Module 2: Lecture 1

Question 1

IOM Report, “The Future of Public Health” (1998), Mission of Public Health:

Answer 1

“fulfilling society’s interest in assuring conditions in which people can be healthy”

Question 2

Early Public Health Efforts Included

Answer 2

improved housing, trade unions, abolition of child labor, maternal & child health, temperance (reduce alcohol consumption)
- closely tied to social reform movement

Question 3

Public Health as Social Justice

Answer 3

minimal levels of income, housing, employment, education, health care should be fundamental rights for everyone

Question 4

Idea of Public Health as a Leader in Social Justice is Resisted by Conservative Thinkers

Answer 4

public health should focus only on controlling infectious diseases and as a safety net to provide medical care to those in dire need

Question 5

America as a Market-Oriented Society (Market Justice)

Answer 5

• individualism prevails
• medical care for all is a “socialist ideal”

Question 6

Americans Oppose Being Told What to do

Answer 6

• resist government restrictions on behavior even if intent is protection
• where does individual responsibility & choice end?
• CONCEPT: individual liberties- individual power making & choice

Question 7

Social Justice

Answer 7

• minimal levels of income, housing, employment, education, health care should be fundamental rights for everyone
• government has an obligation to provide healthy conditions for societal members who are unable or unwilling to provide these conditions for themselves
• attacked as a “socialist” perspective

Question 8

Market Justice

Answer 8

• conservative perspectives
• individual responsibility
• minimum responsibility to common good
• public health should focus only on controlling infectious diseases and as a safety net to provide medical care to those in dire need
• Paternalism: should we be told what to do (e.g. guns, soda & tobacco taxes etc.)

Question 9

Primary Areas of Debate: Economic Impact (Negative)

Answer 9

industries resist public health measures
- landlords and building codes, polluters and environmental regulation; tobacco- income for many people in the South
- short term costs for long-term benefits (environment)

Question 10

Usually, Those who pay for a Public Health Measure are not the ones who Benefit

Answer 10

• short term rewards vs long term benefits of regulations
• what % of medical expenditures go towards public health?

Question 11

Primary Areas of Debate: Libertarian Perspective

Answer 11

• laws are okay only to restrict harm to others (assault, murder, etc.); “tyranny” if laws to restrict harm to themselves
• it is okay to outlaw some activities but not others:
  
  • activities that only harm the individual (e.g. soda, drug use, alcohol use, tobacco use when alone) etc…are permissible
  • when harm is incurred to others some libertarians will agree that intervention is needed

Question 12

Libertarian Point of View (John Stuart Mill)

Answer 12

“the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others.”
- PATERNALISM: why can YOU tell ME what to do with/to MYSELF?

Question 13

Moral/Ethical Perspectives

Answer 13

some behaviors are “immoral” and because of this:
- certain of public health activities/initiatives should be carried out
- funding should be allocated in certain ways
- punishment/incentives against certain behaviors

Question 14

Examples of Moral/Ethical Perspectives

Answer 14

• HIV/AIDS- notion that providing condoms/sexual education etc…promotes promiscuity (abstinence only)
• Drug Use- should we practice harm reduction (clean needles for heroin use)? argument that this promotes drug use; penal system for drug users…not rehab focused
• Funding Allocation for Research- less funding is allocated to studying “immoral” health issues- HIV/AIDS

Question 15

Global (International) Public Health Defined as

Answer 15

the application of the principles of public health to health problems and challenges that affect low-and middle income countries and to the complex array of global and local forces that influence them
- Crosses International Borders

Question 16

Key Issues (Global Health)

Answer 16

urbanization, migration, informational technology and expanding global markets
- primarily focused on low and middle income countries as they have the greatest mortality and morbidity and inadequate health systems to meet the needs of their most vulnerable populations
-improving the health standing of these populations requires an understanding of their social, cultural and economic characteristics

Question 17

Hippocrates “Airs, Waters, & Places”

Answer 17

was the first systematic effort to see the causal relations between environmental factors and disease, and to offer a theoretical basis for an understanding of endemic and epidemic diseases

Question 18

Bubonic Plague (or Black Death)

Answer 18

epidemic of the 14th century, which began in Central Asia, was carried on ships to European ports, and then spread to the interior, killing 25 million people in Europe alone

Question 19

Public Health Tends to Focus on…

Answer 19

the health of a community as a whole (grassroots). their emphasis weighs heavier on primary prevention, rather than tertiary care
- as interventions are created, their focus is on the environment and behavior(s) of a population

Question 20

Medical Approach

Answer 20

tends to focus on the health of individuals
- emphasis weighs heavier on diagnosis and treatment
- they invest more in tertiary care, rather than prevention and control

Question 21

Public Health VS Medicine

Answer 21

population VS individual
public service VS personal service
disease prevention, and health promotion for communities VS disease diagnosis, treatment, and care for individuals
broad spectrum that may target the environment, human behavior, lifestyle, and medical care VS emphasis on medical care

Question 22

Public Health VS Medicine (Which is More Cost Effective?)

Answer 22

Public Health Approach- no treatment

Question 23

United Nations (UN)

Answer 23

intergovernmental organization to promote international cooperation; established in 1945 after World War II in order to prevent another conflict;193 member states; financed by assessed and voluntary contributions from member states; objectives include maintaining international peace and security, promoting human rights, providing humanitarian aid in cases of famine, natural disaster, and armed conflict

Question 24

World Health Organization (WHO)

Answer 24

established in 1948 to build a better, healthier future for people all over the world; working in 150 country offices, in 6 regional offices and at headquarters in Geneva

Question 25

World Bank (WB)

Question 26

World Bank (WB)

Answer 26

an international financial institution that provides loans to developing countries for capital programs; the goal is the reduction of poverty

Question 27

Organization for Economic Co-Operation and Development (OECD)

Answer 27

an intergovernmental economic organization with member countries, founded in 1961 to stimulate economic progress and world trade. It is a forum of countries describing themselves as committed to democracy and the market economy

Question 28

World Bank Income Groups

Answer 28

Low-income :$1,005 or less Lower middle-income :$1,006 to $3,955 Upper middle-income :$3,956 to $12,235 High-income : $12,236 or above Based on gross national income per person

Question 29

Developed Countries

Answer 29

Developed countries- have relatively high income per capita and that are often thought of as “industrialized.” Examples include: United States, Norway, France, New Zealand, Australia, and the United Kingdom The United Nations also notes that Japan in Asia, Canada and the United States in North America, Australia and New Zealand in Oceania, and most European countries are considered "developed" regions or areas.

Question 30

Steady decline in mortality rates in the industrialized countries during the period of 1990-2003 WHY?

Answer 30

new and costly medicines, technology, and interventions. still struggling to control many preventable causes of mortality, including communicable diseases, maternal and perinatal conditions and nutritional deficiencies, violence and injuries

Question 31

Developing Countries

Answer 31

Developing countries have relatively low per capita income and are not heavily industrialized (what do they mean by industrialized) Haiti, Liberia, India, Malaysia, and Honduras Developing countries often refers to those with low levels of economic development, which is usually closely associated with social development, in terms of education, healthcare, and life expectancy.

Question 32

There is a strong correlation between

Answer 32

low income and high population growth

Question 33

Global Health Concerns

Answer 33

Women die of pregnancy-related deaths in so many countries Over 300,000 women a year die in childbirth HUGE amount of malnutrition among children, especially in South Asia and Africa The burden of different infectious and non-communicable diseases around the world, and what can be done to control those diseases The impact of the environment on health globally and the effects of natural disasters and conflicts are also important to global health (WAR?)