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What makes people sick?

It is an interaction between:

1. Host
2. Agent: e.g. microorganisms
3. Environment: location and quality of environment

And this interaction is influences by social determinants of health


What makes Canadian's Sick? % attributable to...

1. Your Environment 10%
2. Your Biology 15%
3. Your Healthcare 25%
4. Your Life 50%


What are health inequalities?

“The presence of a significant difference in the overall rate of disease incidence, prevalence, morbidity, mortality, or survival rates in the population [in question] as compared to the health status of the general population.”


What is the difference between equality and equity?

Equality = everyone gets exactly the same thing

Equity = everyone gets what they need (even if some need more than others)

-> think of diagram of taller and shorter people standing on boxes to reach apples


Describe the difference between health inequality and inequity

Inequalities are facts about disparities (e.g. women live longer than men on average)


Inequity is concerned about whether the unequal distribution is “fair”, which involves a value judgment. (e.g. Should rich people have more health coverage than poor)


How should inequality be reported?

Both absolute and relative inequality should be reported together as complementary measures of inequality


When are relative measures particularly useful?

Relative measures are unit-less
-> Useful when making comparisons between indicators with different units


What is your social context?

What does different social context lead to?

Your age, your economic development and your urbanization (who you are and where you live)

Different social contexts lead to -> differential exposure which leads to-> differential vulnerability which leads to -> differential outcomes


What type of mosquitos carry zika? what other diseases do they carry?

Aedes Aegypti

Dengue, Zika and Chikungunya


What are the characteristics (when do they bite from, what temps do they like) of Aedes Aegypti

Bite from 5am to 8pm and like temperatures between 25-38 degrees


How many cases of Dengue every year?

390 million new cases/year


In 2015 how many cases of Dengue were reported in the Americas?
How many severe?
How many deaths?

2.35 million cases reported
10,200 severe and
1,181 deaths (Americas alone)


How many cases of Zika every year?

Where do 70% of cases occur?

230,000 cases

70% in brazil and colombia


How many cases of Congenital Zika Syndrome every year?

Where do 87% of cases occur?

3,700 cases

87% Brazil & Colombia


What % of the world population is a risk of Dengue?



How often is someone admitted to the hospital with Dengue?

Every minute


How many people are hospitalized with severe Dengue every year (globally)?



How often is a lift lost to Dengue?

every 20 mins


What is the death rate from severe Dengue without experienced medical care?

What could this be brought down to with early diagnosis and quality care?

As high as 20%

could bring it below 1%


What are the Health System Determinants of health that determine who dies from Dengue?

Health System Determinants
- Access to health care
- Opportunity for receiving attention
- Qualified attention
- Health staff knowledge


What is an issue with the vaccine for Dengue?

The vaccine is not safe.

If you had the disease once already and you are vaccinated after, your risk of hospitalization following the vaccine increases (second infection more severe)


What are the 4 phases of near-miss framework?
(causes of death and risk factors that distinguish those who had the risk factors that died vs those with the same risk factors that survived)

Phase 1: Recognizing the need to seek care for first symptoms and warning signs
Phase 2: deciding to seek (preventative) care
Phase 3: identifying and reaching facility that provides necessary care
Phase 4: receiving adequate treatment


Why were girls being admitted to hospitals less for Dengue in Vitenam?

They did a study thinking that it was maybe because of fees for hospital would lead parents to focus resources on boys

Their intervention of making admissions free did not work and they determined that it was probably because girls complain less about symptoms


Who is more at risk of being bitten by a mosquito?

House: bite women and young children
In apartment mosquitos are less prevalent (don't go above a certain amount)