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Global health
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The study of the health of populations in a global context (studying both the diseases and their causes). Is broad and contains many diverse disciplines such as tropical medicine, primary health care, epidemiology, economics, and more
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Questions global health tries to answer
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-why is population health so poor in many developing countries?
-what is the extent of the problem?
-what can be done about it?
-what is the extent of the problem?
-what can be done about it?
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Global health today
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An intricate mix of private, governmental, and international organizations with an overall aim of improving the health of populations in developing countries. Uses "collaborative trans-national research and action" to focus on the people. Strives for health equity and freedom for people
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3 types of initiatives
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1. Agricultural and food security
2. Economic intervention
3. Human rights
2. Economic intervention
3. Human rights
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Amartya Sen (1933 - Present)
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an Indian economist whose work revolves around famines. He showed that starvation is not due just to lack of food any more than poverty is due only to lack of money (gov't plays important role), but that inequity is the root of most problems. He outlined 5 specific types of freedoms that should be both the ends and the means of development
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Amartya Sen's Freedoms
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1. Political freedoms
2. Economic facilities
3. Social opportunities
4. Transparency guarantees
5. Protective security
2. Economic facilities
3. Social opportunities
4. Transparency guarantees
5. Protective security
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Political freedoms
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Being able to vote for who you want in government
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Economic facilities
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People need the ability to control their own resources
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Social opportunities
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Chances/opportunities for self-expression
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Transparency guarantees
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Is everyone following the law and feeling safe?
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Protective security
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Vaccinations, lack of conflict, health services for mental health, feeling safe going to police, etc.
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Inequality
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Measurable! A descriptive term that need not imply moral judgement (just stating the facts). Example: maternal death rates in the US are higher than in Canada
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Inequity
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Political! inequalities deemed unfair or stemming from some form of injustice. Example: rural areas not having as well-equipped, or well-staffed hospitals, implying a moral judgement that those in the city deserve more
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Identifying inequalities depends on
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-one's theories of justice
-one's theories of society
-one's reasoning underlying the genesis of inequalities
-one's theories of society
-one's reasoning underlying the genesis of inequalities
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Millennium Development Goals
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8 goals created following the Millennium Summit of the United Nations in 2000, with the aim to guide global health for the next 15 years. For the most part, the goals are very health focused. We still discuss them because they did not meet what they set out to meet, so there are still areas of improvement, and the UN set the stage for discussions on global health with these goals
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Critiques of the MDGs
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-top-down, North-South approach
-did not include developing countries and the issues happening there when creating them (hypocritical)
-lacked human rights
-progress reaching the goals has been uneven across countries
-did not have adequate involvement of developing countries and were not adapted to national needs (blanket approach)
-left out issues such as disasters, conflict situations, non-communicable diseases, mental health disorders, large inequalities, etc.
-did not include developing countries and the issues happening there when creating them (hypocritical)
-lacked human rights
-progress reaching the goals has been uneven across countries
-did not have adequate involvement of developing countries and were not adapted to national needs (blanket approach)
-left out issues such as disasters, conflict situations, non-communicable diseases, mental health disorders, large inequalities, etc.
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Successes of MDGs
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-increased access to safe drinking water, sanitation, and education
-targets for tackling malaria and tuberculosis were met
-significant poverty reduction and a decline in extreme poverty
-substantial progress made in reducing child undernutrition, child mortality, and maternal mortality
-life expectancy did increase overall from 1966-2013
-targets for tackling malaria and tuberculosis were met
-significant poverty reduction and a decline in extreme poverty
-substantial progress made in reducing child undernutrition, child mortality, and maternal mortality
-life expectancy did increase overall from 1966-2013
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Sustainable Development Goals
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17 goals that are the successor to the MDGs. Transition from MDGs to SDGs was premised on building a sustainable world where environmental sustainability, social inclusion, and economic development were equally valued. Key is in the name "sustainable", we want them to long-lasting. Many criticisms of the MDGs were taken into the SDGs to fix, including issues left out such as disasters, conflict situations, mental health disorders, non communicable diseases, and large inequalities. Even though only goal 3 pertain directly to health, all the goals in a way relate and affect global health
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SDGs targeting health related to poverty
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Majority of people living in extreme poverty can be found in South Asia and sub-Saharan Africa, accounting for about 80% of the extremely poor. Inequality and injustice often follow poverty. Consider the cycle of poverty, health inequality vs health inequity, marginalization, social hierarchy, and social position
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SDGs targeting health related to malnutrition
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Slow progress in reaching MDGs for this due to increased food prices and the global recession, especially in parts of Asia and Africa. Large-scale famines and death from starvation have mostly been replaced by chronic malnutrition. Malnutrition can refer to under or overconsumption
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SDGs targeting health related to childhood illnesses
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Leading causes of death include preterm birth complications (18%), pneumonia (15%), birth asphyxia and trauma (12%), and diarrhea (9%). Child mortality rates have been reduced by half in many countries, but 6 million largely preventable deaths still happen per year. About 100,000 children still die from measles every year
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SDGs targeting health related to pregnancy-related deaths
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Developing regions account for 99% of all global maternal deaths. Majority of maternal deaths in developing countries can be avoidable with improved standards of care. Effects of pregnancy can impact the rest of a woman's life, as women can be left with disabling injuries, chronic infection, or permanent pain
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SDGs targeting health related to Indigenous health
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Widely diverse with 370 million Indigenous people's around the world, forming at least 5k separate groups expanding over 90 countries. Indigenous people often share a history of conquest and discrimination, resulting in poor treatment and reduced access to healthcare. Commonly shared health problems include high rates of substance abuse, diabetes, family violence, suicide, and lower average life expectancy
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SDGs targeting health related to war
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Internal wars have largely replaced external wars between countries, resulting in high levels of violence against civilian populations, progressive economic and social collapse, and displacement, and giving rise to the term 'humanitarian disaster". The cost and long-lasting impacts of war are incalculable on individuals, communities, and nations
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SDGs targeting health related to natural disasters
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The 2 deadliest (the Asian tsunami and the Haitian earthquake) and the two most costly (Hurricane Katrina and the Kobe earthquake) disasters in history occurred during the last decade. As the global population increases, the movement of people towards living in vulnerable areas has attributed to the steady increase in death rates from disasters each decade. Includes climate change, mitigation efforts (preparedness and planning), and global migration (forced and unforced)
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SDGs targeting health related to human rights abuses
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Abuses of basic human rights (just like many other global health issues) is not confined solely to the developing world. Issues include discrimination and oppression on gender (e.g., female genital mutilation and exclusion of girls from schools), violence against particular ethnic/religious/racial groups. Beneficial changes in the rights of individuals are a growing feature of large-scale aid projects
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