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life expectancy
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measure of average number of years an individual within a certain population is expected to live at birth
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current health expenditure
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proportion of healthcare spending in a country relative to the size of its economy
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health (WHO definition)
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state of complete physical, mental, and social well-being and merely not the absence of disease or infirmity
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global health
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collaborative trans-national research and action from promoting health for all
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colonial/tropical medicine
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first stage of global health; concerned with keeping white colonists alive in the tropics
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international health
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second stage of global health; privileged people from high=income countries trying to help people in low-income countries
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morbidity
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state of poor health
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mortality rate
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incidence of deaths in a population during a specific time
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DALY stands for
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disability-adjusted life year
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DALY formula
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years of life lost because of premature mortality + years of healthy life lost due to disability
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YLL stands for
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years of life lost
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YLDs
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years lost to disability
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LMIC
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low- and middle-income countries
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Regions of WHO
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Africa, Americas, South-East Asia, Europe, Eastern Mediterranean, and Western Pacific
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WHO headquarters
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Geneva, Switzerland
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How does WHO get funding?
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1/4 from membership dues and 3/4 from voluntary contributions
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Alma-Ata
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1978; international health conference
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Smallpox elimination
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1979
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H1N1 influenza vaccine
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developed in 2009
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verticalists
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favor biomedical, technical interventions
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horizontalists
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believe WHO should help regions develop their own health infrastructure
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List the Alma-Ata Millennium Development Goals meant to be achieved in 2015
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1) eradicate extreme poverty and hunger 2) achieve universal primary education 3) promote gender equality and empower women 4) reduce child mortality 5) improve maternal health 6) combat HIV/AIDS, malaria, and other diseases 7) ensure environmental sustainability 8) develop a global partnership for development
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United Nations Millennium Declaration
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signed in 2000 with goals for 2015
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Sustainable Development Goals
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17 goals adopted by the UN in 2015 to reduce disparities between developed and developing countries by 2030
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primary healthcare
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decentralized, holistic view of health and wellbeing that promotes community participation
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Universal Declaration of Human Rights (UDHR)
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1948 document; considers all human rights indivisible
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Article 25 of Universal Declaration of Human Rights
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affirmed that health is key part of the right to an adequate standard of living
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Factors required to maintain health
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clean drinking water, nutritious food, adequate housing, well maintained sanitation systems, access to healthcare, education and training opportunities for care providers, and access to needed high-quality treatments
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Requirements for provided health goods and services
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available, accessible, acceptable, good quality
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neglected diseases
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receive relatively little medical and health attention or funding, tend to affect people living in low-resource regions; associated with lack of access to underlying health determinants
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inflammation
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acute immune response to injury and infection; first line of protection
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medical anthropology
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subfield of anthropology that investigates how cultural, historical, socioeconomic, and political factors shape ideas about health, illness, and disease
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cultural relativism
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idea that cultural aspects must be considered in their own terms, without making value judgements based on norms drawn from other cultures
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disease
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objective; biological changes that impair function, largely shaped by biomedicine constructs
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illness
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subjective experience of discomfort/suffering
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sickness
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sociological; socially recognized set of behaviors
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bodies of health
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individual, social, body politic
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Individual body of health
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physical and mental aspects of individual level
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Social body of health
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social factors that may impact individual health
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Body politic of health
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how social and political forces affect individual bodies within society
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medicalization
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process of defining and treating human conditions as medical pathologies in need of intervention
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proximate
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immediate cause of poor health and disease symptoms
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ultimate
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root factors contributing to risk of poor health
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proximate causes
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viruses, hormones, cell growth, organ function
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ultimate causes
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politics, environment, economy, evolution
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biological normalcy
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defining what "normal" condition is through statistical distribution
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selection
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process by which one individual is more likely to reproduce successfully than another in the population due to the possession of an advantageous trait
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stressor
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an external stimulus that challenges the biological processes and health of an organism
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adaptation
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an advantageous trait that evolved for a specific reason and which increases reproductive succes
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culture
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set of shared meanings, embedded in social institutions, and an implicit shaper of individual beliefs and behavior
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ethnomedical systems
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cultural similarities and variation in healing systems
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political economy of health
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examines how structural factors and differences in power/wealth shape health
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structural violence
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social structures that stop individuals , groups, and societies from reaching their full potential
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Johan Galtung
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coined structural violence in 1969
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interpretative approach
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requires anthropologists to fully situate illness within the culture context
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culture syndromes
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conditions that may be recognized in one culture but not others
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applied medical anthropology
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work that applies the knowledge produced through anthropological scholarship to the design and implementation of health interventions
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infectious disease
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disease caused by microorganism; typically communicable
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non-infectious/ chronic disease
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not caused by acute infections process and not directly passed from one person to another; long duration
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epidemiology
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the how and why of disease; upon people study
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John Snow
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helped demonstrate the importance of systematic data collection to trace disease origins
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William Farr
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helped develop health and vital statistics records
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Ignaz Semmelweis
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helped establish hospital best practices for hygiene
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incidence
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rate at which new cases occur over a given time
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prevalence
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total number of cases in a specific time period; proportion of individuals in a population with a disease at any one time
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R₀
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disease reproduction number; the lower the better
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sporadic
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disease that occurs infrequently and irregularly
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cluster
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aggregation of cases in a certain area within a specific time period
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outbreak
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occurrence of more cases than expected in certain area within a specific time period
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epidemic
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new cases spread rapidly through a population
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pandemic
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extreme epidemic, over vast amount of geographic space
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endemic
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new cases occur at a relatively low but constant rate over time
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case fatality rate
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the proportion of people with a disease who die from it
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disease reservoir
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host population in which the pathogen lives and multiplies
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zoonotic disease
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disease that can be passed between animals and humans
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life expectancy at birth
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proxy measure of overall quality of life within a population
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Nuremberg Code (1948)
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ethical code that emphasizes the importance of voluntary informed consent, expected benefit outweighing risk, and avoidance of injuring subject
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Declaration of Helsinki (1964)
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built upon Nuremberg Code by World Medical Association; the interests of subjects should always be placed above the interests of society and every subject should get the best known treatment
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Belmont Report (1978)
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by National Commission with 3 principles: respect for persons, beneficence, and justice
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Community Based Participatory Research
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active involvement of community members throughout the research process
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colonization
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control by on population over an area or people; forced assimilation
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virgin-soil epidemics
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resulted from no biological immunity to foreign-evolved diseases carried by Europeans
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colonial medicine
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born to control disease that imperiled the colonial endeavor
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tropics
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invented term by imperial powers to reflect novel environments that presented unique health challenges
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William Faulkner
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"The past is never dead. It's not even past."
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neoliberalism
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economic liberalism that proposes a lack of government regulation so that economies can flourish and grow
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liberalization
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removing government market oversight
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privatization
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transferring a system from state to private control
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individualism
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individuals are assumed to act in their best interest and choose the options best suited for their needs
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decentralization
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transferring power and accountability from central state government to local levels
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austerity
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set of economic policies implemented by governments to control and reduce national debt
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Bamako Initiative (1987)
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developed by WHO; user fees from individuals would be used to pay for needed health resources; markets best able to determine price of treatments
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World Bank and International Monetary Fund
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developed "Washington Consensus" to stabilize LMIC in financial crisis
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market integration
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the degree to which people consume from and produce for global market economy
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push determinants
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internal population pressure encroachment by outsiders
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pull determinants
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increased food consumption, reduced food variability throughout the year, the allure of foreign goods
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lifestyle incongruity
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inconsistencies between economic status and lifestyle practices
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Levels on which market integration occurs
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individual, household, community, region
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anthropometrics
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scientific measurements and proportions of the human body
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parasite
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any organism that spends a portion or the totality of its life biologically dependent on another species, typically at the expense of the host
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soil-transmitted helminths
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parasitic worms that infect their hosts through fecal-contaminated soil
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SOL
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style of life
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parasite load
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calculation of parasite infection status and eggs per gram
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micronutrients
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vitamins and minerals
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macronutrients
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water, carbohydrates, lipids, and proteins
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calorie
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amount of heat required to raise the temperature of one gram of water by one degree Celsius
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empty calories
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not all calories perceived the same way by our bodies
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stunting
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low height for age
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wasting
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low weigh for age
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Body mass index
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weight/ height
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infectious diseases
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transmitted between people and caused by a pathogen
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chronic on non-communicable conditions
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thought to be contagious, but linked with genetics, living conditions, and environmental exposures
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dual-disease burden
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co-occurrence of infectious disease and chronic/non-communicable conditions
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Life history theory
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explains how natural selection influences reproduction, survival, and lifespan
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REE
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resting energy expenditure
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TEE
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total energy expenditure
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energetics
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Science that looks at energy and its transformation; evolutionary medicine, behavioral ecology, and human biology are all part