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114 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What is global health?
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global health is the study, research and practice of improving health and achieving equity in healthcare worldwide
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What should we care about global health?
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compassion, economic benefit, increased human capital, general and health security
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% of deaths from communicable diseases?
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30%
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% of deaths from non-communicable diseases?
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60%
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% of deaths from injuries?
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10%
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What does AbouZhar say about data?
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there is a great lack of data, 1/3 of births and 2/3 of deaths worldwide are not recorded, this is a problem for information and civil rights
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what is the megatrend involving life expectancy?
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life expectancy has increased by 20 years in the world as a whole form about 47 in 1950 to 69 today
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what is the megatrend involving fertility?
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world fertility has halved from 5 to 2.5 since 1950
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what is the demographic transition?
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the transition from high birth rates and deaths rates (~3-4%) in pre-modern society to low birth rates and death rates (1%) in modern society
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what is the megatrend that the demographic transition results in?
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age bulges, first a child bulge, then a youth bulge, then an old age bulge
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where is the extreme example of age bulges?
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Iran
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what is the megatrend involving urban areas?
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more than half the world population lives in urban areas, most future growth will be in the urban areas of developing countries
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prevalence (2 definitions)
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the number of persons at a given time that have a given condition
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average number of persons exposed to risk
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incidence (2 definitions)
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the number of new cases of a given condition that occur within a given amount of time
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average number of persons exposed to risk during that period
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case fatality rate
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the proportion of individuals who actually die form a given condition during the period of observation
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what is the epidemiological transition?
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when the burden of disease in a country shifts from mainly communicable diseases, nutritional, and maternal causes to mainly non-communicable diseases
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what are CDs not over?
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old CDs with new tricks, new CDs
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what is the double burden of disease?
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in some countries, NCDs are increasing (especially due to aging) while CDs are not yet under control
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life expectancy is increasing worldwide, but the exceptions are... (MEGATREND)
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sub-Saharan Africa (AIDS), Russia and post-communist countries (lower today than in 1950, unemployment, poor health care, alcoholism)
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what is the trend about female life expectancy in the US?
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it is extremely variable CHECK ARTICLE
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what is the trend involving death rates?
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it's a j-shaped curve, males live shorter than females, decreasing at all ages, esp. the very young
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what explains the pattern of decreases in mortality for the different age groups?
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children under 5-low tech, water, sanitation, food
children under 1-vaccine, curative (antibiotics) children under 1 month-obstetric care (very $$$) 80+-better NCD management |
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define DALY.
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disability-adjusted life years=the sum of life years lost to premature mortality and life years lost to disability
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what do human rights value?
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equality, dignity, autonomy, both rights and responsibilities, universal, indivisible, cannot be derogated
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how did human rights develop?
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international dialogue, ratified by the states, legally binding, subject to UN accountability measures
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what are the criticisms of human rights?
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no one cares, it makes no difference, countries that ratify are already doing well, based on Western concepts
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what is the overall goals of the MDGs?
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to eradicate poverty
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what 3 MDGs are directly health related?
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4-reduce child mortality
5-improve maternal health 6-combat HIV/AIDS, malaria, and other diseases |
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what are the targets?
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quantified and time bound levels of ambition
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what are the indicators?
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the ways in which the targets can be met
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overseas development assistance for health has ___ from ___ to ____
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double, 1990, 2000
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much of the increase in overseas development aid after 2000 has gone to combat...
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MDG 6 - combat HIV/AIDS, malaria, and other diseases
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what role does WHO have?
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normative body, knowledge management, operational leadership, advocacy
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what helped success in the case of smallpox?
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pathogen identified, no animal reservoir, not easily transmitted, easy diagnosis, quick incubation, little stigma, eradicated before the pathogen evolved, effective and easily administered vaccine, international and shared surveillance/containment
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what will be future problems for communicable diseases?
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old diseases new tricks, new diseases, diseases spreading internationally more, neglected diseases, breakup of soviet union/downgrading health systems, global climate change, interactions with nutrition and NCDs
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what is the global burden of disease for diarrheal diseases?
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2.2 million
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what do the MDGs say about diarrheal diseases?
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nothing
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who is Dr. John Snow?
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the father of epidemiology because of tracing a cholera outbreak
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how did Dr. Snow solve the cholera epidemic?
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1840s-suspected water borne pathogen
gathered evidence on who, where, when to convince authorities 1854-drew famous map |
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What is ORS?
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oral rehydration salts, one of the most important medical discoveries of the 20th century, case fatality for cholera went from 50% to 1%, very simple solution
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how is cholera today?
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spreading globally but the case fatality rate is decreasing
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what is the global burden of disease for maternal, perinatal, and nutrition?
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maternal-0.5 million
perinatal-3.2 million nutritional-0.5 million |
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what do the MDGs say about maternal health?
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MDG 5-improve maternal health
target 1-reduce by 3/4 maternal mortality ratio target 2-achieve universal access to reproductive health |
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what do the MDGs say about child health?
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MDG 4-reduce child mortality
target 1-reduce by 2/3 the under five mortality rate from 1990 to 2015 |
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what do the MDGs say about nutrition?
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MDG 1-eradicate extreme poverty and hunger
target 3-halve the proportion of people who suffer from hunger from 1990 to 2015 |
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what do we know about the problems with maternal health?
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focus only since 1985, data on epidemiology difficult-definition=diffuse, limited progress, more disparity between and among countries than any other MDG
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what do we know about maternal deaths?
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80% due to obstetric causes, such as hemorrhage, indirect causes include malaria
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what do we think we know about the solutions?
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1987-traditional birth attendants-NOT WORK
40% of births result in complications, 15% life threatening, can kill within two hours and is very unpredictable and not treatable by a TBA (blood transfusion, c-section, oxytocin) solution-family planning, skilled birth attendant, access to emergency obstetric care |
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what has been the progress in child mortality?
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1980-15 million
1990-12.4 million 2008-8.8 million 2010-7.6 million |
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About ____% of child deaths occur within the 1st month
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40%, many are closely tied to obstetric care
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what is the trend involving the presence of underweight children under 5?
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tremendous variation that is not solely dependent on income, for example india has very high rates and north korea has less malnutrition
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what is the global burden of disease for AIDS?
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2 million
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what do the MDGs say about contraception, abortion, and STIs?
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MDG 5-improve maternal health
goal 2-achieve universal access to reproductive health MDG6-combat HIV/AIDS, malaria, and other diseases goal 1-halt and reverse spread of HIV/AIDS by 2015 goal 2- universal access to treatment for HIV/AIDS by 2010 |
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what is the trend concerning contraception?
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contraception increased by 10% in the 1990s but process has slowed since 2000
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what is the disparity between actual and desired number of children?
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varies by wealth
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aid for family planning has ___ in the past ten years?
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fallen
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in the beginning of the demographic transition, women rely on....
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abortion and then switch to contraception as programs improve
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where are STIs in the MDGs?
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invisible
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_____ cases of 4 treatable STIs a year
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340,000,000
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HIV transmission is ___ to ___ times more likely is you're already infected with an STI
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2, 6
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HPV
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500,000 a year->250,000 deaths to cervical cancer
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what is the global burden of disease for AIDS?
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2 million
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number of people living with HIV continues to rise due to....
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life prolonging treatment
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what is a big problem with AIDS transmission?
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you are highly infectious at a time when you may be engaging in the activity that got you sick and you may not have been tested yet
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what is the global burden of disease for malaria?
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0.9 million
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what is the burden of disease for communicable diseaes?
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18 million
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what is the burden of disease for non-communicable diseases?
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35 million
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what is the burden of disease for injuries?
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5.8 million
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what do the MDGs say about NCDs and injuries?
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nothing
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what are the factors that cause NCDs?
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tobacco, drinking, lack of exercise, unhealthy diet
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by eliminating risk factors, we can prevent....
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80% of heart disease, stroke, and type 2 diabetes
1/3 of cancers |
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what do the MDGs say about NCDs and injuries?
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NOTHING
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explain the North Karelia Project.
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1970-Finland has the greatest mortality to CVD in the world
1972-pilot project to reduce prevalent risk factors (smoking, hyperlipemia, hypertension) comprehensive community-based intervention involving health services, NGOs, industry, media, public policy mortality rate among 30 to 64 year olds males from 1975 to 1995 reduced by 73% in North Karelia and 65% in FInland overall |
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what hampers the response to NCDs?
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seen as a normal part of aging, risk factors involve behavioral changes, linkages with other diseases not clear, only recent focus, not 'poverty', invisible in the MDGs, few national policies, counter to commercial interest, mental health has low visibility
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what are the classifications of injuries?
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unintentional
intentional-self-harm, interpersonal, collective |
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what is the burden of disease for communicable diseaes?
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18 million
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what is the burden of disease for non-communicable diseases?
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35 million
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what is the burden of disease for injuries?
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5.8 million
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what do the MDGs say about NCDs and injuries?
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nothing
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what are the factors that cause NCDs?
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tobacco, drinking, lack of exercise, unhealthy diet
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by eliminating risk factors, we can prevent....
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80% of heart disease, stroke, and type 2 diabetes
1/3 of cancers |
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what do the MDGs say about NCDs and injuries?
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NOTHING
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explain the North Karelia Project.
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1970-Finland has the greatest mortality to CVD in the world
1972-pilot project to reduce prevalent risk factors (smoking, hyperlipemia, hypertension) comprehensive community-based intervention involving health services, NGOs, industry, media, public policy mortality rate among 30 to 64 year olds males from 1975 to 1995 reduced by 73% in North Karelia and 65% in FInland overall |
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what hampers the response to NCDs?
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seen as a normal part of aging, risk factors involve behavioral changes, linkages with other diseases not clear, only recent focus, not 'poverty', invisible in the MDGs, few national policies, counter to commercial interest, mental health has low visibility
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what are the classifications of injuries?
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unintentional
intentional-self-harm, interpersonal, collective |
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what does bowman say about injuries?
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there is a paradigm shift from a view as inescapable reality to a view that both intentional and unintentional injuries can be prevented
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what is the WHOs definition of a health system?
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all the activities whose primary purpose is to promote, restore, or maintain health
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what are the most important goals of a health system?
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improve life expectancy, provide high quality services, make patients satisfied, be accessible, make health staff satisfied, being efficient, enduring that patients are not thrown into poverty
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what are the implications of health policy?
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you cannot make health policies without values
conflicts in values often occur understanding ethical theory can help you clarify your position and better understand others |
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what are the building blocks of a health system?
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governance/leadership, financing, information, services, work force, commodities
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what are the different types of revenue collection for health systems?
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(1) universal, tax financed 'beveridge' systems
(2) out of pocket systems (3) national health insurance (4) social insurance 'bismarck' systems with mandatory payroll deductions |
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what are the health systems in the US?
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indian/veteran/military=tax-financed
over 65=medicare working-social insurance system |
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what is demographic aging?
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the proportion of older people increases
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what is individual aging?
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a progressive, generalized impairment of function resulting in a loss of adaptive response to stress and a growing risk of age-associated disease
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what is the life course approach?
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an approach to health which notes that health is a consequence of a wide range of factors (social, economic, health, etc.) which are accumulated throughout life and which affect the risks for chronic disease and health outcomes later in life
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what are 5 ways the EU should address the problem of population aging?
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help people balance work, family, and private life so they can have the number of children they desire
improve work opportunities for the elderly value the contributions of both older and younger employees harness the positive impact of immigration for the job market ensure sustainable public finances |
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define disaster
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a disaster is a SERIOUS DISRUPTION of the functioning of a society, causing widespread human, material, or environmental LOSSES which exceed the ability of the affected society to COPE using its own resources
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define complex emergency
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a situation affecting large civilian populations which usually involves a combination of factors including war or civil strife, food shortages, and population displacement resulting in significant excess mortality
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what are the trends in non-conflict disasters?
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there are increases in hydrothermal disasters and geophysical disasters are leveling off
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what types of armed conflicts are most prevalent?
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intrastate
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what is the trend concerning number of people dying from natural disasters?
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the number is decreasing, we are getting better at saving lives
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____ numbers of IDPs and _____ numbers of refugees.
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increasing, stagnating
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what are the added health risks for displaced persons?
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crowded living conditions, close proximity to livestock, poor water, poor sanitation, limited health care, limited access, limited resources, limited food, linguistic and cultural barriers, decreased family support, psychological trauma
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what determines whether a hazard becomes an emergency?
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vulnerability and resilience
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why did more women and children die in the tsunami in Sri Lanka?
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clothing, access to information, swimming ability
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what is the objective response
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during the acute phase, to rapidly reduce excess mortality as quickly as possible and to stabilize the population's health situation
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what is the standard for excess mortality?
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CDR>=1/10,000 population perday
U5MR>=2/10,000 U5 population per day alternative measure=doubling of the baseline |
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how does WHO calculate climate change is affecting?
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150,000 deaths are occuring from 4 main changes due to climate change-crop failure and malnutrition, diarrheal diseases, malaria, flooding
85% of these excess deaths are in young children |
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what does costello say about the future of climate change?
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changing patterns of disease and mortality, food, water/sanitation, shelter, extreme events, population growth and migration
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what does costello say are the 3 entry points for action?
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mitigation
(1)reduce emission, increase resorbtion (2)decrease the effect on health adaptation (3)adapt health systems to cope with adverse effects |
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IHR?
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dialogue w/ CDC, legally binding, a paradigm shift
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what are the paradigm shifts in IHR?
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control of borders to containment at source
disease list to all public health threats from preset measures to adapted response intersectoral standardized risk assessment |
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what is the scope of the IHR?
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to prevent, protect again, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade
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sort GHIs into the 6 building blocks
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GAVI-commodities
WB-finance PEPFAR-finance Global Fund-finance Gates-finance, info good competitor for WHO |
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