Health determinants, measurements, and the status of health globally
30 important questions on Health determinants, measurements, and the status of health globally
What are the determinants of an individuals health status?
Personal features, social status, culture, environment, educational attainment, health behaviours, childhood development, access to care and government policy
What are the key health status indicators?
Life expectancy at birth
Maternal mortality ratio
Infant mortality rate
Neonatal mortality rate
Under 5 mortality rate (child mortality rate)
What are the terms of key health indicators?
Morbidity: sichness or any departure, subjective or objective from a psychological or physiological state of well-being
Mortality: death
Disability: temporary or long-term reduction in a person's capacity to function
Prevalence
Indicidence
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What is meant by vital registration and what does it registrate?
Vital registration systems record birth, death 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. Developing a system is progress towards understanding and addressing health problems
What should political stability look like?
Necessary for long term gains in health, instability causes illness, disability and death as well as breakdown of infrastructure and services
What is up with the importance of communicable diseases?
40% of the burden of disease in low- and middle-income countries
Disproportionately affect the poor.
Enormous economic consequences
Consequences of emerging and re-emerging infectious diseases?
Direct costs of treating disease
Indirect costs of declines in tourism and trade
Increased costs of treating a drug resistant case
What are the key factors contributing to emergence and re-eergence of infectious diseases?
Microbia adaption change
Human susceptivility to infection
Climate and weather
Changing ecosystems
Economic development and land use
Human demographics and behavior
Technlogy and industry
International travel and commerce
Breakdown of public health measures
Poverty and social inequality
War and famine
Lack of political will
Intent to harm
How is HIV/AIDS being spread?
By unprotected sex, birth or breastfeeding, blood or transplanted tissues
What is the result of an infection with AIDS or HIV?
Attacks the immune system, leaving the body susceptible to opportunistic infections
What are the direct and indirect costs and consequences of noncommunicable diseases, tabacco use and alcohol abuse?
Direct costs of treatment
Indirect costs from lost productivity
Low-income countries are simultaneously facing burden of communicable diseases and noncommunicable diseases
For cancer, which factor is the first priority>?
Smoking and tabacco
What are the goals of a health system?
Good health, responsiveness to the expectations of the population
Fairness of financial contribution
What are the functions of a health system?
Provide health services
Raise money that can be spent on health, referred to as "resource generation"
Pay for health services, referred to as 'financing'
Govern and regulate the health system, referred to as ''stewardship"
How can health systems be categorized?
Approach of each type of health system to providing a basic package of health services as a "right"
WHo owns health facilities
Manner in which insurance is operated
Manner in which insurance schemes are financed
What are the levels of care?
Primary: first point of contact
Secondary: provided by some specialist physicians and general hospitals
Tertiary: provided by an array of specialist physicians and specialized hospitals
Whatis stated in the Declaration of Alma-Ata:?
Speaks of health as a human right
Outlines content of primary health care as care that is essential and socially acceptable
Primary health care as a movement and central tenet of global health
What is the role of public?
Stewardship of the system
Raising and allocation of funds
Establishing approaches to health insurance
Managing key public health functions
What is the role of private (for-profit)?
Provision of services including nonlicensed medical practitioners
Operation of health clinics, hospitals, services and laboratories
Can partner with the public sector or work under contract to the public sector
What is the role of NGO's?
Community-based efforts to promote better health through education, improved water and sanitation
Carry out health services
Can partner with the public sector or work under contract to the public sector
What are the biological determinants of women's (bad) health?
Iron deficiency anemia related to menstruation
Complications of pregnancy
Increased susceptibility of some infections
Conditions, such as ovarian cancer, specific to women
What are the social determinants related to women's health?
Female aborption (infanticide)
Often fed less nutritious foods than male children
Male dominance leads to physical and sexual abuse
Cooking with poor ventilation contributes to respiratory diseases
Low social status limits access to health care
What are the short term and long term effects of female genital cutting?
Can initially cause shock, infection or hemorrhaging.
Long term problems include retention of urine, infertility, and obstructed labor
What are important contributors to global burden of disease?
Unsafe water, hygiene and excreta disposal
Urban air pollution
Indoor smoke from household use or solid fuels
These are leading causes of death in low- and middle-income countries linked with environmental factors (lower respiratory infection, chronic obstructive pulmonary disease, diarrheal disease)
What is the relation between culture and disease?
Some cultures evaluate disease in an other way than common.
Disease: malfunctioning or maladaptation of biologic and psychophysiologic processes in the individual
Illness - personal, interpersonal and cultural reactions to disease or discomfort
Some cultures believe illness can be caused by emotional stress, supernatural causes or bodily imbalance
What is meant by urban decay?
Process in which a city, or part of a city, falls into disrepair and decrepitude.
Occurs almost exclusively in Western countries, particularly North America.
What are the causes of urban decay?
Urban planning decisions
Middle class: flight to the suburbs
Racial discrimination
End result: poor, underpriveleged, vulnerable left behind in decaying city
What are characteristics of urban decay?
Depopulation
Economic restructuring
Abandaned buildings
High local unemployment
Fragmented families
High crime rates
Political disenfrancisement
Inhospitable landscapes and environment
How does urban decay affect health?
Physical >> limited access to medical care, toxic materials in abandoned buildings can damage health, poor health as result of substance abuse, poor nutrition
Mental Depression as a result of unemployment, hopeless, loneliness
Social Social isolation, learned neighborhood collective efficacy
What is the association with malnutrition and disease?
Inadequate dietary intake weakens the body and opens it up to infection
Illness makes it harder for people to eat, absorb the nutrients they take in and raises need for (some) nutrients
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