Exam 1 Flashcards
(198 cards)
1
Q
Low income
A
less than $995 per person
2
Q
Low-Middle income
A
$996-3945 per person
3
Q
Upper-Middle income
A
$3946-12,195 per person
4
Q
High Income
A
$12,196+ per person
5
Q
Millenium Development Goals
A
- UN set these goals in 2000 to be met by 2015
- not met, now have Sustainable Development Goals
6
Q
Sustainable Development Goals, how many?
A
-17
7
Q
Key Determinants of health (7)
A
- individual (genetics, sex, age)
- physical enviro
- employment and working conditions
- access to health services
- health behaviors
- healthy child development
- social enviro (education, culture, gender norms..)
8
Q
Health status for a country generally has to do with what?
A
- wealth of a country
9
Q
health disparities w/in a country closely linked to:
A
- social disadvantage: how people live, work, & health systems that serve them
- life circumstances & health related to political, social, and economic forces
10
Q
Infant mortality rate
A
- # of deaths of infants per 1000 live births in a given yeardeaths
11
Q
Life expectancy at birth
A
- av. # of years a newborn could expect to live if current mortality trends were to continue for rest of his/her life
- US: 77 (#28)
- Japan: 82 (#1)
12
Q
Maternal Mortality Rate/Ratio
A
- # of women who die as a result of pregnancy & childbirth complications per 100,000 births in a given year
- US 8/100,000
13
Q
Neonatal mortality rate
A
- # of deaths of infants under 28 days in a given year per 1000 live births
- neonatal deaths/live births *1000
- US: 5/1000
14
Q
Under 5 mortality rate
A
- probability that a newborn baby will die before reaching age 5, expressed as # per 1000 live births
- US 8/1000
15
Q
Morbidity
A
- sickness or any departure, subjective or objective, from psychological and physiological states of well-being
16
Q
Disability
A
- suffer temporary or long term reduction in person’s capacity to function
17
Q
prevalence
A
- # of people suffering from a certain health condition over a specific time period
18
Q
incidence rate
A
- rate at which NEW cases of a disease occur within a population
- chance of getting a disease
19
Q
Measuring burden of disease (2)
A
- HALE
- DALY
20
Q
HALE
A
- health-adjusted life expectancy
- # of years to be lived in the equiv of good health
21
Q
DALY
A
- disability adjusted life years
- measure of premature deaths and losses due to illness and disabilities in a population
22
Q
Leading causes of DALYs for low & middle income countries
A
- much higher communicable disease rate
- perinatal conditions
- lower resp infection
- ischemic heart disease
23
Q
Leadign causes of DALYs for high income countries
A
- ischemic heart disease
- cerebrovascular disease
- unipolar depressive disorder
24
Q
Life expectancy has risen in all regions of the world since 1990 except (3)
A
- Europe
- Central Asia
- Subsaharan Africa
25
Communicable diseases continue to contribute largely to the burden of disease in (2)
- s asia
| - subsaharan africa
26
Elderly Support Ratio
- ratio between share of population that is working and the share of the population 65+
27
highest income countries generally have: (3)
- low fertility
- declining populations
- aging populations
28
Demographic Transition
- shift from a pattern of high fertility, high mortality to low fertility, low mortality
- usually shifts as income of country raises
29
Epidemiological Transition (what it is and 3 steps)
- shift in PATTERNS of disease
- high & fluct mortality b/c of poor health conditions, epidemics, and famine
- progressive decline in mortality, epidemics less frequent
- further declines in mortality, increase life expectancy, and predominance of non-communicable disease
30
GAVI
- Global Alliance for Vaccines & Immunizations
31
Why are govs of wealthy countries concerned about health of poorer countries?
- places often traveled by their citizens
| - enlightened self-interest
32
Agencies of the United Nations (3)
- WHO
- UNICEF
- UNAIDS
33
Which Multilateral Development Bank largely focused on link between health and poverty?
- World Bank
34
IAVI
- international AIDS Vaccine Initiative
| - largely funded by world bank
35
Bilateral Agencies
- development assistant agencies of developed countries that work directly with developing countries to improve health of their people
36
Foundations
- fund research and aid projects for improving global health
- talked about Rockefeller Foundation, Wellcome Trust, and Bill & Melinda Gates Foundation
37
Largest Research Funder
- NIH
| - Bill & Melinda Gates Foundation also large
38
NIH funds:
- national GH research but also funds research of other international groups (i.e. Haiti group for AIDS research)
39
NGOs (talked about 4)
- non-governmental organizations
- raise money from private sources or receive grants
- BRAC, Doctors w/o borders, Save the Children, Oxfam
40
Save the Children
- NGO
| - work with poor families & communities to identify most important health needs
41
Oxfam
- NGO
| - focused on injustice and poverty
42
Advocacy Orgs
- advocate on behalf of global health issues
| - carry out research and policy studies and use to spread the word about issues
43
Think Tanks & Universities
- Think Tanks: body of experts who generate knowledge and provide advice and ideas
- Universities: set up institutions and programs for GH
44
Consulting Firms
- for-profit and non-profit
- expertise in one field
- often hired through development banks
45
Specialized Technical Orgs
- CDC
46
The Global Fund
- fights AIDS, TB, & Malaria
| - primarily a financing agency
47
Partnerships related to WHO (3)
- Stop TB
- GAVI
- The Global Fund
48
World Health Assembly
- put on by WHO 1x/yr
| - brings attention to pressing issues & ways to address them
49
Public-Private Partnerships for Health
- main goal is to develop new vaccines/products for overall improved GH
ex. )
- TB drug development
- AIDS (IAVI)
50
UNITAID
- housed in WHO
- financed by tax on airline tickets
- purpose is to increase access of low & middle income countries to treatment of TB, malaria, HIV/AIDS
51
Debt2Health
- 3 party agreement between a creditor, beneficiary, and a Global Fund
- cancel a party's debt in exchange the equivalent amt of money put into the beneficiary's global health work in their own country
52
Financing for GH from 1990-2007
- increased by 4x
53
onchocerciasis
- river blindness
| - caused by worm
54
yield gap
- difference between current productivity and the best that can currently be achieved using available genetic materials & technology
55
Poor Countries doomed to stay poor (why wrong)
- many countries making substantial progress in last 50 yrs
- middle class of nations that didn't previously exist
- % of poor people has dropped >50% since 1990
- Africa big strides in health and education (big variations between countries/states)
56
Foreign Aid is a waste (why wrong)
- US spends 1% of budget on aid
| - aid diminishes disease, increases production & economic growth, and gets country OFF aid
57
Saving lives leads to overpopulation (why wrong)
- as child mortality decreases, people have less children because expectation is they will survive
- w/ less children, families have more resources, children get better education, de better for themselves and future families
58
1990: ____ world
now: ______ world
- used to be camel world ( large 3rd world hump, smaller soviet hump, then 1st world)
- now dromedary world (one large hump, most in middle)
59
UNFPA
- also agency of the UN
- fund for population activities
- focuses on women's and girls health
60
BOND
- biomarkers of Nutrition for Development
- project funding currently stopped
- four major nutrients mapped, idea was website for all major nutrients
61
CARIG
- Carotenoid Group research of American Society of Nutrition
- Sherry involved in this
62
Wealth Improves ____ and poverty breeds ______
Nutrition, undernutrition
63
Wealth vs. live expectancy, infant mortality
increase life expectancy
| decrease infant mortality
64
Nutrition --> Height --> Income
- higher nutrition as a child leads to taller stature..
- taller men tend to be better educated
- stunting is a sign of undernutrition
65
wages rise as ____ rises
- calorie intake rises
66
effects of undernutrition span at least how many generations?
- 3
67
Remitances can improve _____
- health and labor productivity (more money)
68
need interventions for nutrition that take into account:
- socioeconomic and gender inequals
| - ex. education about consumption, improved infant feeding
69
quality protein maize fortified with?
- tryptophan and lysine
| - not transgenic
70
in poor household what is necessary for food consumption?
- unequal allotment of food to feed the one who needs to go out and earn money
71
indonesian health clinic experiment
- when they had to pay for clinic, less people went, more sicknesses, and less labor force participation
72
Iron deficiency affects productivity findings
- anemia: less productivity
- when given supplements, work productivity increased
- placebo group productivity also increased but possibly because they were being paid for participating in experiment
73
mother's education can also stunt children because?
- lower education of mother usually equals lower nutrition for children
74
underweight prevalence has (increased/decreased) in all regions
- decreased
75
undernutrition is the underlying cause in how much of under 5 deaths?
about half
76
Top three regions of wealth in the world
- Japan
- N america
- w europe
77
under 5 mortality and underweight prevalence greatly affecting what types of countries?
- poor ones
78
USA women more than ____ x likely to die from childbirth complications than counterparts in Germany, Britain, or Japan
more than 3x as likely
79
2003-2013 USA was one of only 8 countries to see their maternal mortality rates _____
increase
80
strong relationship between health of a population and ______
economic development of the society in which they live
81
Health problems linked with agr (5)
- malnutrition
- occupational health risks
- zoonoses
- food-borne illness
- water associated vector diseases
82
zoonotic diseases can be caused by:
- all types of agents
83
Diseases from tropical regions
- few, possibly none from domestic animals
- many originated from non-human primates
- slow and chronic
- few convey immunity to survivors
- reservior in animals
84
Diseases from temperate regions
- most originated from domestic (agr) animals (small pox)
- agr and concentration of crowd populations crucial to evolution of crowd diseases
- acute
- many convey immunity to survivors
85
stages of endemic human diseases
1. animals only
2. primary infection
3. limited outbreak (from animals to few cycles of humans)
4. long outbreak (from animals or many cycles of humans)
5. exclusively humans
86
which endemic disease stage most deadly to humans?
human to human only (stage 5)
87
Spanish Flu
- started in WWI
| - crowded, unsanitary conditions, soldiers then returned to all points of the world
88
Zika
- first detected 1947
- mosquitos as well as sexual transmission
- causes microcephaly
89
Bird Flu
- no outbreak yet, but could cause millions of deaths worldwide
- just in birds, but humans have no immunity to it
- farmers and other bird handlers at risk for contracting
90
Emerging Infectious Diseases
- 60% are of zoonotic origin
| - strong correlation with human population density
91
what is a hidden cost of human economic devel?
- disease emergence
92
Nipah Virus
- NiV is common in local fruit bats (“flying foxes”)
- from bats to pigs via saliva, feces, or urine
pigs to humans via droplets during resp infections
- large pig farm near wildlife habitat
- mango orchard near pig farm
- pigs eat the mangos
- may have jumped person to person now
93
Aquifer Info
- depletions are very concerning because using more than new coming in (over pumping)
94
Water-bourne disease vectors
- Malaria
- Schistosomiasis
- Bacteria
95
Arsenic poisioning
- dark spots on skin, skin lesions
- malnutrition aggravates arsenic poisioning
- annual fluctuation as well water is depleted during dry season
- in bangledesh b/c of contaminated water used for rice growing
96
Nutrition affects ____ which affects _______
- health which affects labor productivity which affects nutritional intake
- self-reinforcing cycle
- can be good or bad, threat and opportunity
97
When zinc deficient in soil, it's deficient in ____
- plants too
- zn deficiency world-wide
- causes stunting and underweight children
- developmental impairment
98
Demographic Transition Model
- stage one: pre modern: (birth and death rates high)
- stage 2: urbanization/industrialization: (better healthcare, better nutrition, better sanitation…. but birth rates stay high)
- stage 3: mature industrial (rapid and large population growth until birth rates level off)
- stage 4: post industrial (low birth rates and death rates)
99
Mexico after WWII
- death rates declined because rich countries exported more antibiotics and vaccines, implemented public health in poorer countries like safer water
100
Why do birth rates change?
- momentum and fertility
101
Momentum
- tendency for population to increase even after fertility falls to replacement level
- this happens because the large increase in women in childbearing years, even if fertility stays constant, population increases
102
how to tell how much momentum from pyramid graph
- the wider the base of the pyramid, the more momentum you have (young children growing up into childbearing age… more childbearers then to have more kids)
103
if you want to slow population growth what do you need to look at?
- fertility (can't slow momentum)
104
Fertility Rate
- total number of children a woman would have in her repro years
105
Small changes in fertility lead to :
- large changes in population
| - 5% difference in fertility assumptions causes >20% projections for 2050
106
Why choose many children?
- labor, help on farms (poorer countries)
- high death rate
- religion
- care in old age
- culture
- government rewards
107
Why choose little amount of children?
- no longer needed for farm work
- death rates low
- women want to study/work; can earn more
- women more control of lives
- kids have better life if fewer
- other sources of old age security: government, savings
- government incentives and penalties
- religion
- decrease risk of maternal mortality
108
population growth might not be the problem: what is?
- poverty (self-reinforcing cycle)
109
Green Revolution
- large increase in crop production in developing countries because of fertilizers, pesticides, and high yielding crop varieties
110
Genes that sparked the green revolution came from:
-wheat plants
111
Norman Borlaug
- CIMMYT worker
- crossed the hybrid medium stalked wheat with mexico's best wheats
- his semidwarf wheats enabled India to launch its green revolution
112
increased production in green revolution in india has largely been where?
- in irrigated areas, rainfed areas still remain relatively unaffected
113
What happens when some members of a poor community start to get out of poverty?
- can demand better conditions for the rest of the people (i.e. better roads and schools) and will get them
114
the proportion of hungry people in the world has declined but still ___ have insufficient food
- 1 billion
115
population is getting wealthier which does what to food demand?
- as people get wealthier, begin to demand more dairy and meat products… need more of this
116
by 2050 we will need to double food production but _____
- arable land will not increase
117
closing the yield gap by 50% enough to meet basic needs of
850 million people
118
yield gap often how much and what is it caused by
- often 20-80%
| - caused by hinderances such as weeds, disease, and drought
119
is yield gap static?
- no
120
striga
- weed that sucks away nutrients from maize
| - contributes to yield gap
121
who has highest maize yield
- USA then argentina
122
jump in corn production in 1930s-1960s because of
- mendelian genetics
123
increasing production potential to feed 9 billion by
- modifying to enhance responsiveness to light, fertilizer, water
- enhanced tolerance to stress
- use of transgenics
124
reducing food waste to feed 9 billion
30-40% of food is wasted
| - curbing waste in china, USA, and India could feed 413 mil people/yr
125
Energy flow in US food system
5x as much energy in as food energy we get out!
126
feed 9 billion by changing diets in moderation
- expand aquaculture
| - eat less meat (though important source of vitamins and minerals)
127
How to feed 9 billion? (4)
- decrease yield gap
- increase production potential
- decrease food waste
- change diets in moderation
128
Climate Change: A1B model vs B1 vs A2
- A1B: balance model
- A2: business as usual
- B1: non fossil fuel utopia
129
model projects a global average warming of ____ over the next 100 years (compared to what it was 100 yrs ago)
- 2.8C (~5F)
| - 3-4 times what it was 100 yrs ago
130
where is expected to see greatest change in temp?
- artic circle
131
what all dropped in 2003 when temperature was 3.6C over normal?
- people (30-50k of heat stress)
| - loss of yield on maize (36%), fruit, and wheat (~20%)
132
Impacts of climate on food security
- decrease in yields (~10%/ 1C) (probably 30-40%)
- decrease in fertility
- decrease in micronutrients in crops
- increase in water stress
- increased respiration
- increased disease transmission rates
133
constitutional and legal protection of the right to food around the world
- 23 countries: right
| - 56 countries: principle
134
Genebank
- place where different maize with genetic qualities are stored for future use
- can explore to breed plants for heat tolerance, resistance to pests etc
135
climate change expected to affect which more? tropical or temperate?
- tropical
136
what is important to remember when breeding staple crops?
- breeder enviro is different than farmers' enviro
| - i.e. farmers less fertilizer, no irrigation possibly, fewer pesticides, late planting/late weeding
137
when food prices go up what foods go up and what foods are purchased less?
- food prices up, staple foods purchased more, other foods down
138
Inflated food prices can lead to
- food riots and death
139
maize is deficient in essential AA:
- lysine and tryptophan
140
which two nutritional related disorders associated with corn-based diets?
- pellegra (niacin b12 deficiency because need tryptophan)
| - kwashiorkor: edema, anorexia, increased susceptibility of infections, (low quality protein) (bloated stomach)
141
symptoms of pellegra
- diarrhea, dermatits, dementia, death (4 Ds)
| - lysine can also lead to niacin deficiency
142
what corrects niacin deficiency found with a maize based diet?
- nixtamalization (used lime)
143
what does QPM lead to in animals? humans?
- larger animals
| - weight and heigh gain in humans
144
Obatanpa
- QPM variety
- originated with Ghana, use has spread to other African countries, philippines, and nicaragua
- means good mother
145
Human Development Index (HDI)
- provides a composite measure of three basic dimensions of human development: long & healthy life, education, and standard of living
146
can get basic quality of life by mapping ___ v _____
- human development index vs micronutrient deficiency
147
Vitamin A deficiency
- causes night blindess, corneal scarring, and overall blindness
- also weakened immune system so more prone to measles, diarrhea, malaria
- S asia and Africa highest prevalence
148
Which deficiency is highest around the world.. vit A or iron?
- iron higher
149
micronutrient malnutrition affects more than ____ of the world's population
- more than half
150
Dietary sources of vit A
- meat (esp. liver)
| - veggies (carrots, sweet potatoes, spinach)
151
Dietary sources of Iron
- red meats, fish
| - lentils, beans, leafy veggies
152
Zinc
- oysters, animal products
| - beans, nuts, whole grains
153
what enzyme affects the ratio of carotenoids in the biosynthetic pathway?
- LCYE
154
What enzyme affects B-carotene conversion in the biosynthetic pathway?
- HYDb1
155
methods for carotenoid screenign
- UPLC best
| - can also use HPLC but more costly and slower
156
porridge preparation: how much b carotene is lost?
- 25%, even more in snack prep by deep frying (36-40%)
157
what promotes absorption of Vit A into system? (4)
- Zn, Iron, Fats, vit E
158
provitA and bcarotene promotes absorption of what?
- Fe/Zn
159
if changing a staple food's look, what is important?
- cost (should be less or equal), labor required to make it (less or equal), needs to be high yielding
160
can be an amazing product, but what needs to happen for it to be successful?
- acceptance by community, acceptance by farmers
161
oats now being bred how?
- with higher beta carotene
| - increases fiber consumption which decreases risk of heart attack and type ii diabetes
162
____ % of people in developing countries live in rural areas
- 75%
163
3 distinct rural worlds exist:
- Agr-based countries (32% GPD, 70% poor)
- Transforming countries (7% GDP, 82% poor)
- Urbanized countries (5% GDP, 45% poor)
164
IMPORTANT about Transforming countries
- higher % of poor live in rural areas in transforming (82%) than in agr-based (70%)
165
Progression out of poverty
chronological order
- small-holder most efficient producers
- larger, commercial farming becomes more efficient
- diversification of nonfarm economy (migration out of agriculture)
166
way to make small-holder farming more productive
- improve price incentives
- improve access to financial services
- promote innovation through science and technology
- make agr more sustainable
167
increasing assets in rural farming to get out of poverty may need to include
- affirmative action to include disadvantaged groups
168
Saraguro Project
- provide farmers with improved staple crop seeds
- increased their income
- improved child nutrition
- success lead to more infrastructure in towns (could demand better when have more money)
169
Agr-maize-and poverty alleviation
- give appropriate technologies
- less labor requirement
- reduced vulnerability of crops
- more profit
- better nutrition and health
170
Emergent properties
- just by looking at components cannot get all the answers
- need to look at big picture
- feedback systems also in play
171
Parts of a system (6)
- context
- boundary
- components
- relationships
- inputs
- outputs
172
Approaches to looking at a system (2)
- Reductionist
| - Holist
173
Reductionist approach to looking at a system
- analysis
- pieces and parts
- mechanisms
- structure
174
Holist approach to looking at a system
- synthesis
- whole
- meanings
- function
175
Ecosphere health
- how humans affect food, agr, & enviro
176
Enviro health
- how does food, agr, and enviro affect human health
177
Can improve enviro to improve health examples
- sunscreen use, stop smoking, use low carbon emissions, lower noise, occupational risks
178
Ecosphere health (5 parts)
- Climate
- Water
- Soil
- Energy
- Biodiversity
179
Climate and ecosphere health
- planet getting warmer
| - ice melting, sea levels rising, heat of ocean up, CO2 emissions up
180
Impact of climate change on human health
- CO2 up, temps up, sea level up, extreme weather up,
- natural disasters up
- vector ecology changed (disease transmission up)
181
Eutrophication
- increased nitrogen and phos in water
- this fertilizes algae
- when algae dies, requires O2 to decay which leads to hypoxia in water
- dead zone
182
Pesticide pollution
- endocrine disrupters
183
Soil and ecosphere health
- soil being degraded
| - more land converted to cropland in last 30 years from forests
184
Coal Oil, Nat Gas are (renewable/nonrenewable)
- non-renewable
185
Biodiversity and ecosphere health
- high conversions of forests to urban or farming
- effect on animal species
- people benefit greatly from ecosystems.. food, culture, primary production, health, wellbeing
- if we lose biodiversity lose abilities of cycles like nitrogen fixing, genetic diversity
186
Sustainable Agricultural Dimensions
- need production of food that is good for the enviro, economically feasible, and socially inclusive
- doesn't destroy soil, doesn't contribute to climate change, doesn't lower water quality
187
Industrial agr
- high yeilding
- machinery and fossil fuels
- chemical fertilizers
- pesticides, herbicides, fungicides
- irrigation
- scientific knowledge only
188
Chemical fertilizers lead to
- eutrophication, water pollution
189
pesticides lead to
- biodiversity impacts, human health
190
Tillage/machinery lead to
- reduced soil cover, erosion
191
improved seeds in monoculture lead to
- loss of genetic resources, & crop diversity
192
Agroecology
- Nature Model: heterogeneity, ecosystems processes, optimization (optimize crop for humans but do not maximize)
- local adapted species and cultivators
- biological N fixation, manure, composts
- biological pests and disease control
- scientific knowledge integrated with farmer knowledge
193
Agroecological Intensification
- redesign approaches to increasing food yield that is environmentally friendly
194
Annual Crops v Perrenial crops
- Annual (wheat, barley, rice, corn): extremely productive, require high external inputs, unintended consequences (sensitive to weather shifts, pest issues, enviro issues)
- Perennial: control erosion, reduce leaching of extra N and Phos, fix carbon, multiple uses (pastures, forages for feed, biomass for energy, perennial grains)
195
Perennial dual purpose crops (1)
- Kernza
| - intermediate wheat grass
196
Relative enviro impacts of beed production systems
- feeding grain to cattle: less carbon footprint, more fossil energy use, more soil erosion, more pesticide use
197
Grazing System
- lowers energy consumption, soil erosion, pesticide eco-tax, nitrogen
- higher nutrient value
198
Problems with areas that need more food
- do not have the resources
| - need to change way we produce food if want to solve hunger and rising population
