question
Closing the Gap
answer
Closing the Gap = a report and a commission (WHO)
- improving living conditions, decreasing inequalities (power, gender, etc), assess and measure the problem and potential solutions
- improving living conditions, decreasing inequalities (power, gender, etc), assess and measure the problem and potential solutions
question
Advocates vs Scientists
answer
- Both go hand in hand
- involves communicating scientific data to inform awareness about global health issues
- advocacy an science work together to eliminate inequities
- involves communicating scientific data to inform awareness about global health issues
- advocacy an science work together to eliminate inequities
question
Advocacy
answer
- State your conclusions first, then support them
- Limit the number of messages
- Too many facts and figures overwhelm the audience
- Extensive qualifications can overwhelm the audience
- Technical jargon can confuse people
- Simplification is preferable
- Quick, but accurate, preparation and action are often necessary to take advantage of opportunities
- Present a passionate and compelling argument based on facts
- Limit the number of messages
- Too many facts and figures overwhelm the audience
- Extensive qualifications can overwhelm the audience
- Technical jargon can confuse people
- Simplification is preferable
- Quick, but accurate, preparation and action are often necessary to take advantage of opportunities
- Present a passionate and compelling argument based on facts
question
Science
answer
- Build your case gradually before presenting conclusions
- Several points can be made in single research paper
- Supporting evidence is vital
- Extensive qualifications can be necessary for scholarly credibility
- Technical jargon can add greater clarity and precision
- Detailed explanations are useful
- Hastily prepared presentations can be discredited
- Be objective and unbiased
- Several points can be made in single research paper
- Supporting evidence is vital
- Extensive qualifications can be necessary for scholarly credibility
- Technical jargon can add greater clarity and precision
- Detailed explanations are useful
- Hastily prepared presentations can be discredited
- Be objective and unbiased
question
The Gap in Global Health
answer
- The gap in global health can be described as the health inequities that exist between wealthy and impoverished populations
question
Life Expectancy
answer
- high income countries have greater life expectancy and lower levels of illness
- low income countries = higher levels of illness and premature mortality
- low income countries = higher levels of illness and premature mortality
question
Direct vs Indirect effect on poverty
answer
Direct
- can't buy food
- don't have clean living conditions
Indirect
- stressors
- menta burden on finance
- feeling lack of support
- can't buy food
- don't have clean living conditions
Indirect
- stressors
- menta burden on finance
- feeling lack of support
question
Social Determinants of Health and gaps in health
answer
- The gap in global health exists because of social determinants
- The social determinants of health are the circumstances in which people grow, live, work, and age, and their accessibility to healthcare, all of which allow them to deal with illness
- The social determinants of health are the circumstances in which people grow, live, work, and age, and their accessibility to healthcare, all of which allow them to deal with illness
question
Social Gradient
answer
- As wealth increases, so does health, in a stepwise fashion
- extreme poverty = worse health than those who are wealth
- work environment = affect social gradient (not job or income)
- low income/social class = more labour/dangerous/physically demanding jobs
- extreme poverty = worse health than those who are wealth
- work environment = affect social gradient (not job or income)
- low income/social class = more labour/dangerous/physically demanding jobs
question
Social Gradient and the SDHs
answer
- low education = low employment and low income
- low income = more likely to be exposed to harm of climate change
- higher education = more access to health-promoting resources
- low income = more likely to be exposed to harm of climate change
- higher education = more access to health-promoting resources
question
The Poverty Trap
answer
- individuals are trapped in poverty UNLESS external force like providing $ and resources occurs
- once in poverty = self-reinforcing
- low-paying job - more hours, more physical exhaustion, poor health
- the money you make today necessarily does not mean that it helps them make money in the future (current investments vs future income)
- once in poverty = self-reinforcing
- low-paying job - more hours, more physical exhaustion, poor health
- the money you make today necessarily does not mean that it helps them make money in the future (current investments vs future income)
question
Closing the Gap and SDH
answer
- health inequities increase because of SDH inequities
- overcome SDH inequities = health inequities and unequal health outcomes will be eliminated
- overcome SDH inequities = health inequities and unequal health outcomes will be eliminated
question
WHO Closing the Gap in a Generation Report
answer
COMMISSIONS ON SDH:
- WHO created for all government to take action to close the gap
- ex of gap in health inequities in the world = For instance, a girl born in Lesotho, a poorer country, has a life expectancy 42 years less than born in Japan
2. What are the social determinants of health? Why are these important?
- The social determinants of health are the social conditions of where people are born, live, grow, work, and age
- They are important because they impact the health of individuals, and by extension, populations
3. How should we broaden our understanding of health?
- Traditionally, health is thought of in medical terms
- In reality, health should also be viewed socially, so that changes can be made to social and economic conditions that will have positive impacts on health
- WHO created for all government to take action to close the gap
- ex of gap in health inequities in the world = For instance, a girl born in Lesotho, a poorer country, has a life expectancy 42 years less than born in Japan
2. What are the social determinants of health? Why are these important?
- The social determinants of health are the social conditions of where people are born, live, grow, work, and age
- They are important because they impact the health of individuals, and by extension, populations
3. How should we broaden our understanding of health?
- Traditionally, health is thought of in medical terms
- In reality, health should also be viewed socially, so that changes can be made to social and economic conditions that will have positive impacts on health
question
Goals of Closing the Gap in a Generation
answer
GOAL 1: Improve Daily Living Conditions:
- implement universal social protection policy from unemployment
- There are five areas that can be addressed to improve
1. Equity from the start
2. Healthy places, Healthy People
3. Fair employment and healthy work
4. Social protection throughout life
5. Universal health care
GOAL 2: Address Inequalities in Power, Money, and Resources:
- division of resources and power across public and private sectors via health policy
GOAL 3: Measure and Understand the Problem and Assess the Impact of Action:
- Increase global health research
- evaluate the impact that policies have on health
- implement universal social protection policy from unemployment
- There are five areas that can be addressed to improve
1. Equity from the start
2. Healthy places, Healthy People
3. Fair employment and healthy work
4. Social protection throughout life
5. Universal health care
GOAL 2: Address Inequalities in Power, Money, and Resources:
- division of resources and power across public and private sectors via health policy
GOAL 3: Measure and Understand the Problem and Assess the Impact of Action:
- Increase global health research
- evaluate the impact that policies have on health
question
START OF GOAL 1: Housing and Home Environment
answer
- Housing is a key social determinant of health
1) Physical Dimensions
- need basic survival needs
- This includes having clean water and sanitation, electricity, plumbing, heating, proper ventilation, and a safe infrastructure
2) Social Dimension
- affordability and home ownership,
- sense of belonging and control over their home
- no overcrowding
- domestic violence = central
3) Spatial Dimension
- location of house
- distance to schools, healthcare services, recreation areas, and grocery stores
- The proximity to industrial waste and other environmental contaminants is also important to consider
1) Physical Dimensions
- need basic survival needs
- This includes having clean water and sanitation, electricity, plumbing, heating, proper ventilation, and a safe infrastructure
2) Social Dimension
- affordability and home ownership,
- sense of belonging and control over their home
- no overcrowding
- domestic violence = central
3) Spatial Dimension
- location of house
- distance to schools, healthcare services, recreation areas, and grocery stores
- The proximity to industrial waste and other environmental contaminants is also important to consider
question
Syrian Refugees
answer
- war = no housing --> finding is extremely difficult, shelter
- respirator infections, poor ventilation, spread of diseases
- limited access of food and drinks
- MSF expanded growing health needs, free medical care, etc.
- respirator infections, poor ventilation, spread of diseases
- limited access of food and drinks
- MSF expanded growing health needs, free medical care, etc.
question
Impact of Poor Living on Health
answer
1) poor sanitation
2) crowded living quarters
3) refugees and mental struggles
4) poor ventilation
5) spread of communicable diseases
2) crowded living quarters
3) refugees and mental struggles
4) poor ventilation
5) spread of communicable diseases
question
Living Conditions on Indigenous Reserves
answer
- Many outcomes of the worse health care for Indigenous Peoples is long-term drinking water advisories = below standard
- As of December 2020, there were a total of 59 long-term drinking water advisories in 41 communities
- As of December 2020, there were a total of 59 long-term drinking water advisories in 41 communities
question
Early Childhood Development & Health
answer
- good living condition = healthy early childhood
- first six years of life are crucial (developmental changes)
- BRAIN = progression of linguistic, cognitive, psychosocial development
- 200 million child = poor living conditions
Equity from the Start
- Close the gap = how early childhood development is critical to health
- means every child is given the same opportunities and access to services so that they grow up in safe and healthy environments
- first six years of life are crucial (developmental changes)
- BRAIN = progression of linguistic, cognitive, psychosocial development
- 200 million child = poor living conditions
Equity from the Start
- Close the gap = how early childhood development is critical to health
- means every child is given the same opportunities and access to services so that they grow up in safe and healthy environments
question
The Jamaican Study
answer
- The Jamaican Study was a longitudinal study that looked into the relationship between ensuring the healthy development of children, both physical and psychosocial and a child's later development in life
Population: children that were stunted (not growing)
---> Control group
---> Supplemented with high nutrition group
---> Stimulated psychosocially group
---> Stimulated BOTH group
- Mean developmental scores were better when they had both increased
- Early childhood development is a really key time to be able to make a huge impact on the social determinants of health as well as on the health of an individual in the future and on closing that gap in global health
Population: children that were stunted (not growing)
---> Control group
---> Supplemented with high nutrition group
---> Stimulated psychosocially group
---> Stimulated BOTH group
- Mean developmental scores were better when they had both increased
- Early childhood development is a really key time to be able to make a huge impact on the social determinants of health as well as on the health of an individual in the future and on closing that gap in global health
question
Employment and Working Conditions
answer
Working Conditions:
- poor working conditions = low-status job
- poor physical and psychosocial health and stress
Job Security
- Unemployment = negative effect on physical and mental health
- financial insecurity, material deprivation, a lack of opportunities for person development, and increased stress
- poor working conditions = low-status job
- poor physical and psychosocial health and stress
Job Security
- Unemployment = negative effect on physical and mental health
- financial insecurity, material deprivation, a lack of opportunities for person development, and increased stress
question
COVID-19 and Employment
answer
- word from home, economic disruption, businesses closing down
- lot's of jobs you can't work from home (manual labour and retail)
- choosing between note earning enough or returning to work with risk of becoming infected
- cost of child care and negative mental health
- home can be a more unsafe place (domestic violence)
- lot's of jobs you can't work from home (manual labour and retail)
- choosing between note earning enough or returning to work with risk of becoming infected
- cost of child care and negative mental health
- home can be a more unsafe place (domestic violence)
question
Migrant Work and Early Childhood Health & Development
answer
Ex. India
- construction industry = 2nd largest employer
- cannot afford childcare --> 3 million children were unsupervised on site
MOBILE CRECHES
- adults take care of children
- increase positive health outcomes
- removing children from sites = increase work productivity
- construction industry = 2nd largest employer
- cannot afford childcare --> 3 million children were unsupervised on site
MOBILE CRECHES
- adults take care of children
- increase positive health outcomes
- removing children from sites = increase work productivity
question
Neighbourhood and Natural Environment
answer
- large built-in environment where people live, has impact on physical and mental health
- WHO's healthy cities program = initiative that aims to create an environment that supports health to a good quality of life
- WHO's healthy cities program = initiative that aims to create an environment that supports health to a good quality of life
question
Healthy Cities, Healthy Communities Movement
answer
- With growth of urbanization, people living in cities usually have better access to opportunities and healthcare
- However, city life leads to sedentary lifestyles, pollution , and crowded living conditions, which can negatively impact population health
- However, city life leads to sedentary lifestyles, pollution , and crowded living conditions, which can negatively impact population health
question
Urbanization and Health
answer
1. Crowding
2. Violence and Injuries
3. Diseases
4. Pollution and Climate Change
5. Gentrification
2. Violence and Injuries
3. Diseases
4. Pollution and Climate Change
5. Gentrification
question
1. Crowding
answer
- increase urbanization = increase population density
- urban centers = more investment thus rural communities suffer from underinvestment
- urban centers = more investment thus rural communities suffer from underinvestment
question
2. Violence and Injuries
answer
- urban cities = increase crime rates
- women, migrants and refuges experience lack of security
- women, migrants and refuges experience lack of security
question
3. Diseases
answer
- increase urbanization = increase spread of communicable disease (close in proximity)
- also effects dietary patterns and physical activity levels (non-communicable)
- city design = affect walkability and access to services
- more fast food restaurants
- also effects dietary patterns and physical activity levels (non-communicable)
- city design = affect walkability and access to services
- more fast food restaurants
question
4. Pollution and Climate Change
answer
- increase urbanization = increase in green house gas emission which contribute to climate change
- disproportional impact on those living in low SDI countries
- disproportional impact on those living in low SDI countries
question
5. Gentrification
answer
- The process through which low-value neighborhoods experience an influx of affluent residents and business, transforming the neighborhoods to high-value areas
Consequences:
1) increase rent and property values
2) changes in racial and ethnic composition
3) can't afford daily basics
4) social and economic changes with community identity
Consequences:
1) increase rent and property values
2) changes in racial and ethnic composition
3) can't afford daily basics
4) social and economic changes with community identity
question
Impact of Climate Change in developing countries
answer
- Lack of policy (or implementation of policy) to control pollutants including those in food (pesticides, etc.)
- Lack of social security/insurance helping those living in poverty to be able to afford to live in decent areas/housing conditions
- Crowded living
- Lack of universal healthcare and health promotion interventions
- Lack of social security/insurance helping those living in poverty to be able to afford to live in decent areas/housing conditions
- Crowded living
- Lack of universal healthcare and health promotion interventions
question
Two areas of improvement within the policy level of global and population health
answer
1. Social protection
- 29% of population have social security for protection
- implementing social protection policy = increased health
- barriers = limited infrastructure and finance
- political ideologies and economic policies = favors economic growth
2. Across the Life course Universal Healthcare
- language, cultural, and spiritual
- 29% of population have social security for protection
- implementing social protection policy = increased health
- barriers = limited infrastructure and finance
- political ideologies and economic policies = favors economic growth
2. Across the Life course Universal Healthcare
- language, cultural, and spiritual
question
Feasibility of Social Security
answer
- A key global aspiration is universal healthcare coverage for all individuals, regardless of their ability to pay
Things into account:
1. Who is covered
- 10% to 97% change in China for who is covered
- Accessible and convenient medical care
2. What services are covered
- Prevention vs early diagnosis
3. What level of quality
- Mexico = the People's Insurance (vaccination)
- Thailand = even expensive treatments
4. How are they paid for
- Community managed
Things into account:
1. Who is covered
- 10% to 97% change in China for who is covered
- Accessible and convenient medical care
2. What services are covered
- Prevention vs early diagnosis
3. What level of quality
- Mexico = the People's Insurance (vaccination)
- Thailand = even expensive treatments
4. How are they paid for
- Community managed
question
Racial Inequality in Healthcare
answer
- visible minorities in Canada experience healthcare inequities --> attributed to lack of minority healthcare workers (lack the ability to deliver culturally sensitive care)
- language, cultural, spiritual differences between physicians and patients
- language, cultural, spiritual differences between physicians and patients
question
The ABC Project
answer
The ABC project was a longitudinal study (North Carolina)
- intervention = enriched preschool and healthcare
Effective?
- difference in health an risk of disease
- early health and education can produce later health
- GOV: policies don't need to be all about giving free health services, but the access to them when they are younger also helps a lot too
- intervention = enriched preschool and healthcare
Effective?
- difference in health an risk of disease
- early health and education can produce later health
- GOV: policies don't need to be all about giving free health services, but the access to them when they are younger also helps a lot too
question
Goal 2: Addressing Inequities
answer
- The second major recommendation of the report identified the need to tackle inequalities in power, money, and resources
- suggests the need to develop policies that promote equity
- suggests the need to develop policies that promote equity
question
Optimal Healthcare Systems 4 pillars
answer
1) local actions
2) equitable systems
3) primary level of care
4) prevention, health promotion, and intervention
2) equitable systems
3) primary level of care
4) prevention, health promotion, and intervention
question
Health Inequity in the Canadian Indigenous Population
answer
1. Nursing Stations
- primary care
- indigenous lacks in nursing stations (lack of staff)
- deserve the same access to essential health services from qualified nurses (training)
2. Medical Transportation
- remote reserves
- lack of transportation to the big city
- indigenous individuals who are not registered in Indian Registration System = denied access (1/2 children are not registered)
3. Support Allocation and Comparable Access
- Health Canada did not account indigenous health needs when allocating support
TWO INITIATIVES TO INCREASE ACCESS
Ex. Telehealth
- long-distance patient and clinician content
- translation support and fee
ex. NOSM
- educate doctors to contribute to care in Northern Ontario urban, rural, and remote communities
- primary care
- indigenous lacks in nursing stations (lack of staff)
- deserve the same access to essential health services from qualified nurses (training)
2. Medical Transportation
- remote reserves
- lack of transportation to the big city
- indigenous individuals who are not registered in Indian Registration System = denied access (1/2 children are not registered)
3. Support Allocation and Comparable Access
- Health Canada did not account indigenous health needs when allocating support
TWO INITIATIVES TO INCREASE ACCESS
Ex. Telehealth
- long-distance patient and clinician content
- translation support and fee
ex. NOSM
- educate doctors to contribute to care in Northern Ontario urban, rural, and remote communities
question
Actions to Enhance Health Equity in Indigenous Populations (Truth and Reconciliation
answer
- speaking with indigenous peoples to identify and eliminate
- sustainable funding to address residential school harms
- value of traditional healing practices
- indigenous health care professionals
- sustainable funding to address residential school harms
- value of traditional healing practices
- indigenous health care professionals
question
Equitable Health Policies
answer
- don't rely on individuals to pay for healthcare
- can be determined by # of government and economic factors
Policy for high fat and sugar foods
- promotes the production and trade of fruits and vegetables to be better aligned with health policy and make such products more accessible
- can be determined by # of government and economic factors
Policy for high fat and sugar foods
- promotes the production and trade of fruits and vegetables to be better aligned with health policy and make such products more accessible
question
Intersectoral Action for Health (ISA)
answer
- align health policies with government to promote health equity
- design policies beyond health sector and work with other sectors to address SDHs
- The Public Health Agency of Canada (PHAC) and WHO have been working collaboratively to eliminate inequalities
- design policies beyond health sector and work with other sectors to address SDHs
- The Public Health Agency of Canada (PHAC) and WHO have been working collaboratively to eliminate inequalities
question
Market Responsibility
answer
1. Social goods should be governed by the public sector
2. Legislation should promote gender equality
3. Promote political empowerment
commercialization of education, healthcare and other basic needs --> produce health inequity governed by public sector
2. Legislation should promote gender equality
3. Promote political empowerment
commercialization of education, healthcare and other basic needs --> produce health inequity governed by public sector
question
Gender Equity
answer
- women have less power, education, opportunities, entitlements, income
- gender inequity = health inequity
- gender inequity = health inequity
question
Empowering Women
answer
- Legislation that enforces equity and equality
- Making discrimination on the basis of gender illegal
- Investing in formal and vocational education for girls
- Guaranteeing pay equity
- Increasing investment in female sexual and reproductive health
- Making discrimination on the basis of gender illegal
- Investing in formal and vocational education for girls
- Guaranteeing pay equity
- Increasing investment in female sexual and reproductive health
question
Gender Inequality in Healthcare (South Asia and NA)
answer
South Asia
- Gender bias towards males is accepted
- malnourishment -> maternal conditions
North America
- LGBTIQ youth population -> greater risk to health and well-being
- exclusion, isolation, fear of homophobic = barriers
- mental health issues
- ex. HIV
- Gender bias towards males is accepted
- malnourishment -> maternal conditions
North America
- LGBTIQ youth population -> greater risk to health and well-being
- exclusion, isolation, fear of homophobic = barriers
- mental health issues
- ex. HIV
question
Political Empowerment
answer
- decrease health inequity = increase political empowerment of disadvantages people
- ability for individuals to contribute and be included in political process
- inequity to who can participate in political decision making
- unfair distribution of societal power + resources
- ability for individuals to contribute and be included in political process
- inequity to who can participate in political decision making
- unfair distribution of societal power + resources
question
Top Down and Bottom Up
answer
- Top down
---> When the state works to guarantee a complete set of rights for ALL citizens, and a fair distribution of resources across society
- Bottom-up, or grassroots
---> Founded by self-organization of disadvantaged groups
---> When the state works to guarantee a complete set of rights for ALL citizens, and a fair distribution of resources across society
- Bottom-up, or grassroots
---> Founded by self-organization of disadvantaged groups
question
2. Female Genital Mutilation
answer
- Tanzania
- No health benefits and seen as a rite of passage prior to marriage
- Physical trauma, significant emotional trauma --> violation of rights
- Cultural belief = parents and cutters
- do that when the girls are even younger
- No health benefits and seen as a rite of passage prior to marriage
- Physical trauma, significant emotional trauma --> violation of rights
- Cultural belief = parents and cutters
- do that when the girls are even younger
question
Top Down Promotes a Bottom Up Approach in FGM
answer
- Criminalization of FGM--> grassroots organizations
- NAFGM --> set of complementary actions to combat the practice at the grassroots and community level
- Running rescue homes, educating both boys and girls, education midwives and cutters
- NAFGM --> set of complementary actions to combat the practice at the grassroots and community level
- Running rescue homes, educating both boys and girls, education midwives and cutters
question
...
answer
...
question
Goal 3: Measuring and Monitoring Health
answer
MDG Task Force Report provide critical information about the successes and short-comings of interventions as a way to improve the future interventions
question
Barriers and Enablers
answer
Barriers = obstacles
- That could harm the feasibility of a policy or intervention
Ex.
- Civil unrest Governmental policies or agendas
- Physical barriers (lack of infrastructure)
- Cultural barriers (mistrust of western medicine)
Enablers = factors or resources
- Leveraged to increase the feasibility or effectiveness of a policy or intervention
Ex.
- The willingness of a community to accept a policy or participate in an intervention
- Governmental programs that make additional resources available for addressing the health issue
- That could harm the feasibility of a policy or intervention
Ex.
- Civil unrest Governmental policies or agendas
- Physical barriers (lack of infrastructure)
- Cultural barriers (mistrust of western medicine)
Enablers = factors or resources
- Leveraged to increase the feasibility or effectiveness of a policy or intervention
Ex.
- The willingness of a community to accept a policy or participate in an intervention
- Governmental programs that make additional resources available for addressing the health issue
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