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Multiple Metrics for Health
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1. Traditional metrics: Disease and injury prevalence and incidence, death numbers and rates.
2. Years of life lost due to premature mortality (YLLs) - count the number of years lost at each age compared to a reference life expectancy of 86 at birth
3. YLD- Years lived with disability
4. *Disability-adjusted life years (DALYs)
5. Healthy life expectancy (hale)
2. Years of life lost due to premature mortality (YLLs) - count the number of years lost at each age compared to a reference life expectancy of 86 at birth
3. YLD- Years lived with disability
4. *Disability-adjusted life years (DALYs)
5. Healthy life expectancy (hale)
question
What are the principal factors associated with child mortality?
answer
Education
Nutrition
Family Income
Water, sanitation, housing
Health Care
War and Violence
Inequality
Nutrition
Family Income
Water, sanitation, housing
Health Care
War and Violence
Inequality
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What are the THREE BIGGEST DETERMINANTS OF HEALTH?
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1. PATERNAL EDUCATION
(Greater than income and access to health services combined
Accounts for most of the rural/urban, family size mortality associations
Maternal is more important than paternal education
Primary to secondary is more important than literacy
How important is paternal education? VERY IMPORTANT)
2. NUTRITION
(Nutrition is highly associated with mortality
Nutrition is associated with over 50% of all mortality from all diseases in kids
UnEVEN progress (especially in africa))
3. FAMILY INCOME
(Poorer families have much higher child mortality rates
*Increasing national income doesn't really affect the overall life expectancy*)
(Greater than income and access to health services combined
Accounts for most of the rural/urban, family size mortality associations
Maternal is more important than paternal education
Primary to secondary is more important than literacy
How important is paternal education? VERY IMPORTANT)
2. NUTRITION
(Nutrition is highly associated with mortality
Nutrition is associated with over 50% of all mortality from all diseases in kids
UnEVEN progress (especially in africa))
3. FAMILY INCOME
(Poorer families have much higher child mortality rates
*Increasing national income doesn't really affect the overall life expectancy*)
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Other health determinants?
answer
4. Water
(Dirty water kills about 1.5 million kids per year
Sub-Saharan Africa contains the dirtiest water)
5. Sanitation
(Many people still don't have toilets
The same trend in sub-Saharan Africa)
6. Housing
7. Healthcare
8. War and Violence
9. Inequality
(Dirty water kills about 1.5 million kids per year
Sub-Saharan Africa contains the dirtiest water)
5. Sanitation
(Many people still don't have toilets
The same trend in sub-Saharan Africa)
6. Housing
7. Healthcare
8. War and Violence
9. Inequality
question
Epidemiologic Transition
answer
distinctive causes of death in each stage of the demographic transition
(Involves:
Declining child mortality
Improvement in living conditions
Improvement in education
vaccinations)
(Involves:
Declining child mortality
Improvement in living conditions
Improvement in education
vaccinations)
question
demographic transition
answer
change in a population from high birth and death rates to low birth and death rates
(Declining fertility and families having fewer children
Declining child mortality because of improved living conditions
Urbanization, social security systems
Higher cost of raising children
Female literacy
For countries with populations that are increasing at a rapid rate are more likely to have worse health problems, such as kenya. But it is also easy for wealthier countries to tay on top of it.)
(Declining fertility and families having fewer children
Declining child mortality because of improved living conditions
Urbanization, social security systems
Higher cost of raising children
Female literacy
For countries with populations that are increasing at a rapid rate are more likely to have worse health problems, such as kenya. But it is also easy for wealthier countries to tay on top of it.)
question
What should we measure when we measure health?
answer
1. Death
What are the causes of death, how many people, and what age?
2. Illness, morbidity
How many people are infected?
How do you get the data? Survey?
How do you measure the impact of illness?
3. Disability
Some diseases cause disability
What are the causes of death, how many people, and what age?
2. Illness, morbidity
How many people are infected?
How do you get the data? Survey?
How do you measure the impact of illness?
3. Disability
Some diseases cause disability
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How do we measure health in Public Health?
answer
1. Incidence: new cases over a certain period of time
(Number of new cases over a certain time period / total population at risk over the same time period)
2. Prevalence: percentage of the population that has a (certain disease or epidemic at a given time
ex) HIV POSITIVE / total pop)
3. Infant Mortality Rate (IMR): how many infants die in a year
(Total number of infant deaths (0 - < 1 yr) in a given year and locality / Total number of life
births in that same year and locality (X TIMES 1000))
4. Under 5 Mortality Rate: how many kids under 5 years of age die
5. Maternal Mortality: how many women die from maternal or birth related causes
6. Life expectancy: the number of years that someone or a population is expected to live at birth
(Number of new cases over a certain time period / total population at risk over the same time period)
2. Prevalence: percentage of the population that has a (certain disease or epidemic at a given time
ex) HIV POSITIVE / total pop)
3. Infant Mortality Rate (IMR): how many infants die in a year
(Total number of infant deaths (0 - < 1 yr) in a given year and locality / Total number of life
births in that same year and locality (X TIMES 1000))
4. Under 5 Mortality Rate: how many kids under 5 years of age die
5. Maternal Mortality: how many women die from maternal or birth related causes
6. Life expectancy: the number of years that someone or a population is expected to live at birth
question
How do you measure the burden of disease?
answer
1. Levels of morbidity by age
2. Levels of mortality by age
3. The value of a healthy year of life at specific ages
2. Levels of mortality by age
3. The value of a healthy year of life at specific ages
question
Some critiques of DALYs
answer
1. Social values of researchers
What is worse than the other?
2. Values live in terms of productivity
3. Devalues lives of the disabled
4. Devalues lives of the elderly
5. Health as an absence of disease
What is worse than the other?
2. Values live in terms of productivity
3. Devalues lives of the disabled
4. Devalues lives of the elderly
5. Health as an absence of disease
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What are some other things we should measure?
answer
1. GINI Coefficient
2. Health and Development Index (HDI)
3. Life expectancy at birth + gross national income (gni) per capita = HDI
4. Physical Quality of Life Index (PQLI)
5. Basic literacy rate + infant mortality + life expectancy at age one = PQLI
6. Happiness
2. Health and Development Index (HDI)
3. Life expectancy at birth + gross national income (gni) per capita = HDI
4. Physical Quality of Life Index (PQLI)
5. Basic literacy rate + infant mortality + life expectancy at age one = PQLI
6. Happiness
question
What are the non medical determinants of health?
answer
1. Biological
2. Infrastructural
3. Educational
4. Economic
5. Social
6. Political
2. Infrastructural
3. Educational
4. Economic
5. Social
6. Political
question
What are the leading causes of childhood mortality worldwide?
answer
1. Pneumonia
2. Preterm birth complications
3. Birth asphyxia
4. Diarrea
5. Malaria
2. Preterm birth complications
3. Birth asphyxia
4. Diarrea
5. Malaria
question
What is the general trend for poor children relating to their health?
answer
They generally have poorer health outcomes as a result of a poor household.
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The Global Fund
answer
A mutual fund that purchases international stocks and bonds as well as U.S. securities.
question
Describe some of the key determinants of health for people living in vulnerable circumstances.
answer
1. paternal education 2. nutrition 3. family income 4. water 5. sanitation 6. housing 7. healthcare 8. war and violence 9. inequality
question
Describe the most important health indicators.
answer
Incidence, prevalence, infant mortality rate, under 5 mortality rate, maternal mortality, and life expectancy
question
Discuss the differences between incidence and prevalence.
answer
Incidence is the amount of new cases over a given amount of time, whereas prevalence is the percentage of a population that is infected by a given epidemic/disease.
question
Discuss links between health and education.
answer
Trends show that if people are well educated about health, their health (along with people they influence) will improve greatly.
question
Describe the demographic and epidemiological transition models.
answer
The demographic transition model is a model that measures the growth of a population based on statistics from a given year. The epidemiological transition model is one that measures the prevalence of an epidemic in a population, and how that affects the growth of that population.
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Understand major drivers of disease globally.
answer
1. Biological 2. Infrastructural 3. Educational 4. Economic 5. Social 6. Political
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Describe the origins of debt globally and the influence of indebtedness on poor health.
answer
...
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Define evolving global health from "economic development leads to health" to "health leads to development."
answer
h
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Explain critical connections between health and equity.
answer
The connection between health and equity is one that is very crucial- if everyone had an equal playing field in terms of health, there would be better healthcare and decreased disease.
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Discuss the determinants of selected infectious diseases.
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These include lack of sanitation, education, resources, money, heath workers and patient consistency with medications.
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Discuss the importance of these diseases to global health.
answer
They are important because they spread fast and treatment/cures/prevention are a main focus of global health.
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Discuss the burden of NCDs worldwide.
answer
Non-communicable diseases are not infectious, but they are nearly as dangerous. Most progress over time, vary throughout the world, and are difficult to cure/treat. Examples of NCDs are mental health, cancer, and obesity.
question
Identify leading infectious diseases globally and the factors that influence the spread of those diseases.
answer
Leading infectious diseases: Tuberculosis, malaria, and ebola.
TB: spreads through the air and through saliva, has a cure- pill taken every day for 6-8 months
Malaria: just in low-income countries (lack of resources and money is a big determinant), transmitted by a very specific female mosquito. A treatment called ACT is used- one form of malaria stays with the patient for their life and the other does not..
Ebola: A rare but dangerous disease passed through water or any contaminated liquids.
TB: spreads through the air and through saliva, has a cure- pill taken every day for 6-8 months
Malaria: just in low-income countries (lack of resources and money is a big determinant), transmitted by a very specific female mosquito. A treatment called ACT is used- one form of malaria stays with the patient for their life and the other does not..
Ebola: A rare but dangerous disease passed through water or any contaminated liquids.
question
Distinguish between non-communicable and infectious diseases.
answer
A non-communicable disease is one that is not passed from one person to another, it is formed by the person over time. An infectious disease is one that IS passed from one person to another.
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Review the costs and consequences of infectious diseases of importance.
answer
Costs- It takes a large portion of money to create and maintain pharmaceutical treatments and it's hard to maintain a steady flow of health workers.
Consequences- If it is not handled with utmost care, it could be even more of a disaster.
Consequences- If it is not handled with utmost care, it could be even more of a disaster.
question
Relate in some detail the particular challenge and impact of HIV/AIDS in the field of global health.
answer
HIV/AIDS is a virus that targets defense cells
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Describe the most important noncommunicable diseases (NCDs).
answer
Mental illness (such as psychosis, mood disorders, substance use disorders, anxiety disorders, and cognitive disorders), cancer, heart disease, and strokes.
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Demonstrating a beginning understanding of the challenge of mental health issues and service deficits globally.
answer
Mental illness has been greatly misunderstood as someone being lazy, weak or dangerous. It is often hard to detect and needs constant treatment or an improvement in environment. There is a very small amount of mental health workers, especially in impoverished countries, therefore there is a large lack of resources.
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Discuss the difference between morbidity, disability and mortality.
answer
Morbidity is the condition of being diseased, disability is a physical or mental condition that limits a person's movements, senses, or activities, and mortality is the state of being subject to death.
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Describe how colonialsim has an enduring effect on health globally.
answer
Colonialism leaves certain countries poorer than others and impoverished countries are more susceptible to epidemics and poor health care.
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Explain the importance of Alma-Ata as a guiding principle in health care reform discussions.
answer
...
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Describe success stories that lead to the convening and declaration at Alma-Ata.
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b
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Understand the model of primary health care and its key attributes.
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c
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Describe some challenges that the Declaration of Alma-Ata encountered.
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d
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Articulate the major drivers of ill-health in low and middle income countries.
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e
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Describe success stories and failures in global health.
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a
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Critique selective primary health care.
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b
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Describe the difference between vertical, horizontal, and diagonal programs.
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c
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Describe the main functions of a health system
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d
question
Review how health systems are organized
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e
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Explain global approaches and movements towards health reform.
answer
f