HLPR 233 Test 1

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

Focus is on the health of the individual

Focus is on the health of the population

Transnational health concerns. Global perspective on public health problems

Generally used to refer to low-income countries

Health improves with the introduction of western medicine

Health education and health behavior, epidemiology and biostatistics, environmental health, health policy, health economics, and health administration and
management

Health metrics provide a foundation for evidence-based policy and practice. 8 featured countries: USA, South Korea, Poland, Brazil, China, India, Kenya, Sierra Leone

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

Finding which diseases people suffer from •Determining the extent to which the disease causes death or disability, carrying out disease surveillance. To perform these functions, it is important to use a consistent set of indicators in order to make comparisons

Birth, death rates, causes of death (mortality), morbidity rates, causes of disease (morbidity) and disability, risk factor rates

The study of the size and composition of human populations

Birth rates: births per year per 1000 people in the total population. Death rates: deaths per year per 1000 people in the total population. Age-adjusted rates make different populations with different age structures
comparable

Challenges: In many lower-income parts of the world vital statistics are not collected (no death registry), cultural barriers to timely vital registration, it is sometimes difficult to assign one cause of death (either because the cause is unknown or because there were many contributing causes)

The average number of additional years a newborn baby can be expected to live if current mortality trends were to continue for the rest of the person's life.

The number of years the average person born into a population can expect to live without disability

Illness or disease

new cases of disease. new cases / susceptible population over a particular time period)

total cases of disease. proportion of a population with the condition at a particular point in time or a particular time period

An estimate of the impact of disease, disability, and premature death on a population

A way of estimating burden of disease in a population by adding years of life lost (YLLs) to premature death plus years of life with disability (YLDs)

Requires estimating the weight of the burden of various conditions (like assuming a "10% disability" for a particular type of injury or infection)

If a population has a high prevalence of modifiable risk factors for common diseases, these risk factors can be targeted by public health interventions

Grouped with infant health, maternal health (conditions related to pregnancy), and undernutrition

Bacteria, viruses, fungi, and parasites (protozoa and helminths/worms)

Cardiovascular diseases (such as heart attacks and strokes), cancers, chronic respiratory diseases (such as asthma), endocrine disorders (such as diabetes), digestive diseases

Mental illnesses, developmental disorders, neurological disorders

Physical harm or damage to the body. May be intentional or unintentional, may cause long-term disability (especially for the poor, who may not be able to afford treatment and rehabilitation)

Global health situation 100 years ago: high birth rates, high death rates/short life expectancy, high burden from infections and undernutrition. High-income countries today: low birth rates, low death rates/long life expectancy, high burden from chronic diseases and overnutrition

A shift toward lower birth and death rates that occurs as populations become higher-income economies

A shift from a high burden due to infections toward a high burden from chronic, noncommunicable diseases (NCDs) that occurs as populations become higher-income economies

A shift from undernutrition problems to overnutrition problems that occurs as populations become higher-income economies

Improvements in raising life expectancy and improving health not uniform across countries. Life expectancy in South Asia and sub-Saharan Africa lags behind other regions. Life expectancy in Europe and Central Asia changed little from 1990-2011, related to break-up of Soviet Union. Life expectancy in East Asia increased dramatically, partly due to rapid economic growth

Economies of low-income countries need to grow in order to invest in health. Impact of economic development will depend on how equitable growth is across population groups and investments in areas that improve health such as water, sanitation, and education

Development of vaccines, drugs, and diagnostics, country's ability to adopt these changes will determine their effect on health

Impact not entirely clear, possible migration from places that become uninhabitable, adverse weather, possible change in populations of disease vectors

Necessary for long-term gains in health, instability causes illness, disability, and death, as well as breakdown of infrastructure and services that leads to further health issues, instability has impeded many Development Goals

Occurrence and impact difficult to predict pandemic flu could have a major impact in the future, drug resistance outpacing our ability to produce safe and effective drugs could also have a substantial impact on the burden of disease

Difficult to predict but can use models to project, substantial changes projected to 2030, low- and lower-middle-income countries will shift away from communicable disease, causes associated with aging will increase in importance, mental health issues will increase in importance for all income groups

Health usually increases as national income increases, some countries have achieved higher life expectancies than their incomes would predict, this is possible with investments in the "best buys" such as nutrition, education, good hygiene, and low-cost services that have a high impact such as vaccination programs and TB control

Census data, vital statistics registries, surveillance systems, health services (hospital / clinic) records, insurance claims

Indicators of a person's standing in a society based on social, economic, and educational characteristics

SES conditions that influence health status and access to health services

Take-home pay

Accumulated worth

Households with low income and low wealth have few resources to draw on when a family member develops a severe illness or injury. Poor households tend to live in less healthy environments (air pollution, unclean water, etc.)

Some jobs are hazardous, manual laborers have higher all-cause mortality rates than professional workers, unemployed persons often have reduced health status

Literacy allows readers to acquire health information and navigate the health system. Female literacy is especially important for child and family health

Those with political, economic, or social power generally have greater access to health services. Those in power can limit the access of others to health care and health resources

Differences in health status between populations

Inequalities that are avoidable, unfair, and unjust

Groups people based on cultural heritage, nationality, religion, language, and other factors

Superficial categories that group people based on physical attributes like skin color

Minority populations may have reduced access to healthcare

There are many types of immigrants, both voluntary and involuntary. Migrants may face health risks during their transition to a new residence

10 million people worldwide are incarcerated on any given day (including more than 2 million in the United States). Prisons, jails, and detention centers may be unsafe environments (infections, injuries, undernutrition, mental health, etc.). Tuberculosis is a particular concern

Health disparities: "a type of difference in health that is closely linked with social or economic disadvantage"

Less well-off people, with less social and political power, will generally have worse health, poorer services, and less fairness and protection for financing health

Enormous variation in basic indicators. Differences reflect status of economic development, inequitable relationships between countries, and political choices. Life expectancy in OECD countries is 30% higher than in sub-Saharan Africa

Some countries have substantial variation in health indicators across population groups. Tend to be low- and middle-income countries or high-income countries with significant ethnic minorities

Urban dwellers and health status, coverage, and access to services. Rural people and incomes, education, access to services, and political voice

Strong association between ethnicity and health status, access, and coverage. Linked to strong association between ethnicity and power, education, and income