Health determinants, measurements, and the status of health globally

Personal features, social status, culture, environment, educational attainment, health behaviours, childhood development, access to care and government policy

Life expectancy at birth
Maternal mortality ratio
Infant mortality rate
Neonatal mortality rate
Under 5 mortality rate (child mortality rate)

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

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

Necessary for long term gains in health, instability causes illness, disability and death as well as breakdown of infrastructure and services

40% of the burden of disease in low- and middle-income countries
Disproportionately affect the poor.

Enormous economic consequences

Direct costs of treating disease
Indirect costs of declines in tourism and trade
Increased costs of treating a drug resistant case

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

By unprotected sex, birth or breastfeeding, blood or transplanted tissues

Attacks the immune system, leaving the body susceptible to opportunistic infections

Direct costs of treatment
Indirect costs from lost productivity

Low-income countries are simultaneously facing burden of communicable diseases and noncommunicable diseases

Smoking and tabacco

Good health, responsiveness to the expectations of the population
Fairness of financial contribution

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"

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

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

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

Stewardship of the system
Raising and allocation of funds
Establishing approaches to health insurance
Managing key public health functions

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

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

Iron deficiency anemia related to menstruation
Complications of pregnancy
Increased susceptibility of some infections
Conditions, such as ovarian cancer, specific to women

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

Can initially cause shock, infection or hemorrhaging.

Long term problems include retention of urine, infertility, and obstructed labor

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)

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

Process in which a city, or part of a city, falls into disrepair and decrepitude.

Occurs almost exclusively  in Western countries, particularly North America.

Urban planning decisions
Middle class: flight to the suburbs
Racial discrimination

End result: poor, underpriveleged, vulnerable left behind in decaying city

Depopulation
Economic restructuring
Abandaned buildings
High local unemployment
Fragmented families
High crime rates
Political disenfrancisement
Inhospitable landscapes and environment

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

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