global health 101 duke midterm

state of complete physical, mental and social well being, not merely the absence of disease and infirmity

area for study, research and practice that prioritizes improving health and achieving equity in health for all people worldwide
Global health emphasizes transnational health issues, determinants and solutions; involves many disciplines within and beyond health sciences and promotes interdisciplinary collaboration a synthesis of population-based prevention with individual level care

collaborative trans-national research and action for promoting health for all, emphasizing the critical need for collaboration

social justice, diseases don't respect borders, economic and social development, global security and freedom

health, relation to PH and medicine, equity/solidarity, transnational/global, multi-disciplinary/multi-directional, prevention focused, history, goals, data

8 goals, limitations are narrow focus, one size fits all, focus on half goals, number and type of stakeholders, etc.

17 goals, more specific with a lot of targets, created with more broad research and input, zero goals instead of half which means they are focusing on the actual systems, not just the superficial stuff you can cut away

Relative importance (burden) depends on frequency (incidence and prevalence), severity (mortality and morbidity), consequences (health, social, economic), and people affected (gender, age, SES and cultural position, etc.).

diseases of poverty - infectious, communicable, maternal and perinatal, nutritional disorders

diseases of affluence - non-communicable and neuropsychiatric

injuries (intentional or unintentional)

meeting needs of the present (effectively by taking into account multi-sectoral levels of determinants) to improve the future

Idea that disease and illness are affected by multiple levels of organization, from the molecular to the societal; three primary areas of influence - biology, social, psychological

Shows individuals and health in broader context of ecology, shows nested risks

Human health as inextricably linked to (part of) the natural world; health of people is connected to health of animals and the environment, interconnected

networks, barriers, structural violence, global transitions, health-wealth gradient, status syndrome

The number or rate of new cases of a particular condition during a specific time.

frequency of event/disease, often out of 100,000 people, is a true rate because it takes time into account in precise way

Proportion of individuals who get disease, ranges from 0-1; number of new cases of disease during time period/size of population during time period, not a true rate because it is a proportion

Number of existing cases/population count, proportion of people who have specific disease at point in time; measure of present status of disease

prevalence at point in time

prevalence during a specific time period

all cases of disease in a period of time during a person's lifetime

death; crude death rate - number of deaths in time period per 100,000 people; not does not take into account demographic factors

measure of living with disease, made up of incidence and prevalence, no clear endpoint; impairment, handicap, disability

health gap and health expectancy

HALE (health adjusted life years) - population health status - years lived healthily+years lived with disability, takes into account morbidity not just mortality

HeaLYs, DALY, QALY

healthy life years: healthy life lost combined with premature death years, loss of life expected if diseases hadn't occurred

disability adjusted life years: years of life lost+years of life with disabliity

quality adjusted life year: how many years or months of reasonably quality life a person could gain from treatment/intervention

YLL - years of life lost due to premature mortality, based on age at death and standard expectancy of age of death for that community; YLD - years of life with disability, years of healthy life lost due to living in state of less than full health, some state of morbidity

based on gross national income, sorted into high, upper-middle, lower-middle, lower income

low and middle income countries, world bank classification

development scale based on income, educational attainment and fertility rates; grouped into high, high-middle, middle, low-middle, low SDI

high income countries and greater modern infrastructure and use of resources vs. LMICs and less infrastructure and resources

higher income.earlier industrialization, more resource use and development vs. later industrialization, higher poverty, less development

The development of a region can impact access to healthcare, quality of healthcare, distance from healthcare, barriers to health care and more. In a rural, maybe less developed area the health care resources may be more scarce and lower quality, people may have to travel further to reach higher quality health care and may not have the means to

Countries with a lower income/developmental classification/SDI are more commonly impacted by group 1 diseases, diseases of poverty, while middle income/development and high SDI countries are impacted more by group 2 diseases, diseases of affluence and sometimes group 3, injuries

SDG goal 2- ensure healthy lives and promote wellbeing for all at all ages

9 main targets, reduce maternal mortality rate to <70/100,000, end preventable newborn and child deaths, communicable disease (AIDS, tuberculosis, malaria, etc.), reduce premature death from NCDs by 1/3, strengthen prevention and treatment for substance abuse, halve global deaths and injuries from traffic injuries, universal access to sexual and reproductive health services, universal health coverage, greatly reduce mortality and illness from environmental pollution

Copenhagen consensus smart development goals, cost-benefit analysis, 19 of 169 targets are the best value-for-money by 2030; all 169 targets spreads resources out too thinly and returns $2 trillion whereas focusing on the 19 has $10 trillion worth of benefits

differences in health outcomes

differences in health outcomes that are avoidable, unwanted and unnecessary, making them unjust

Inequality means that there are different outcomes in health but inequities means that there are more barriers or risks for some people that make them more likely to have inequalities, however these are systemic and based on certain factors that can often be changed with the right support and effort

environmental, metabolic or behavioral determinants