Environment, Health & Wellbeing

Question 1

What are the 2 key parameters of health and well-being?

Answer 1

Mortality and morbidity

Question 2

What does mortality mean?

Answer 2

Death

Question 3

What are the 3 indicators of death?

Answer 3

crude death rate, infant mortality and maternal mortality.

Question 4

What does morbidity mean?

Answer 4

Illness

Question 5

What is morbidity often measured by?

Answer 5

• The disability-adjusted life year (DALY).
• This is a measure of overall disease burden, expressed as the number of years lost due to ill health, disability or early death.

Question 6

Between 1990 and 2016, how much has child mortality decreased?

Answer 6

Mortality in Children under 5 years has declined by 60%

Question 7

Which region has the highest child mortality rate and compare it to another region?

Answer 7

• It is still highest in the WHO African Region (57 per 1000 live births).
• This is eleven times higher than that in the WHO European Region (5 per 1000 live births).

Question 8

How much has child mortality decreased in African region?

Answer 8

It has increased from 0.6% per year between 1990 and 1995 to 4.5% per year between 2005 and 2016.

Question 9

What are the 4 stages of the Epidemiological Transition Model?

Answer 9

1) An age of pestilence and famine
2) An age of receding pandemics
3) An age of degenerative diseases
4) An age of delayed degenerative diseases

Question 10

Who made the Epidemiological transition model?

Answer 10

Abdel Omran in 1971

Question 11

What does stage 1 of the epidemiological transition model talk about?

Answer 11

• A period when mortality is high.
• Main causes of death are infectious diseases and poor maternal conditions, reinforced by nutritional deficiencies.

Question 12

What does stage 2 of the epidemiological transition model talk about?

Answer 12

• Socio-economic developments and advances in medical science and healthcare. (E.g. better public water supplies and penicillin)
• This means that infectious diseases are reduced and life expectancy increases.

Question 13

What does stage 3 of the epidemiological transition model talk about?

Answer 13

• As infectious diseases are controlled and people live longer, there is increased visibility of degenerative diseases. (E.g. cancers and heart disease.)
• Diseases associated with modernisation and industrialisation (obesity, type 2 diabetes) also begin to increase.

Question 14

What does stage 4 of the epidemiological transition model talk about?

Answer 14

• This fourth stage has recently been added.
• The causes of death are generally the same as the third stage (although dementia is more prevalent), they just occur later in the life cycle as life expectancy increases.

Question 15

What did Abdel Omran state the relationship between diseases and development?

Answer 15

• Omran stated that socio-economic development is responsible for the movement of society through these ‘ages’.

Question 16

What did WHO state about the connection between air pollution and premature deaths?

Answer 16

• According to the WHO, ambient (outdoor air) pollution in both cities and rural areas was estimated to cause over 4 million premature deaths worldwide in 2016.
• Some 88% of those premature deaths occurred in low and middle-income countries, with the greatest number in the WHO Western Pacific and South-East Asia regions.

Question 17

How many people have no access to safe, clean water?

Answer 17

Almost 1 billion people

Question 18

How many deaths are attributed to unsafe water?

Answer 18

2 million annual deaths

Question 19

How many countries report cholera to WHO?

Answer 19

More than 50 countries

Question 20

What water-Bourne disease has infected nearly 260 million people?

Answer 20

Schistosomiasis

Question 21

What is Malaria?

Answer 21

A biologically transmitted disease which has significant impacts on health and well-being.

Question 22

According to WHO, How many cases and deaths has malaria led to over?

Answer 22

• In 2016 an estimated 200 million cases of malaria occurred globally.
• The disease led to over 600,000 deaths (WHO).

Question 23

How many people and countries are at risk of being infected with malaria?

Answer 23

3.3 billion people and 100 countries

Question 24

Where does malaria occur in?

Answer 24

• Tropical and sub-tropical regions
• areas of rainforest and savanna grasslands with at least 1000mm of rain per year

Question 25

What are the 4 links between malaria and socio-economic environments?

Answer 25

- Densely clustered housing and overcrowded dwellings - Unsanitary conditions in the community, - Occupation matters such as farm workers and irrigation workers. - less well-educated people, who have not completed their primary education, are more likely to catch malaria.

Question 26

What is the malaria parasite and what temperature does it need to develop?

Answer 26

The malaria parasite (plasmodium falciparum) needs temperatures of 16-32 degrees to develop.

Question 27

How much does malaria account for in terms of public health expenditure?

Answer 27

40%

Question 28

What are the 4 mitigation and management strategies to tackle malaria?

Answer 28

- Vector controls that reduce transmission by the mosquito to humans using ITNs, LLIN (long-lasting insecticidal nets) or IRS (indoor residual spraying). - Chemoprevention can prevent blood infections in humans. - Diagnostic testing and ACTs (treatment by artemisinin-based combination therapies) are being used more on people that might have malaria, as well as those who do have it. - Making sure pregnant women get preventative treatment during their pregnancy to reduce child deaths.

Question 29

How many people have T2D (type 2 diabetes)?

Answer 29

projected to rise from over 400 million in 2015 to almost 600 million in 2035.

Question 30

What type of emerging countries have the most T2D cases?

Answer 30

It is estimated that 80% of the people who have T2D live in emerging countries (ECs).

Question 31

How much does T2D account for in terms of world mortality?

Answer 31

8%

Question 32

How many people are obese in emerging countries?

Answer 32

1 billion people

Question 33

What are the 4 factors that lead to T2D

Answer 33

- Diet - Urban Lifestyle - Tobacco use - Stress

Question 34

How does diet lead to T2B?

Answer 34

- High calorie intake is the main factor leading to obesity. - In ECs, rapid economic development has introduced a more ‘Western’ diet with less fruit and vegetables, combined with a higher intake of carbohydrates, fatty foods, salt and sugar.

Question 35

How does urban lifestyle lead to T2B?

Answer 35

- Rates of urbanisation in ECs are considerably higher than elsewhere. - This leads to a more sedentary lifestyle, with a low level of physical activity.

Question 36

How does tobacco use lead to T2B?

Answer 36

- Smoking is a key risk factor linked to T2D. - An estimated 50–60% of adult males in ECs are regular smokers.

Question 37

How does stress lead to T2B?

Answer 37

- Stress increases blood sugar levels, raises blood pressure and can suppress the digestive process. - Raised blood sugar levels are a key risk factor in the development of T2D.

Question 38

What does DASL stand for?

Answer 38

the Diabetes Association of Sri Lanka

Question 39

What has Sri Lanka done to prevent T2D?

Answer 39

- DASL has a walk-in centre in the capital, Colombo, where individuals can be screened or take part in structured health programmes at a small cost. - It also provides information through workshops, a website and printed materials. - DASL is also spreading the message that exercise can help reduce the threat of T2D.

Question 40

What is WHO?

Answer 40

The WHO is an agency of the UN, established in 1948 and based in Geneva, to further international cooperation for improved health conditions.

Question 41

What are the 4 ways in which WHO helps in tackling diseases?

Answer 41

- Providing central information on health (e.g. vaccines, cancer research, nutrition) - Sponsoring measures for the control of epidemics and endemic diseases by promoting mass campaigns. (E.g. vaccination programmes, instruction on using antibiotics) - Advising on the prevention and treatment of diseases. - Working with other UN agencies (e.g. UNAIDS and UNICEF) and NGOs on international health issues and crises (e.g. the Ebola crisis in 2014/15).

Question 42

What are 2 examples of NGOs

Answer 42

Médecins Sans Frontières (MSF) and Oxfam

Question 43

Example of a charity organisation sponsored by wealthy individuals?

Answer 43

E.g. The Bill and Melinda Gates Foundation.

Question 44

What is Médecins Sans Frontières?

Answer 44

Is a worldwide movement, with 90% of its income coming from individual donations, which allows it to stay independent and impartial.

Question 45

list the 4 things of what MSF do?

Answer 45

- Works in over 60 countries, with specialist teams ready for any health emergency. - Monitors epidemics on the ground continuously and are able to mount rapid emergency responses. - In 2014, it treated over 47,000 people in 16 cholera outbreaks. (They provided beds, plastic sheeting, oral rehydration salts and surgical equipment.) - Managed a meningitis outbreak in Niger where 350 patients were being treated on a daily basis.