Global health and childhood illnesses Flashcards
What is an IMMEDIATE cause of death?
typically define as the disease or injury directly leading to death
e.g. pneumonia
What is an UNDERLYING cause of death?
typically defined as the disease or injury that initiated the train of morbid events leading to death
e.g. malnutrition
What is health?
[WHO 1946]
Health is a state of complete mental, physical and social wellbeing, not merely the absence of disease or infirmity
What aspect of ‘health’ is global health largely based on?
based on mortality and morbidity patterns e.g. negative health indicators
What info do we gain from mortality figures on disease?
LIFE EXPECTANCY
death rates across ages
AGE-SPECIFIC MORTALITY RATE
death rates within specific ranges e.g. neonate, infant, 60+, adult
MATERNAL MORTALITY RATIO
mothers who die during childbirth
CAUSE-SPECIFIC DEATH RATES
e.g. HIV, TB etc
What info do we gain from morbidity figures on disease?
PREVALENCE
of specific diseases
e.g TB, HIV/AIDs
What is ‘healthy life expectancy (HALE) at birth’?
combo of mortality and morbidity together
= average number of years that a person can expect to live in ‘FULL HEALTH’
Takes into account years lives in < full health due to disease and/or injury
What is the major pattern of health and disease globally?
-> there are enormous differences between countries in both prevalence of disease and cause of death
What is the global pattern for life expectancy?
older life expectancy for MEDCs than in LEDCs
F>M globally
What is the global pattern for HALE?
HALE = healthy life expectancy (HALE) at birth
Greater difference between HALE and life expectancy in MEDCs than in LEDCs
= in MEDCs, older age, but this comes with a lower QoL at the end years
What is the global pattern of mortality at different ages?
1/3 of deaths 0-29y
1/3 of deaths at 30-69y
MEDCs: deaths mainly in older adults
LEDCs: deaths mainly in children, adults and mothers
What is the probability of dying <5y globally?
x58 for a child to die <5y in Haiti than in Japan
What is the probability of dying between 15-60y globally?
MALES
x4 as likely to die at this age in Japan than in central African republic
FEMALES
x8 as likely to die at this age in Japan than in central African republic
What are the trends seen in countries with low life expectancy?
- high death rates in infancy and early childhood
[strong influence on life expectancy] - high death rates in adult life
- high maternal mortality rates
Where are the majority of deaths under 5 years globally?
99% occur in low and middle income countries
48% occur in (mainly SubSaharan) Africa
30% occur in the Indian subcontinent
[50% of these deaths occur in just 6 countries]
In which 6 countries is there the highest risk of death <5y?
- Sierra Leone
- Haiti
- Chad
- Angola
- Somalia
- Congo
What are the IMMEDIATE causes of death for <5y?
(in order of prevalence from most abundance cause)
- neonatal causes
- pneumonia
- diarrhoea
- malaria
- injury
- AIDS
- Pertussis
- Meningitis
What specific causes underly neonatal deaths?
(most abundant first)
- prematurity
- asphyxia
- sepsis
- congenital abnormality
- tetanus
Which causes of death in <5y are most abundant in SubSaharan Africa?
- Malaria
- AIDS
- TB
[and neglected tropical diseases]
Where is the risk of death in 15-60y highest globally?
higher in low income, low life expectancy countries
What are the IMMEDIATE causes of death for 15-60y?
usually a combo of:
- infectious disease
- chronic disease (non-infectious)
- accidents (esp. RTAs, suicide violence)
- maternal deaths
What are the 5 most common causes of global deaths in adults?
- RTA
- Self-harm
- Violence
- Maternity
- HIV/AIDS
What is meant by the term ‘neglected tropical diseases?’
VIRAL
Dengue, Rabies
PROTOZOA
Chagas disease, trypanosomiasis, Leishmaniasis
HELMINTH
Cystericercosis/Taeniasis, Lymphatic filariasis
BACTERIA
Leprosy, Trachoma, Yaws
What is maternal mortality?
death of a woman while pregnant or within 42 days of birth, from causes related to pregnancy or its management
How is maternal mortality assessed?
MATERNAL MORTALITY RATIO
= number of maternal deaths per 100,000 live births
Where is the risk of maternal mortality highest globally?
- SubS Africa
- Oceania
- S Asia
What risk factors contribute to maternal death?
- high maternal age
- multiple pregnancies
- poor nutrition
What are the statistics for maternal death risk globally?
high income countries
~ 1 : 3000
low income countries
~ 1 : 40
What are the main IMMEDIATE causes of maternal mortality?
- severe haemorrhage
- abortion complications
- eclampsia/high BP
- maternal sepsis
- obstructed labour
What are the current trends in life expectancy?
- life expectancy is rising
- death rates falling (esp. in young from infectious disease)
- low life expectancy, low income countries still vulnerable to infectious disease and other chronic infections
- growing numbers of deaths due to chronic, non-infectious disease (even in low and middle income countries)
What are the key UNDERLYING causes of death and disability in W. Europe?
- tobacco smoke
- High BP
- Obesity
- physical inactivity
- high BM
What are the key UNDERLYING causes of death and disability in SubS Africa?
- underweight child
- indoor air pollution
- suboptimal breastfeeding
- iron deficiency
- high BP
What factors contribute to the relationship between income and life expectancy?
Low income related to:
- inadequate nutrition
- inadequate sanitation/water
- inadequate housing
- poor educational prospects
- conflict/war
- difficulty overcoming ecological hazards
What are the major types of undernutrition?
(v. important in low income countries)
- protein-energy malnutrition
- Iodine deficiency
- Iron deficiency
- Zn deficiency
- Vit A deficiency
What are the consequences of undernutrition?
- susceptibility ot infection (esp. infancy and early childhood)
- limits growth (stunting)
- increases pregnancy risk
What are the risks in pregnancy associated with undernutrition?
- Stunting increases risk of complicated labour
- increases risk of maternal haemorrhage and infection
What diseases does unsafe water increase risk of?
- cholera
- typhoid
- giardiasis
Which health care deficiencies are present in low income countries?
LACKING:
- immunisation programmes
- maternal medical care
- child health
- HIV/AIDS treatment programmes
- medication costs not met by health services
What are the links between nutrition trends and morbidity in high income countries?
HIGH SATURATED FAT
coronary heart disease
HIGH SALT
high BP
HIGH ENERGY (compared to expenditure) Obesity, T2DM
What is the link between tobacco and mortality?
= most readily preventable modern cause of premature death and disease
- cancers
- CHD
- stroke
now declining in high income countries
What are the main consequences of physical inactivity?
- obesity
- T2DM
- CHD
- Stroke
- Cancers (colon, breast, endometrium, prostate)
What are some goals set out by the ‘UN sustainable development goals (SDGs)’?
- end poverty and hunger
- achieve gender equality
- promote sustained and sustainable economic growth
- promote peaceful societies
etc
[17 in total]
