Global Health 101 Chapter 1 The Principles and Goals of Global Health The reason for studying global health is to gain a better understanding of the progress made so far in addressing global health problems and to understand the most important global health challenges that remain and learn how to address them rapidly, effectively, efficiently and fairly with the help of different actors.
Progress in global health: increased life expectancy, decrease in child
mortality, progress against vaccine preventable diseases, fewer maternal deaths, decrease in tobacco consumption.Health = a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.Public health = the science and art of preventing disease, prolonging life, promoting physical health and mental health and efficiency through organized community efforts toward a sanitary environment; control of community infections; education of the individual in principles of personal hygiene; organization of medical and nursing service for the early diagnosis and treatment of disease; the development of the social machinery to ensure to every individual in the community a standard of living adequate for the maintenance of health.
Winslow: Also promoting people to drive with seatbelts, regulating
industrial pollution or maintenance of disease surveillance systems.Principles of public health; prevention of disease, respect for the rights of individuals and a commitment to developing public health in conjunction with communities. They highlight the need to pay particular attention to disenfranchised people and communities and the importance of evidence based.Difference public health and medicine Differentiating factors Public health Medicine FocusPopulationIndividual Ethical basis Public service Personal service Emphasis Disease prevention and health promotion for communities Disease diagnosis, treatment, and care for individuals Interventions Broad spectrum that may target the environment, human behaviour, lifestyle and medical care Emphasis on medical care Global health implies a global perspective on public health problems. It suggests issues that people face in common such as the impact of a growing and aging worldwide population on health or the potential risks of climate change to health. It also relates to problems that require cooperative action. 1 / 4
Significant global health issues include how countries can organize and manage their health systems to enable the healthiest population possible given the resources available.One health = the integrative effort of multiple disciplines working locally, nationally, and globally to attain optimal health for people, animals and the environment.Planetary Health = the achievement of the highest attainable standard of health, wellbeing, and equity worldwide through judicious attention to the human systems – political, economic and social – that shape the future of humanity and the Earth’s natural systems that define the safe environmental limits within which humanity can flourish.Difference; one health focusses on interconnectedness of animal, human, and environmental health whereas planetary health has a greater focus on the health of the environment and the connections between and human and animal well-being.The WorldBank classifies countries into four income groups, based on
estimates of their gross national income (GNI) per capita:
-Lower-income economies: GNI per capita of 995 dollars (Ethiopia)
-Lower-middle-income economies: GNI per capita between 995-3895
dollars (India)
-Upper-middle-income economies: GNI per capita between 3895-
12055 dollars (Turkey)
-High-income economies: GNI per capita of 12056 or more dollars
(Netherlands)
Sustainable Development Goals : build on the Millennium Development
Goals (MDGs) which were formulated in 2000 at the United Nations Millennium Summit. All the goals have an important, even if indirect, relationship with the achievement of good health and wellbeing.
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Chapter 2 Health Determinants, Measurements, and the Status of Health Globally Determinants of health = range of personal, social, economic and environmental factors which determine the health status of individuals or populations.Social determinants of health = conditions in which people are born, grow, live, work and age.
Group of factors that helps to determine health:
-Personal and inborn features of the individual: genetic makeup, sex
and age
-Individual lifestyle factors: eating pattern, drive safely, alcohol etc.
-Social networks: the extent to which people receive social support
from family, friends, community. The stronger the networks and the stronger the support, the healthier people will be.
-Living and working conditions: housing, access to safe water,
nutrition etc.-Social economic factors. It refers to a person’s economic, social and work status.
oEducation: brings with it knowledge of good health practices, it
provides opportunities for gaining skills, getting better employment, raisings one’s income and enhancing one’s social status.
oCulture: shapes how one feels about health and illness, how
one uses health services and the health practices in which one engages.
oEnvironment: the safety of the environment in which people
work (pollution in air, lack of safe drinking water and sanitation).Key Health indicators (to make comparisons across people); 3 / 4
-Infant mortality rate = the number of deaths of infants under the age 1 per 1000 live births in a given year.-Life expectancy at birth = the average number of additional years a newborn baby can be expected to live if current mortality trends were to continue for the rest of that person’s life. The higher the life expectancy at birth, the better the health status of a country.-Maternal mortality ratio = the number of women who die as a result of pregnancy and childbirth complication per 100,000 live births in a given year.-Neonatal mortality rate = the number of deaths of infants under 28 days of age in a given year per 1000 live births.-Under-5 mortality rate (child mortality rate) = the probability that a newborn baby will die before reaching age 5, expressed as a number per 1000 live births.They all vary with level of income; the more the income the lower the rates. Sub-Saharan Africa has the worst health indicators, South Asia the second worst.Morbidity = sickness or any departure, subjective or objective, from a psychological or physiological state of wellbeing.Mortality = death Death rate = number of deaths per 1000 population in a given year.Disability = temporary or long-term reduction in a person’s capacity to function.Prevalence = the number of people suffering from a certain health condition over a specific time period. It measures the chances of having a disease.Point prevalence = the proportion of the population that is diseased at a single point in time.Incidence rate = how many people get a disease, for a specified number of people at risk, for a given period of time. The denominator for the rate usually depends on how commonly the disease occurs in a year and is often per 1000 or per 100,000 people.Prevalence is pool of people with the disease and incidence as the flow of new cases of people with that disease into that pool.Primary prevention = intervening before health effects occur, through measures such as vaccinations, altering risky behaviours, and banning substances known to be associated with a disease or health condition.Secondary prevention = screening to identify diseases in the earliest stages, before the onset of signs and symptoms, through measures such as mammography and regular blood pressure testing.Tertiary prevention = managing disease post diagnosis to slow or stop disease progression through measures such as chemotherapy, rehabilitation and screening for complications.Communicable diseases (group I) = infectious diseases, illnesses that are caused by a particular infectious agent and that spread directly or indirectly from people to people, animals to people, or people to animals.
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