Chapter 16: Global Health

includes health within the borders of each nation, within population groups with unique cultures and languages, and across international borders and cultures

1. Patterns of care
2. Demographic transitions
3. Epidemiologic transitions

•Place or the lived environment
•Perceptions of health care
•Privilege or inequality
•Population health differences (demographics)
•Providers
•Procedures and interventions
•Partnerships
•Politics and policies
•Personal insight of health care workers

-Population increase or decrease (births vs. deaths)
-Migrations (e.g., rural to urban)
-Demographic transition theory
•Slow change in high-income countries (centuries)
•"Long life, small family"
-Fast change in low-income countries (decades)
•"Short life, large family"

•Era of infectious diseases

•Era of chronic, long-term health conditions

•Era of social health conditions

•Most died from infectious disease (plague, TB)
•High death rate and birth rate; short life expectancy

•Advent of antibiotics: increased life expectancy
•Increase in chronic illness (heart disease, cancer)

•"Where you live determines your health"
•Neighborhood wealth/poverty, housing, crime, drugs

-Global burden of disease
-Health for All initiative
-Health in All Policies initiative
-Primary health care achievements
-Sustainable development goals
-Telehealth
-Women's health

-a series of studies with the goal of calculating health disparities among global populations
-factors include: social, economical, and environmental

-commissioned by world bank in 1990
-brought together economists and health experts
-later managed by WHO
-the focus: impact of morbidity and mortality rates

GBD= population's disability- adjusted life years

-Initiative emphasizing primary health care (PHC)
-Created at International Conference on PHC in 1978

Goals:
-Affordable, culturally acceptable, accessible PHC
-Delivery of PHC via partnerships between:
•National health services
•Local communities
-Implement PHC for all by the year 2000

-each country to set goals for its population needs

Common PHC services:
•Health promotion
•Disease prevention
•Treatment
•Rehabilitative care provided by health care workers who live in the same community

-response of the US; Healthy People
•Launched in 1979
•Goal: reduce preventable death, injury by 1990
Updated every decade

-Healthy People 2030
•Nation's current health goals and objectives
•Includes objectives for health attainment

Premise: •good health in any society requires policies across all sectors to actively support health

Policymakers must consider health impact of policies for:
•Transportation
•Housing
•Employment
•Nutrition
•Water and sanitation
•Education

A collection of 17 global health goals targeting:
•Health improvement
•Eradication of:
•Poverty
•Hunger
•AIDS
Discrimination against women and girls

-Long-distance provision of health care support and information via broadband and Internet devices

-Enables remote client and provider:
•Contact
•Care
•Advice
•Reminders
•Education
•Intervention
•Monitoring

•Eliminate health disparities affecting women globally
•Decrease infant and maternal mortality
•Improve prenatal and delivery care

-United Nations (UN) and World Health Organization (WHO)
-Managing global diseases during epidemics and pandemics
-Interdependence of nations during migration
-Armed conflict, uprisings, wars, and humanitarian emergencies

formed in 1945 by 50 nations to promote:
-international peace and security
-friendly relations among nations
-social progress
-improved living standards

supports and manages several international funds, programs, and specialized agencies that focus on health

•A specialized agency within the UN
•Created in 1948
•Headquartered in Geneva, Switzerland
•Goal: promoting the health of all people globally
•As of 2020, has 194 member states

•Global Outbreak Alert and Response Network (GOARN)
•International Health Regulations
•Public Health Emergencies of International Concern
•Global Health Security Agenda
•Global Influenza Surveillance Network
•One Health
•Centers for Disease Control and Prevention

- SARS-CoV2 (COVID-19)
- Ebola
- Tuberculosis
- Malaria
- HIV/AIDS
- Acute respiratory tract infections

•Natural disasters
•Climate change
•Economic opportunities
•Violence or armed conflict
•Food insecurity

Adopted by UN in 2016 as a framework for international cooperation for orderly migration

•Health services become disorganized
•Decreased resources from disrupted supply chains
•Failure of infrastructures
•Epidemics
•Care of combatants prioritized over civilians
•Relocation of families
•Children injured, orphaned, at risk for disease
•Disruption of food cultivation, harvest, distribution, leading to malnutrition

-Requires global health ethical considerations

-Positive outcomes for C/PHN
•Increased awareness of socioeconomic disparities
•Improved cultural awareness
•Increased interest in PH, PHC careers

-Positive outcomes for communities
•Influx of resources, extra hands, supplies

•The weight of authority
•The volunteer effect
•The burden of hosting
•Individual motivations