Global Health Final Flashcards
Richard Lewontin
published a paper in 1972 where he observed based on classical markers such as blood groups that 85% of variation occurs within populations so most genetic variation occurs within races not between them
Non Concordance
The observation that when groups of people were classified, clusters based on morphology (physical characteristics that tend to be used to define race socially) are different from clusters based on classical markers of genetics
Current definition of race
Race can be thought of as a socially defined category that sometimes overlaps with a continent of origin. It has a long, troubled scientific history
Clines
people tend to be more similar to people who live near them than to people who live farther away. This is likely due to isolation by distance since there is a higher gene flow between geographically close populations and human genetic diversity forms from geographic clines which is a continuum with an infinite number of gradations from one extreme to the other and there are no discrete boundaries.
Embodiment
framework of health that considers how lived experiences shaped by our social and physical environment have very real biological effects. It can help explain the health differences we see between racial groups such as how chronic stress is linked with frequent experiences of discrimination and may lead to biological changes that increase the risk for morbidity and mortality. Lifestyle factors and structural violence can also contribute to this.
Intersectionality
A framework of health that moves beyond examining individual health determinants and considers how health determinants interact and shape health outcomes jointly. They can also lead to more nuanced examinations of differences within groups that are often considered to be homogenous and highlight the role of power and access in shaping inequities.
What is LBW? What are some short- and long-term health risks associated with LBW? What is the evidence that LBW is linked with social rather than ancestry?
Low birth weight infants are less than 2500 g at birth and are small for their gestational age and usually experience preterm delivery. They have an increased risk of mortality and morbidity due to infectious disease, impaired immunity, and chronic metabolic conditions later in life, and they are also at risk for growth failure/reduced cognitive development, and this may lead to multigenerational effects. Percentage of LBW infants varies across racial/ethnic groups and disparities are observed globally, where 91% of LBW infants are from low or middle income countries.
Arline Geronimus
posited that minority communities experience chronic stress and health deterioration due to repeated experiences with social/economic adversity, discrimination, and political marginalization and these experiences can lead to premature deterioration of health, a phenomenon known as weathering.
How does weathering connect with telomeres and allostatic load?
Chronically activated stress responses wear down the body and lead to higher allostatic loads, and greater “wear and tear” on the body. Telomeres are caps on the ends of chromosomes that protect DNA during cell division, and increased allostatic load is linked with more cell repair/division meaning more cell repair/division and earlier degradation of tissues. But social support networks, income, and education can reverse this. This can particularly impact prenatal and postpartum health in black mothers along with premature physiological aging.
Dr. Benjamin Chavis
defined environmental racism as racial discrimination in environmental policy making, enforcement of regulations/laws, targeting of communities of color for toxic waste facilities, official sanctioning of life-threats (poisons/pollutants), history of excluding POC from leadership of ecology.
Professor Robert Bullard
(“father of environmental justice”). Claimed environmental racism is any policy, practice, or directive that differentially affects or disadvantages individuals, groups, or communities based on race.
Environmental justice
EPA defines it as the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies. Goal should be for everyone to achieve the same degree of protection from environmental/health hazards and equal access to decision-making to have a healthy environment in which to live, learn, and work.
Some examples of environmental disparities are that POC in STL are more likely to experience pollution (lead poisoning), mold, limited access to nutritious food, trash dumping, higher asthma rates
Jose Martinez Cabo
defined indigenous communities as those that have historical continuity with pre-invasion and pre colonial societies that develop on their territories, consider themselves as distinct from other sectors of society, and are determined to preserve and transmit their ancestral territories to future generations.
Ethical concerns about genetic research in Indigenous communities
Genetic material can be acquired from old samples or living people and genetic research has advanced research by tracing disease origins but it must be conducted ethically. Some concerns are that samples can be used for studies outside of the bounds of original consent documents, genetic evidence can contradict a tribe’s oral history, and it can have implications outside of the bounds for tribal sovereignty and land rights. This occurred in Arizona where samples from an Indigenous tribe were used for biomedical studies without consent.
Environmental and health benefits of Indigenous knowledge (e.g., regarding the possible development of new medications)
Indigenous people have a deep understanding of land/history and the loss of traditional healing practices can lead to worse health outcomes along with biomedical health model being forcibly used and medicalization can also worsen Indigenous health. Current medical treatments such as quinine were used to treat malaria before being marketed so the potential for life-saving treatments can be lost if Indigenous knowledge is ignored. They also used local plant saps and seeds to clear intestinal parasite infections effectively.
Possible contributions anthropologists can make to address health disparities in Indigenous communities?
Anthropologists can assess the ethnographic studies of health patterns, the effects of global scientific practices/technology within local contexts, critique the effectiveness and identify the limitations of global health programs, and ensure the results of a given study reach communities and are of use to participants. They should also consider their role in shaping health outcomes and ensure research practices are ethical.
Neglected Tropical Disease definition
Refers to parasitic, bacterial, and viral diseases that are chronic, debilitating, and promote poverty among those that are infected. They tend to affect low income areas and receive relatively low levels of attention and funding from researchers. They may impair physical and cognitive function resulting in suboptimal growth and development patterns.
Peter Hotez
A leading NTD researcher
Parasite
Organism that spends a portion or the totality of its life biologically dependent on another species, typically at the expense of its host. Many NTDs tend to be parasitic infections.
Blue Marble Health
Refers to a paradigm of global health that claims that poor people in wealthy countries account for most of the poverty related illnesses around the world and they should be the focus of attention when looking at different issues such as NTDs.
Dr. Peter Hotez
coined the term NTD and is helpful in developing vaccines against them
Dr. Rojelio Mejia
highlighted that it can be harder to combat NTDs in lower income areas in the US than lower income countries
MacArthur Genius Catherine Coleman Flowers
did work highlighting the role sewage failure plays in parasite infection
Inflammation
Inflammation refers to the acute inflammatory response that is activated in the presence of a pathogen. It is beneficial when there is a cut because as tissue heals, phagocytes and macrophages can consume bacteria and cell debris. It is harmful when it is chronically activated and dysregulation occurs
Hygiene Hypothesis
Posits that we’re “too clean” and that a western lifestyle, the widespread use of antibiotics, a shift towards urban environments, our diet, sanitation systems is favoring Th2 cell production and creating imbalances between different types of T cells and this is leading to dysregulation of inflammatory processes
Old Friends Hypothesis
A more narrowly focused version of the hygiene hypothesis that posits that the absence of worms is novel in our environment and that helminth infection is key to the development of our immune systems so in their absence, immune systems are less robust since Th2 cells aren’t developing and Th1 over response is occurring
Disappearing Microbiota hypothesis
Posits that microbes play important roles in immune function, digestion, and more in the human body and that a Western lifestyle is changing our microbial composition resulting in poorly developed immune systems and making us more susceptible to autoimmunity/allergy
Variolation
Variolation refers to a method of immunizing patients by infecting them with a substance (usually pustules) from a mild form of the disease. This method served as the origin of vaccination but it was deemed to be unsafe since it relies on a live virus which can lead to a full blown infection in some cases. Vaccines came about as people became interested in developing safer alternatives to this method.
Edward Jenner
Development of first contemporary vaccine
