Global health Issue
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chapter_1.pptxGlobal Health 101 By Richard Skolnik
Chapter 1
The Principles of Global Health
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Chapter 1 Learning Objectives
Define the terms health, public health, and global health
Discuss some examples of public health efforts
Discuss some examples of global health activities
Describe some of the guiding principles of public health work
Describe the Millennium Development Goals and their relation to global health
Why Study Global Health?
Understand the progress that has already been made
Understand the challenges that still remain
Diseases are not limited by national boundaries
Significant health disparities among groups
Link between health and development
Dengue Fever
With more than one-third of the world’s population living in areas at risk for infection
Dengue virus is a leading cause of illness and death in the tropics and subtropics.
As many as 400 million people are infected yearly.
Dengue is caused by any one of four related viruses transmitted by mosquitoes.
No vaccine available
Dengue has emerged as a worldwide problem only since the 1950s.
(CDC, 2015)
Distribution of Dengue Fever, 2009
Data from Centers for Disease Control and Prevention. Dengue Fever (DF) and Dengue Hemorraghic Fever (DHF). Available at: http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-5/dengue-fever-dengue-hemorrhagic
Distribution of Dengue Fever, Past 90 Days
(CDC, 2015)
Health, Public Health, and Global Health
Health
“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”
Health, Public Health, and Global Health
Public Health
“…the science and art of preventing disease, prolonging life, and promoting physical health and mental health and efficiency through organized community efforts toward a sanitary environment; the control of community infections; the education of the individual in principles of personal hygiene; the organization of medical and nursing service for the early diagnosis and treatment of disease; and the development of the social machinery to ensure to every individual in the community a standard of living adequate for the maintenance of health.”
(Winslow, 1923)
Health, Public Health, and Global Health
Public Health
“Public health is the science of protecting and improving the health of families and communities through promotion of healthy lifestyles, research for disease and injury prevention and detection and control of infectious diseases. Overall, public health is concerned with protecting the health of entire populations.”
(CDC, 2015)
Example of Public Health Efforts
Fluoridation of water
Promotion of hand washing
Promotion of bicycle helmets
Large scale screening of eyesight in children
Supplementary feeding programs for children
Promotion of knowledge about HIV/AIDS
And of course, Vaccines
Health, Public Health, and Global Health
Global Health
“…an area for study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide. Global health emphasizes transnational health issues, determinants, and solutions, involves many disciplines within and beyond the health sciences, and promotes interdisciplinary collaboration; and is a synthesis of population based prevention with individual-level clinical care.”
Critical Global Health Concepts
Determinants of health
Measurement of health status
Importance of culture to health
Global burden of disease
Key risk factors
Demographic and epidemiologic transitions
Organization and function of health systems
Links among health, education, poverty and equity
Examples of Global Health Issues
Emerging and re-emerging infectious diseases
Antimicrobial Resistance
Eradication of polio
Diarrhea, measles, and pneumonia in children
STI in women
TB
Mental Illness
Examples of Global Health Issues
Malaria
HIV/AIDS
Parasitic infections, such as hook worm and toxoplasmosis
Diabetes and heart disease
War/violence
Hunger
Ebola
Poverty
Low, Middle, and High Income
Low-income : $995 or less
Lower middle-income : $996 to $3,945
Upper middle-income : $3,946 to $12,195
High-income : $12,196 or above
Based on gross national income per person
Examples of Low-Income Countries
Bangladesh (Avg. Life Expect. 71 yrs)
Cambodia (Avg. Life Expect. 64 yrs)
Ethiopia (Avg. Life Expect. 58 yrs)
Haiti (Avg. Life Expect. 64 yrs)
Mozambique (Avg. Life Expect. 53 yrs)
Zimbabwe (Avg. Life Expect. 57 yrs)
(Canty Media, 2015)
Examples of Lower Middle- Income Countries
Angola (Avg. Life Expect. 56 yrs)
Bolivia (Avg. Life Expect. 69 yrs)
Egypt (avg. Life Expect. 74 yrs)
Iraq (Avg. Life Expect. 72 yrs)
Morocco (Avg. Life Expect. 77 yrs)
Philippines (Avg. Life Expect. 73 yrs)
Swaziland (Avg. Life Expect. 51 yrs)
(Canty Media, 2015)
Examples of Upper Middle-Income Countries
Botswana (Avg. Life Expect. 54 yrs)
Costa Rica (Avg. Life Expect. 78 yrs)
Panama (Avg. Life Expect. 78 yrs)
Turkey (Avg. Life Expect. 74 yrs)
Venezuela (Avg. Life Expect. 75 yrs)
(Canty Media, 2015)
Examples of High-Income Countries
Belgium (Avg. Life Expect. 80.05)
Canada (Avg. Life Expect. 81.76)
Denmark (Avg. Life Expect. 79.25)
Monaco (Avg. Life Expect. 89.52) (Ranks 1st in top 100 countries)
Italy (Avg. Life Expect. 82.12 years)
Japan (Avg. Life Expect. 84.74)
United States (Avg. Life Expect. 78.88 years) (Ranks 53rd in top 100 countries)
(Canty Media, 2015)
Millennium Development Goals
Countries signed pledged to meet goals by 2015
Explicit statement of goals for development efforts
All relate to health, whether directly or indirectly
Important to understanding global health issues
Table 1.5: Millennium Development Goals and their Related Targets
Table 1.5: Millennium Development Goals and their Related Targets (cont)
Take-Away
Strong links among health, human development, labor productivity, and economic development
Health status is determined by a variety of factors
Enormous progress in improving health status over last 50 years
Much of the progress due to improvements in public hygiene, better water and sanitation, and better education
Progress in health status has been very uneven across countries
Enormous disparities in health status and access to health services within and across countries
Take-Away
Countries do not need to be high-income to enjoy good health status
Burden of disease is evolving in light of economic and social changes, the aging of populations, and scientific and technical progress
Some issues can only be solved through cooperation
People and communities have the ability to enhance their own health status
Each of us should be concerned with the health of others for health, security and humanitarian reasons
Hans Rosling
http://www.ted.com/talks/hans_rosling_shows_the_best_stats_you_ve_ever_seen?language=en
http://www.gapminder.org
Community Based Health Intervention (CBHI)
Community Types:
Geographic Communities
Physical Boundaries
Geographic Boundaries
Political Boundaries
Communities of Interest
Shared Interests
Shared Behavior
Shared Characteristics
Shared Disease
Professional Communities
Community Based Health Intervention (CBHI)
How the community is defined determines:
How resources will be allocated
How an intervention will be delivered
How a message will be framed
IN OTHER WORDS, WE BEGIN WITH AN ASSESSMENT
Needs Assessment
Ecological Theory
Types of Intervention for Each Ecological Level
Primary, Secondary, and Tertiary Prevention
Primary: Goal of preventing or avoiding the malady before it begins
Secondary: Efforts on screening or early diagnosis of the malady
Tertiary: Aims to prevent disease progression after a risk factor or disease has been identified
Gun Violence in Chicago
Year to Date:
Shot and Killed: 283
Shot and Wounded: 1660
Total Shot: 1943
Total Homicides: 326
A Person is Shot Every 2 hrs: 59 min
A Person is Murdered Every 17 hrs and 44 min
Gun Violence in Chicago
Gun Violence in Chicago
City of Chicago
West Englewood
67 homicides (2014)
2503 YPLL
Avg. per capita income $11317
Lincoln Park
7 homicides (2014)
23 YPLL
Avg. per capita income $71551
http://www.cityofchicago.org/city/en/depts/cdph/provdrs/pol_plan_report/svcs/office_of_epidemiologydataanalysisrequests.html?cq_ck= 1338570736462
Gun Violence In Chicago
Needs Assessment:
Describe the type of community and its boundaries
Ecological Model (Individual, Family, Community, Policy)
Prevention Levels (Primary, Secondary, and Tertiary)
