An Overview Of Global Health Flashcards
Learning Objectives
- Planetary health
- One health
- Health and development
- International organizations concerned with health
- The MDGs and SDGs
- The World Health Organization
- Universal Health Coverage
- Health Inequalities
- Primary care
- The current status of global health
- Leading causes of death
What is global health about today?
- Health is more prominent and influential as a global issue
- Globalized world provides complex backdrop to health improvement
- Factors affecting health across all aspects of political, economic, and social development
- Global health at the crossroads of agendas concerning security, economic development and social justice
- Cluster of trade, food, water, environment, finance and energy challenges relevant to health
Define planetary health
“The health of human civilization and the state of the natural systems on which it depends”
Describe one key health issue
- Antibiotic-resistant germs can spread through food, healthcare and the environment e.g. food and water
- This makes is harder to treat certain infections in animals and people.
- Vector-borne diseases are increasing with warmer temperatures and expanded mosquito and tick habitats.
- Diseases in food animals can threaten supplies, livelihoods, and economies.
- Contamination of water used for drinking and recreation can make people and animals sick.
Why is it important to build a culture of health and well-being?
- Building a culture of health to improve population health, well-being and equity means:
- Making health a political marker of a successful society
- Making health a shared value; fostering cross-sectoral collaboration to improve well-being;
- Enhancing bottom-up, participatory approaches; creating healthier and more equitable communities;
- Such a “culture of health” would be mutually reinforcing with a culture of sustainable behaviours (e.g., environmental, economic and health benefits of walking and cycling).
- This also needs to be integrated by and linked to structural environments that enables the choice of healthy behaviours and protect and promote health e.g., safe walking and cycling routes, green spaces, clean air, safe workplaces.
What is meant by development?
- Development is not purely an economic phenomenon but rather a multi-dimensional process involving reorganization and reorientation of entire economic and social system
- Development is process of improving the quality of all human lives with three equally important aspects. These are:
- Raising peoples’ living levels, i.e. incomes and consumption, levels of food, medical services, education through relevant growth processes
- Creating conditions conducive to the growth of peoples’ self-esteem through the establishment of social, political and economic systems and institutions which promote human dignity and respect
- Increasing peoples’ freedom to choose by enlarging the range of their choice variables, e.g. varieties of goods and services
List the institutional elements relevant to development
- Governance
- Public representation and elections
- The rule of law
- Independence of judiciary
- Governmental regulatory capacity
- Taxation
- Economy
- Customs
- Monetary policy
- Banking
- Protection of private property and contractual rights
- Employment creation
- Investment in social infrastructure
- Health
- Education
- Social protection
What is the Millennium Development Goals (MDGs)?
- United Nations Millennium Declaration (September 2000)
- Eradicate extreme poverty and hunger
- Achieve universal primary education
- Promote gender equality and empower women
- Reduce child mortality
- Improve maternal health.
- Combat HIV/AIDS, malaria, and other diseases.
- Ensure environmental sustainability.
- Develop a global partnership for development.
What has been achieved from the MDGs so far?
- Poverty as measured by the number of people living on less than $1.25 per day has declined by more than half
- Under 5 mortality decreased at an annualized rate of 2% from 1990 to 2000, and 3.5% from 2000 to 2013
- Maternal mortality decreased slowly at an annualized rate of 0.3% from 1990 to 2003, and from 2.7% from 2003 to 2013.
- Global mortality from HIV/AIDS and malaria increased from 1990 to 2005, but then declined substantially
- Development assistance for health increased from $11.6 billion in 2000 to $33.1 billion in 2012.
How many SDG goals are there?
- There are 17 goals altogether
- SDG #3 is one of the most important ones
- It’s to Promote healthy lives and well-beings for all at all ages
Provide the World Health Organisation’s definition of “Health”
Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity
What is the World Health Organisations triple billion target?
- Universal Health Coverage
- Health and Well-being
- Health Emergencies
Define Universal Health Coverage (UHC)
(UHC) is defined by the World Health Organization (WHO) as ensuring that all people have access to promotive, preventive, curative, and rehabilitative health services of quality, when and where they need them, without financial hardship.
Define Well being
The state of being comfortable, healthy, or happy
Provide examples of elements of well-being
- Environmental quality
- Social connections
- Personal security
- Civic engagements and governance
- Jobs and earnings
- Income and wealth
- Health status
- Housing
- Subjective well-being
- Work-life balance
- Education and skills
Provide examples of elements of happiness
- Social support
- Life expectancy
- Freedom to make life choices
- Generosity
- GDP per capita
- Perceptions of corruption
What is the world health organisation?
- Specialized Agency of the UNITED NATIONS
- World Health Assembly (194 members). Meets once a year (May)
- Executive Board (32 members). Meets twice a year (January and May)
- Secretariat (7000 staff) Head: Director-General
List the core functions of the WHO
- Providing leadership on matters critical to health and engaging in partnerships where joint action is needed;
- Shaping the research agenda and stimulating the generation, translation and dissemination of valuable knowledge;
- Setting norms and standards and promoting and monitoring their implementation;
- Articulating ethical and evidence-based policy options;
- Providing technical support, catalysing change, and building sustainable institutional capacity; and
- Monitoring the health situation and assessing health trends.
What are the changing expectations of health systems pressures for reform?
- Demography-the increasing proportion of the old and the very old
- Co-morbidities amongst the old
- Technological advances-diagnostic, therapeutic, pharmaceutical
- Raising population expectations for quality care
- Litigation pressures
- The increasing involvement of public institutions and financing
- Pressures for quality, efficiency and cost-control
List the different mechanisms for the public funding of care
- “Single payer” tax-based general revenues-provide care directly through state-owned and run facilities e.g. the UK, Canada
- Possibility of earmarked (hypothecated) health tax
- Social insurance financing e.g. Germany, France,
- Individually based insurance e.g. United States (see Affordable Care Act)
- Support health care consumers directly through “vouchers”
What is the problem when it comes to inequities?
- Inequities are killing people on a “grand scale” reports WHO’s Commission 57
- A child born in a Glasgow Scotland suburb can expect a life 15 years shorter than another living only 5 miles away.
- A girl in Lesotho is likely to live 26 years less than another in Japan.
- Maternal mortality ratio (maternal deaths per 100,000 live births) in Sweden is 4, in Afghanistan 638.
- Biology does not explain any of this. Instead, the differences between - and within - countries result from the social environment where people are born, live, grow, work and age.
- Inequities driven by differences in the distribution of “power, money and resources”.
What are the upstream approaches to health promotion?
- Structural policy responses to social and economic determinants
- Tackling health destructive environments e.g. obesogenic environments
- Promoting health literacy
- Providing health information and education
- Health promotion and empowerment
- Making healthy choices easy choices
- “Nudge” type policies
- Regulation and legislation
Describe the structural approaches to health improvements (PART 1)
- Structural interventions refer to public health interventions that promote changes in the structural drivers of people’s lived experience
- Increasing health equity requires changes in the distribution of “power, money and resources” (Marmot)
- E.g., political, social, economic and economic factors e.g., autonomy; employment, income; housing; environmental circumstance; stigma, and discrimination around gender, race, ethnicity, sexuality
- Intersectionality-these factors operate together in complex ways to reduce health status
Describe the structural approaches to health improvements (PART 2)
- Increasingly structural determinants are integrated with social determinants of health as “social and structural determinants of health (SDOH)”
- Thinking driven by recent life expectancy falls in USA and UK
- Shift from traditional public health practices to broader approaches that engage the larger socioeconomic thinking in which health exists
- Disease and conditions are part of, and exist within, a larger set of social and physical factors