-Morbidity
-Disability
-Mortality
-Prevalence
-Incidence
-Infant mortatlity
-Life Expectancy at Birth
- Maternal Mortality Ratio
-Neonatal Mortality Ratio
-Under-5 Child Mortality Rate
Learning Objectives
Its an attempt to construct a single indicator to compare how far countries are from the state of good health. Leading Causes of morbidity, mortality, and disability. Variations in causes by age, gender, and region. Change over time.
People are living longer than before. Increase in the years people live with
Burden of Disease- trends
Why?
Burden of disease has shifted increasingly toward non-communicable diseases in all World Bank regions. Globally, women live 5 years longer than men. Mortality rates have decreased, particularly for children under 5
The expected number of years a person will live in good health (takes into account mortality and disability)
- A health-expectancy measure
The sum of years lost due to premature death (YLLS) and years lived with disability (YLDs)
DALYs are also defined as years of healthy life lost
A "health-gap" measure
Indicates losses due to illness, disability and premature death in a population
Group 1: Communicable, Maternal, and Prenatal Conditions, and Nutrition Disorders
Although ischemic heart disease and stroke are leading causes of death for females, global health literature focuses on reproductive health.
Rural populations are less healthy than urban populations. Disadvantaged ethnic minorities are less healthy than majority population. Females suffer from a number of conditions related to their relatively disadvantaged social positions. Poor people are less healthy than wealthier people. Uneducated people will be less health than those better educated.
Population growth, population aging, urbanization, demographic divide, demographic transition, epidemiological transition.
Elderly support ratio- ratio between the number of people aged 15 to 64 years, compared to the number of people over 65. Aging population and shift in the elderly support ratio has profound implications for:
- The burden of diseases
-Healthy expenditures
-How health care will be financed
Shift in pattern of high fertility and high mortality to low fertility and low mortality, with population growth in between. Decline in mortality with improved hygiene and nutrition, followed by fertility. Population grows with gap between births and deaths. Population growths slows and older share of population increases as births and deaths equalize.
Factors that lead to improvement in health are complex, they include
-Nutrition
-Education
-Improved Infrastructure
-Health Care Systems
Culturally Competent Care
-Political Stability
-Scientific Improvements
Burden of disease will be influenced by changing factors, some of which will relate to the determinants of health.
-Economic development
-Scientific and technological change
-Climate change
-Political stability
-Emerging and re-emerging infectious disease (e.g. COVID-19)
Improvemenst in life expectancy and health are not uniform across or even within countries. Health indicators and improvements in life expectancy in South Asia and subsaharan Africa lag being other regions. Investing effectively and efficiently in relatively low-cost but high-impact health services: :best buys" such as nutrition, education, good hygiene, and low-cost services that have a high impact such as vaccination programs and TB control. Take community-based approach to primary health care.
Roots in black feminist social science and legal scholarship.
-Primary tenets:
"Multiple sites of power"- individual and group inequities shaped by interplay of institutional oppression, and structures of discrimination
Examples- 1) Cardiovascular 2) Migration
Intersectional lens provides more nuance and complexity about differential risks with multi-level analysis
Health disparities
Health and Education:
Malnutrition and disease affects children cognitive development and school performance.
Education contributes to disease prevention and management.
- Minoritized genders
-Minoritized sexualities
-Minoritized race and ethnic groups
-Rural area residents
-High density urban areas
- Those working in the informal sector
-Less educated
Health, the Costs of Illness, and poverty
Urban dwellers tend to enjoy better health status, coverage, and access to services than rural dwellers. Rural people tend to have lower incomes, less education, less access to services, and weaker political voice.
When engaging with global health activities:
-Keep equity, inequality, and disparities in mind at all times
-Always consider the various dimensions of these issues
-Be careful when using averages for indicators
-Examine how each piece of key data relates to different population groups, especially the poor and marginalized.
Expenditure by any level of government or government agency. Expenditure by sources other than the government such as non-governmental organizations or individuals.
Cost-effectiveness
-Good health promotes economic development
-Higher levels of economic development also promote better health, but not quickly enough. Many of these relate to improvements from education and technology.
-Therefore, low- and middle-income countries must adopt policies that speed achievement of health goals, even with constrained incomes
Cost- effective
-International conventions and treaties recognize access to health services and health information as human rights.
-Failure to respect human rights is often associated with harm to human health.
-Health research with human subjects puts people at risk for the sake of other people's health.
-Health investments must be made fairly, because resources are limitedd
-Assess health policies, programs, and practices in terms of impact on human rights
-Analyze and address the health impacts resulting from violations of human rights when considering ways to improve population health
-Prioritize the fulfillment of human rights
-Circumstances in which someones right may be suspended; for example, outbreak of an emerging or a reemerging disease
-Suspension of rights should be as narrow as possible
-Suspension should be carried out with due process and monitored
Health condition that is stigmatized and discriminated against
-Associated issues:
- Protecting the rights of people who are HIV-positive to an employment, schooling, and participation in social activities
-Ensuring access to care
-Policies regarding testing
-Protection of confidentiality
-Research is essential for improving global health
-However, most research studies do not benefit the people who participate in them
-Ethical concerns about putting participants at risk for the sake of other people's health
Important issues when the subjects are likely to be poor, under-educated, and without access to good care.
-Standard of care
-Post-trial benefits
-Ancilary care
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