Global Health Exam 1 part 1

state of complete physical, mental, emotional, spiritual, environmental, and social well-being and not merely the absence of disease or infirmity

science and art of preventing disease, prolonging life, and promoting physical health and mental health and efficiency through organized community efforts toward a sanitary environment

Differentiating Factors:
-Focus
population (public health) vs individual (medicine)
-Ethical
public service (public health) vs personal service (medicine)
-Emphasis
disease prevention/health promotion for communities (public health) vs disease diagnosis, treatment, and care for individuals (medicine)
-Intervention
broad spectrum that may target the environment, human behavior, lifestyle, and medical care (public health) vs emphasis on medical care (medicine)

an area for study, research, and practice that places a priority on improving health & achieving equity in health for all people worldwide

promotion of handwashing, bicycle/motorcycle helmets, knowledge of HIV/AIDS, large scale screening for diabetes/ HTN, eyesight, mass dosing, supplementary feeding, taxation on tobacco/alcohol, regulation of industrial pollution, regulation of food labeling

emerging /re-emerging infectious diseases, antimicrobial resistance, eradication of polio, TB, malaria, HIV, increasing global prevalence of DM and heart disease

aimed at addressing the health problems and diseases that afflict low- & middle-income countries

•Low-income $995 or less
•Lower middle-income $996 to $3,895
•Upper middle-income $3,896 to $12,055
•High-income $12,056 or more

Based on gross national income per person

•Determinants of health
•Key risk factors for different health conditions
•Global burden of disease
•Measurement of health status
•Importance of culture to health
•Demographic and epidemiologic transitions
•Organization and function of health systems
•Links among health, education, poverty, and equity

•Environmental health
•Nutrition
•Women's health and reproductive health
•Child and adolescent health
•Communicable diseases
•Noncommunicable diseases
•Injuries

Afghanistan
ethiopia
haiti
mozambique
nepal
zimbabwe

bangladesh
bolivia
cameroon
egypt
india
morocco
phillipines
swaziland

botswana
costa rica
jamaica
south africa
turkey
venezuela

argentina
belguim
canada
denmark
italy
netherlands
portugal
singapore

•Formulated in 2015
•17 SDGs
•Countries that signed pledged to meet goals by 2030
•All relate to health, whether directly or indirectly

•Strong links among health, human development, labor productivity, and economic development
•Health status determined by variety of factors
•Enormous progress in improving health status over last 50 years
•Much progress is the result of public hygiene, better water and sanitation, and better education
•Enormous disparities in health status and access to health services within and across countries

•Countries do not need to be high-income to enjoy good health status
•When considering health policy, one must ask, "if I only had $100 to spend, how should I spend it to achieve the maximum health gains for the key groups, at least cost?"
•Burden of disease is evolving in light of economic and social changes, aging populations, and scientific and technical progress

•Some issues can only be solved through cooperation
•Each of us should be concerned with the health of others for humanitarian, health, and security reasons
•People and communities have the ability to enhance their own health status

•Low-income countries should focus on "...burying old people, instead of young people, making the transition as fast as possible, and doing so at least cost"
•The health goals for all countries are to enable their people, at least cost and in fairly distributed ways, to enjoy the maximum possible health

•behavior and beliefs that are learned and shared"
•Culture influences family, social groups, individual growth, communication, religion, art, politics, and the economy
•Health policies and programs must always keep culture in mind
•Critical to note - some cultural practices enable good health but some do not

•Culture is related to health behaviors
•Culture is an important determinant of people's perceptions of illness
•Culture affects usage of health services
•Different cultures have different health practices

-Insider - shows the culture as viewed from within. It refers to the meaning that people attach to things from their cultural perspective.
-Outsider - refers to the culture as viewed from the outside. Rather than meaning, it conveys a structural approach, or something as seen without understanding its meaning for a culture.

•Ethnocentrism refers to seeing your own culture as "best."
•Ethnocentrism is a natural tendency because the survival and perpetuation of a culture depend on teaching children to accept it.
•Ethnocentrism becomes a barrier if people approach a culture with the attitude that it is inferior.
•Story of Guatemalan De-Worming Study

Perceptions of Illness
•Illness: "personal, interpersonal, and cultural reactions to disease or discomfort"
•Vary across groups
•One culture may view certain signs or symptoms as an affliction while others consider them normal

Perceptions of Disease
•Disease: "malfunctioning or maladaptation of biologic and psychophysiological processes in the individual"
•Some cultures believe illness can be caused by emotional stress, supernatural causes, or bodily imbalance

•Cultural interpretations of physical states that people perceive to be illness, but that do not have a physiologic cause
•Efforts to improve health need to consider these beliefs

•Many cultures have taboos that concern avoiding illness
•Many concern foods to avoid during pregnancy
•Wide variety of ritual practices to avoid illness
•U.S. Example: Not eating domesticated pets

•Common to try a home remedy, then visit a local healer, then consult a "western doctor"
•"Patterns of resort" affected by cost of services and manner in which the provider treats them socially
•Story in Mexico of Medicine Man

•Risk factors for leading causes of death related to culture include:
-Nutrition and eating practices
-Tobacco use
-Unsafe sex
-Hygiene
•All risk factors are related to unhealthy behaviors

Barber shops in many countries are "community centers" in which men congregate for discussion. Several countries have created programs in which barbershops and barbers provide health education messages

•Culture is an important determinant of health
•Perceptions of illness and disease vary considerably across cultures
•Many forms of traditional behavior are conducive to good health but some are not
•It is important to consider how healthy behaviors can be promoted

In order to address global health issues, we must understand:
•The factors that influence health status most
•The indicators used to measure health status
•The key trends in health status that have occurred historically

•The interconnected factors that determine an individual's health status
•Determinants include personal and inborn features, socioeconomic status, culture, environment, educational attainment, health behaviors, childhood development, access to care, and government policy

Health status indicators are critical for:
•Determining the causes of morbidity, disability, and death
•Carrying out disease surveillance
•Making comparisons about health within and across countries
Thus, it is important to use a consistent set of health indicators

# births infants under age 1 per 1,000 live births in given year

avg. # years newborn baby could expect to live if current mortality trends continue for the rest of newborn's life

# deaths infants under 28 days of age in given year per 1,000 live births in that year

# of women who die from pregnancy & childbirth complications per 100,000 live births in a given year

probability that a newborn baby will die before reaching age 5, expressed as a number per 1,000 live births

•Sickness or any departure from a psychological or physiological state of well-being

death

•Temporary or long-term reduction in a person's capacity to function

•Number of people suffering from a certain health condition over a specified period

rate at which new cases of a disease occur in a population

intervening before health effects occur

•screening to identify disease before the onset of signs and symptoms

managing disease post diagnosis or stopping disease progression

Illnesses caused by a particular infectious agent that spreads directly or indirectly from people to people, animals to people, or people to animals; also called infectious diseases

Illnesses not spread by an infectious agent

•Include road traffic injuries, falls, self-inflicted injuries, and violence, among other things

•Vital registration systems record births, deaths, and causes of death
•An accurate system is key to having quality data on a population
•Many low- and middle-income countries lack a vital registration system
•Often there are cultural barriers to timely vital registration

•Understanding global health issues requires understanding the determinants of health
•Determinants of health include: country income group, education, nutritional status, socioeconomic status, age, and sex.
•Health data is used to measure health status, carry out disease surveillance, make decisions about health investments, and assess health program performance

•SSA and SA have the lowest health status
•SSA has a unique profile of young child deaths: risks are equally spread across neonates, children, and adolescents
•In high-income countries, the majority of child deaths are among neonates and related to neonatal conditions
•There are substantial disparities between the better off and the worse off regions and income groups