Global Mental Health

"An area of study, research, and practice that places a priority on improving health and achieving health equity for all people worldwide" (Beaglehole & Bonita 2010)

Global health focuses on "health problems, issues, and concerns that transcend national boundaries, may be influenced by circumstances...in other countries, and are best addressed by cooperative actions and solutions" (1997:1 Institute of Medicine's America's Vital Interest in Global Health

Health problems transcend national boundaries
-Globalization
-Communicable disease (HIV/AIDS, MDR/TB, Covid-19, Monkeypox, etc)
-Climate change
-Flow of refugee and migrant popu;ations

Health interventions can across borders
-Uganda's ABC Campaign
--Abstinence before condoms
-Role of non-governmental actors
--WHO, Gates Foundation, Partners in Health

MH tied to economic, social, and political welfare
-Economic inequalities
-Urbanization, migration, social change
-Warfare and violence

MH as a global challenge
-Substantial disease burden
-Substantial economic costs
-Developing world lacks training and infrastructure

Interventions can "cross borders"

Epidemiology: "The study of the distribution and determinants of health-related states or events in specific populations, and the application of this study to the prevention and control of health problems."

Distribution of disease
-Distribution by sex, age, SES, occupation, exposure to contaminants, residence, ethnicity

"Determinants" of disease
-Social, economic, cultural, and environmental factors associated with the disease
-Risk factors
--Smoking, high sodium/fat diet
--Poverty, inequality, discrimination
--Exposure to toxins

Resilience factors
--Supportive social network
--Internal "locus of control"
--Access to health care, healthy food

"Prevention and control of health problems"
--How can we improve the health status and well-being of a population?
--Which interventions are most effective?

Incidence and Prevalence

Rate of occurrence of new cases arising in a given period in a specified population
-First psychotic episode of schizophrenia
-New diagnosis of leukemia, malaria, diabetes
-Identification of episode of child abuse
-First heart attack
-Expresses risk of becoming ill

Frequency of existing cases in a defined population at a given point/period of time
-Existing cases of leukemia, malaria, diabetes, major depressive disorder, schizophrenia

Expresses the percentage of a population who are ill during a focal period of time

Useful at looking at a chronic illnesses and disease burden
-He has a diagram on powerpoint, we got the printout for this lecture

SHS provide 'snapshot' of relative health and well-being of a given population

Basis for comparison between populations

Basis for policy making and investment

Mortality
-Infant mortality
-Child mortality rate (Under 5)
-Maternal mortality rate
-Adult mortality rate (15-60 years of age)
--Lmao there is no 6-14 data really picked
-Life Expectancy

"Global Burden of Disease" Project - WHO, World Bank, and Harvard School of Public Health
-GBD is the gap between pop's current health status and ideal state

Years of life lost (YLL)
-Discrepancies from global standard life expectancy

Years of life lost to disability (YLD)
-Number of cases due to injury/illness multiplied by average duration and severity

Global Burden of Disease (1990)
-New metric for burden of disease: Disability adjusted life years (DALY)
-DALY = YLL + YLD

There are charts in the powerpoint that show cause of death ranked with and without disabilities