica, turkey, venezuela)

GNI per capita of $12,056 and up (US, canada, switzerland, china, france, UK)

developing a capmaigne in the city to encourage people not to text and drive, or implementing a healthy food plan for schools

worldwide distribution of vaccine that crosses borders

doctor diagnosing and treating a patient

sustainable development goals for the global community to meet (17 of them)
examples: no poverty, zero hunger, quality education, clean water and sanitation, gender equality, good health and wellbeing, good education

37 high income countries that discuss and develop economic and social policy regarding health
ex: canada, switzerland, UK, france, germany, denmark, austria

to understand which global health issues are most important and what factors cause them

so we have some ways to look at data and track diseases/causes in specific regions

ex: what defines maternal death means the same thing in the US and every other country

infant mortality rate, life expectancy at birth, maternal mortality ratio, neonatal mortality ratio, under 5 mortality rate

the # of deaths of infants under age 1 per 1000 live births in a given year

average # of years a newborn could expect to live if current mortality trends were to continue for newborn's life (OECD countries have higher expectancy, wealth=health)

the # of women who die as a result of pregnancy and childbirth complications per 100,000 live births in a given year (sub-Saharan africa is ridiculously high compared to everywhere else and south Asia kinda high)

the # of deaths to infants under 28 days in a given year per 1000 live births in that year (south Asia and sub-Saharan Africa tied at 28)

the probability that a newborn will die before reaching age 5 as expressed as a # per 1000 live births

A measure of burden of disease, one DALY equals one year of healthy life lost due to time lived with illness, disease or injury.

Heart disease
Alzheimers and other dimentias
Stroke
Lung cancer
COPD
Lower respiratory infections

heart disease
low back and neck pain
stroke
lung cancer
organ diseases
alzheimers disease and other dimentias

Lower respiratory infections
Heart disease
Diarrheal disease
Malaria
HIV/AIDS
Tuberculosis

Malaria
Lower respiratory infections
Diarrheal diseases
HIV/AIDs
Neontal

communicable, noncommunicable and injuries

shift from high fertility and high mortality to low fertility and low mortality (low income countries tend to have higher fertility and mortality rates so as a country stabilizes, these rates go down)
(high and fluctuating mortality is related to very poor health conditions, epidemics and famines)

a shift in patterns of diseases from communicable to noncommunicable disease
(there are progressive declines in mortality as epidemics become less frequent thus communicable disease)
declines in mortality increase life expectancy and the predominance of non-communicable diseases

the range of personal, social, economic and environmental factors which determine the health status of an individual

ex: education (higher educated individuals know more about treating symptoms they experience than very uneducated people)
ex: sex (women more prone to dying of breast cancer and giving birth whereas men are more prone to become alcoholics and thus liver cancer)
ex: income (the amount of money you have is directly related to health)
ex: access to safe drinking water and sanitation

the achievement of health and the the capability to obtain good health including the fairness of these processes

differences in health that are not only unnecessary and avoidable but unfair and unjust (low income people or a certain race having poorer health)

differences in health that are closely associated with social and economic disadvantages

evaluating other cultures based on your own cultures customs and beliefs (often judging)

the idea that every culture is unique and should be evaluated based on only their own standards and valules

disease is malfunctioning and of a bodily process causing discomfort

illness represents personal, interpersonal and cultural reactions to disease/comfort (ex: in many low income countries they still think illness is from the devil for your sins or doing something bad)

the ability to interact effectively with people of different cultures

a person's capacity to obtain, process and understand basic health information and services to make an informed health decision

the sum of knowledge, skills and practices based on beliefs, theories and experiences of those native to a culture which is used in maintenance of health as well as prevention, diagnosis or treatment of illness

a system in which medical doctors and other health care providers (nurses, pharmacists, therapists) treat symptoms and diseases using surgery, drugs, and radiology (also called allopathic medicine, biomedicine, mainstream medicine or orthodox medicine)

the combination of organizations, institutions and resources who's primary function is to "deliver health services to the population"

1. provide health services
2. raise money that can be spent on health, referred to as "resource generation"
3. pay for health services, referred to as "financing"
4. govern and regulate the health system, referred to as "stewardship"

service delivery, health workforce, information, medical products, vaccines and technologies, financing, leadership/governance

health disparities are social and economic disadvantages that result in a poor health status for a individual. this is seen in the remote access medicine film we watch in class as one woman couldn't pay for her sons medicine when he was sick because she did not have enough money for it. another one that the patients in that film lived in a poor and rural environment which makes it harder for them to access health care. Lastly, some of them lacked education such as the idea that they were not fully aware smoking is really terrible for you which results in poor health conditions from chronic smoking

health and education are closely related because populations or individuals who are uneducated in result do not what what is good and bad for them or know the important of healthy practices like washing hands and eating healthily. An example would be dr.bacha's discussion on tanzania. Tanzania's reflects this idea very well because they are a population with high mortality rates and many communicable diseases for their leading causes of death, while many of the population also cannot read. This strongly depicts the idea that many uneducated people tend to fall to an unhealthy lifestyle (pregnant women in low income countries were not fully educated on the effects of HIV/AIDs which would lead them to death during birth and infecting their children with poorer health and nutrition which would ultimately lead to lower enrollment in school) (their is also a link between cognitive development and school performance with those malnourished in low income countries)

demographic transition is the transition from high fertility and high mortality rates to low fertility and low mortality rates. when a country makes this transition it becomes much more stable such as many low income countries such as (Nigeria whos fertility rate used to be about 7 children per women 20 years ago and is now about 5. Although still in progress, the country is undergoing a demographic transition with lower fertility and death rates ) or (haiti is currently undergoing a mortality rate decrease however their next step is decreasing fertility rate as it remains high still

epidemiological transition is the transition of patterns of diseases from predominantly communicable to noncommunicable. it highlights that as fertility and mortality decline, the less epidemics occur for a country.

eradication of smallpox is considered very important to public health/global health because it exhibited the collaboration of countries in a global effort to better the health of the population. It was fully eradicated do to the WHOs smallpox eradicated unit which did much research and was able to widely mass produce and distribute an updated version of the original vaccine created by edward jenner. This was made even easier when the bifurcated needle was introduced which didn't require refrigeration of the vaccine and could thus be distributed across the world efficiently. it was officially declared as eradicated in 1980.

the tuskegee study was a study of 600 african american men, of which 399 had syphilis and 201 did not. were told they were getting treated for their "bad blood" but actually were not and were just receiving aspirin and iron supplements. this is clearly violation because it is not benefitting participants and supporting beneficence, it also is fully lying to participants so they are not informed of the research. it also was supposed to go on un for only 6 months and then ended up lasting 40 years. after the experiment got released, the national advancement for colored people sued the government for 9 million dollars and then made them pay for the participants infected families lifetime health care along with proper burial service. a commission was also created for subjects in biomedical and behavioral studies which set guidelines for consent and beneficence.

years of life lost due to premature death + years lived with diabillity