Global health care

refers to countries with a stable economy, a wide range of industrial and technological development, low child mortality, high gross national income, and a high human asset index

any country that does not meet the above criteria (stable economy, a wide range of industrial and technological development, low child mortality, high gross national income, and a high human asset index)

a composite score that considers education and health

considers mortality rate of children under 5 yrs., prevalence of growth stunting, and maternal mortality rates

considers adult literacy rate, secondary school enrollment, as well as gender ratios of secondary school enrollment

the rate at which the population is replaced (i.e. for every one death there is one birth = 1:1 ratio)

the process of increasing our social and economic dependence and integration with other countries

the development of industries and infrastructure in a country or region on a large scale

is the greatest in less developed countries (West africa has the highest PRL. # of births neccessay to maintain a population after taking into account how many leave)

U.S. market economy is dependent on outside sources as a result of globalization
Labor and production of materials are generally cheaper in other countries
World population growth attributed to decreased mortality rates
U.S. population growth attributed to public health initiatives, advances in medicine, and
a shift from infectious disease processes to chronic illnesses
Foreign-born immigrant population of the U.S.
Advances in transportation

Money invested into developing countries leads to

Builds the country's infrastructure

Better sanitation practices lower the risks of communicable infectious diseases

Developing country's health begins to improve

Improved conditions in the developing country decreases the spread of disease between countries

Provides both direct and indirect benefits
Industrialization helps both developing and underdeveloped countries
$ is invested into underdeveloped countries and helps build the country's infrastructure, leads to better sanitation practices, makes country's infrastructure healthier, and less spread of disease between countries

Feeding large populations becomes difficult in times of famine, international trade problems, and war

malnutrition, disease, and death

Food may be plentiful, but stress is evident in overpopulated cities

overcrowding, pollution, stress, disease, and violence

More than 50% of the population is located in 4 countries (China, India, Indonesia, & the U.S.)

Indicative of the health of the country
Captures the mortality rate along the entire life course vs. at a specific point in time

Developed vs. developing • Type of healthcare delivery
system
Morbid base or population based healthcare delivery system, morbidity and mortality, under developed and developing countries in poverty in general experience higher rates of death and disease

Disproportionately distributed between developed and developing countries

Avg. global life expectancy is 70 yrs. old and there's large inequalities in life expectancy depending on the area of the world you live in

36% of the world lacks basic sanitation
Impacts their ability to perform basic
hygiene practices
• Handwashing
• Safe drinking water
Exacerbates malnutrition and promotes infectious diseases (cholera, dysentery, hepatitis A)
Death rates are disproportionately higher by 1,000-fold

Environment is a source of food, water, fuel, building products, etc.
Produces waste, e-waste, environmental pollution (air, water, land, & noise)
• Impacts human health
Damages society's goods and services
Interferes with the ecological balance
Increases our carbon footprint
• Global average: 4 tons/person
• U.S. average: 16 tons/person

can lead to cancer, birth defects, interferes w/ ecological balance, global warming and climate change through deterioration
Carbon footprint, the total amount of greenhouse gases including CO2 & methane that are generated by our actions

mpacted by lifestyle, health and cultural beliefs, infrastructure, politics, and economics

Shift from an infectious disease profile to a chronic disease profile

continue to experience high mortality rates from infectious disease

poor sanitation

poor hygiene practices

malaria, zika

lack of stable economy combined with high population replacement rates

shows decline but continues to be prevalent in country migration that plays a major role in the continued spread of HIV/Aids

refers to a higher burden of illness, injury, disability, or mortality
experienced by one group relative to another group
Difference in health between groups

refers to the difference between groups relative to insurance coverage, access to and utilization of care, and quality of care

the view that everyone deserves equal economic, political, and social rights and opportunities

for the most # of people you have to sacrifice others to take care of a bigger group of people. If you can't save everyone, you have to let some people go

more than just treating people fairly. It involves rejection of the status quo for the greater good. Whole belief in doing what's better for the greater good. When you look at the greater good, sometimes you reject the care of an individual for the greater good.

refers to an individual's ability to achieve their highest level of health
through the elimination of disparities in health and health care

addresses structural/systemic racism (invisible evil) and racial inequalities in biomedical research and science (manifests in areas such as criminal justice, employment, housing, healthcare, and politics

Required intervention for hospitals claiming non-profit status
Expanded medicaid coverage for postpartum women

refers to a combination of ways society fosters racial discrimination through mutually reinforcement systems of housing, education, employment, earnings, benefits, credit, media, health care, and criminal justice
Racism negative affects mental and physical health both directly and by creating inequalities across the social detriments of health

Wealthier countries asked to double financial aid to (1) rebuild the public healthcare system, (2) develop new and effective medicines, and (3) provide adequate reproductive and sexual health services

Millennium Development Goals (MDGs) were created to relieve poor health conditions around the world

Goals outlined in the "Declaration of Alma-Ata"
Acknowledges the extent of global health inequalities and calls on all member
nations to unite for social justice

MDGs updated to reflect the Sustainable Development Goals (SDGs) which
are more comprehensive and detailed (

Successfully models a population health approach

Creation of a healthy supportive environment
• Achievement of a good quality of life
• Provision of basic sanitation and hygiene needs
• Provide access to healthcare

Adopted a Call to Action on addressing population health and promoting health on a
global level
Identified major gaps in the effort to address health concerns
• Health programs lacking evidence-based guidelines on health promotion
• Lacked the incorporation of social determinants of health in policy-making
• Health systems that lack performance indicators

an unexpected increase in the number of disease cases in a specific
geographical region (CDC)
Examples: yellow fever, smallpox, measles, polio • Not limited to contagion-type diseases
• Nile fever - the result of infection from the West Nile virus
• Obesity - U.S.

a disease outbreak that is consistently present but limited to a particular region
• Disease spread and rates are predictable
• Example: Malaria

a virus that covers a wide area, affecting several countries and
populations (WHO)
• Disease growth is exponential• Each day, cases grow more than the day prior

Devastating impact on the mental and physical health on the citizens of that country
• Major cause of disability worldwide• Significant loss of human life
• Displaced populations are at an increased risk of contracting infectious disease

deplete the country of life sustained resources, health, care services are depleted, first aid, medications, food insecurity, poor sanitation and hygiene problems, and lack of adequate shelter

Estimated 24.9 million victims worldwide and 50,000 trafficked into the U.S. taken cave or
2019: 118,932 human trafficking victims identified
Estimated that 28-50% of victims have accessed the healthcare system while
being trafficked

Sexual exploitation (53%)
• Forced labor (40%)

Identify risk factors and clinical manifestations
• Ask the right questions
• Identify the language of sex trafficking and then mirror that language
• Continuing education now required as part of RN license renewal

2016: Shortage of 18 million• WHO (2020) Projections (PRE COVID)
• 2022: 15 million
• 2030: 10 million

Half of the world's population growth concentrated in 10 countries
• Largest rate of growth in Africa (PRL = 4.325 births/woman)
1. Africa
2. India
3. Nigeria
4. Pakistan
5. Democratic Republic of Congo
6. Ethiopia 7. United Republic of Tanzania 8. United States 9. Indonesia 10. Uganda

The misalignment in the number and/or skillsets of healthcare workers in comparison to the demand for services within a specified geographical location

14% of the world's population
10% of the world's disease burden
37% of the healthcare workforce
Spends 50% of the world's fin

11% of the world's population
24% of the world's disease burden
3% of the healthcare workforce
Spends <1% of the world's financial
resources

Shortage of healthcare workers
• Poor allocation of financial resources (U.S. Healthcare Lecture)
• Attracting healthcare workers to rural areas is difficult due to pay differentials
• Cost of a medical education in the U.S. has increased dramatically in the past 50 yrs.
(funding goes to acute care services and physicians)

Health for all
Attainment by all citizens of the world to obtain a level that will permit them to lead a socially and economic productive way of life

Health is a fundamental human right
• Health disparities are unacceptable
• Importance of community involvement

Notable Achievements
• Eradication of smallpox and polio from the Americas
• Elimination of endemic transmission of measles and rubella
• Reduction in infant and child mortality
• An increase in the average life expectancy of 35 years since 1902

seeks to reflect the moral authority of their 193 member nations.
Current agenda: committed to world peace and security. Equal vote in decision making. " Designer babies"

Created in 1946 to assist sick and hungry children in more ravaged areas. In 1950 they expanded their work to address the needs of women and children globally, not just war areas. Their current agenda is addressing child sexual abuse and exploitation in foreign countries

Improve health status of individuals and populations in areas that lack economic development, provide low interest grant and loans to developing countries for education, and health initiatives (goal)

Addresses global nursing shortages
• 1995: established the "Leadership for Change" program
Prepares nurses with the leadership skills needed to implement change for the purpose of achieving better health outcomes
Program tailored to the specific health challenges of the implementing country
Leads "Train the Trainer" workshops to ensure program sustainability globally

Bill & Melinda Gates Foundation
Goal: improve the health of developing countries
Current Agenda: Improving access to antiretroviral medications in Africa to
prevent and treat HIV, TB, and malaria
Covid: funded and partnered with manufacturer companies to get vaccines into developing countries