Global Health Exam 1

making globalization work better for health

-better allocation of aid -sustainable economic growth -international agreements -assessment of impact of international agreements

Goals of the GBD study

-provide policy makers data for decision making & use a common metric for burden of disease

3 types of epidemiology

1. Descriptive 2. Analytical 3. Experimental

Sustainable Development Goals

17 universal goals adopted by the UN with 169 targets and 230 indicators which replaced the MDGs

stanley milgram obedience experiments

40 adults administered shock in the name of exacting obedience Led to intensive debate about the extent to which deception would be tolerated in social science research and how harm to subjects should be evaluated

Which statement is the most important when taking an equity lens to health: A) It is important to consider health disparities across countries and within countries B) It is important to consider health disparities across countries C) It is important to consider health disparities within countries D) It is important to consider health disparities among selected groups

A

Disability refers to: A) Death B) Temporary or long-term reduction in a person's ability to function C) Short illness D) Illness

B

capabilities approach

Deprivation of basic needs such as food, health and education makes a person incapable to function and, hence, violates the persons principal rights and freedoms enshrined in law

Declaration of Helsinki

Ethical principles for medical research involving human subjects which states that in any medical study every patient should be assured of proven effective treatments methods.

which 5 countries do half of the worlds poor live in

India, Nigeria, Dem Rep Congo, bangladesh, & ethiopia

Health System Approaches

National Health Insurance, National Health Service, or Pluralistic

Vital Registration System

Registration system that collects information routinely on vital events such births, deaths, and COD

what do the GDGs demostrate

They demonstrate, beyond any doubt, the need for urgent action by showing how far progress lags behind expectations.'

DALYs equation

YLLs+YLDs

YLD

Years of life lost due to disability

YLL

Years of life lost to premature death

why does health matter to development

health matters in its own right + health increases income and consumption acting as a driver out of poverty

holistic approach

human rights are indivisible, interdependent, and interrelated and of equal important

what is the right to health founded in

international law

human rights education approach

"The most effective means of enhancing people's capabilities is to facilitate their own social transformation through participation in the decisions that affect development"

effects if globalization on health

-accelerates travel of people and diseases -increased demand for goods puts a stress on the environment -homogenization of lifestyles and values means lifestyle diseases are more prevalent -health products and services can be available and affordable

Effects of Globalization

-identical products and services -homogenization of lifestyles and values -standardization of socioeconomic systems and rules -uniform social structures

applications of GBD study

-used to asses performance of healthcare system -generates forums for informed debate of values and priorities -helps to identify national disease control priorities -helps determine what resources need to be developed -provides a scientific criteria for resource allocation

what is the target percent for countries to spend of their GNI on official development assistance (UN)

0.7%

Objectives of Epidemiology

1) study the natural course of disease from onset to resolution. 2) determine the extent of disease in a population. 3) identify patterns and trends in disease occurrence. 4) identify the causes of disease. 5) evaluate the effectiveness of measures that prevent and treat disease.

Generally, people who are healthier earn: A) More money than those in less good health B) Less money than those in less good health C) About the same as those in less good health D) About the same as those with minor disabilities

A

The Sustainable Development Goals A) Include a range of goals and targets that relate to health B) Focus on a healthy environment C) Are all to be achieved by 2020 D) Say little about global health

A

The major principle(s) of the Belmont Commission Report include: A) Respect for persons, Beneficence, and Justice B) Fairness, Beneficence C) Justice, Respect D) Fairness

A

demographic dividend

A rise in the rate of economic growth due to a rising share of working age people in a population.

A DALY measures: A) The sum of years spent in illness B) The sum of years lost due to premature death and years lived with disability, calculated on a weighted basis C) The sum of years lost to premature death and years spent in illness D) The sum of years spent in disability

B

Human capital refers to: A) The amount of money people have B) The skills and knowledge people have that allows them to be productive C) The amount of people's assets D) None of these are correct

B

The Declaration of Helsinki says that anyone participating in human subject research must provide the following: A) A waiver of liability B) Voluntary, informed consent C) Informed consent D) Both A waiver of liability and Voluntary, informed consent

B

The only human disease ever eradicated was: A) Rinderpest B) Smallpox C) Guinea worm D) Polio

B

Which factor is expected to have the greatest impact in the next two decades on the burden of disease?A) Urbanization B) Population aging C) Population growth D) Both Population aging and population growth

B

Which two conditions are among the top three causes of death globally?A) Diabetes and ischemic heart disease B) Ischemic heart disease and stroke C) Chronic kidney disease and chronic obstructive pulmonary disease D) Diabetes and COPD

B

In general, clinical trials of a drug on human subjects require that the "control group" for the trial receive at least: A) A drug related to the drug being tested B) A placebo C) The best proven drug for the condition for which the trial is being conducted D) A drug for the condition for which the trial is being conducted

C

Life expectancy at birth is: A) How long a person will live B) How long the population will live C) How long people born today are expected to live, given continuation of existing mortality trends D) How long people born today are expected to live

C

the best description below of the focus of public health a) achieving medical care for all b) reducing road traffic injuries C) Preventing disease, prolonging life, and promoting physical health through organized community effort D) Extending life expectancy

C

"The rights-based approach to health" suggests that: A) Health policies, programs, and practices should be considered in terms of their impact on human rights B) The health impacts of human rights violations should be considered C) The fulfillment of human rights should be central to health efforts D) All of these are correct

D

In 2020, which of these countries is not among the top five with the highest number of extreme poor: A) India B) Democratic republic of Congo C) Ethiopia D) Bangladesh E) Nigeria

D

It is important in human subject research to allow participants to: A) Withdraw from the research B) Preserve their confidentiality C) Be treated respectfully D) All of these are correct

D

Epidemiologic Transition

Describes a shift in the patterns of morbidity and mortality from causes related primarily to infectious and communicable diseases to causes associated with chronic, degenerative diseases

International Research ethics Regime principles

Duty to alleviate suffering Duty to show respect for persons Duty to be sensitive to cultural differences Duty not to exploit the vulnerable

health system control knobs

Financing Payment Organization Regulation Behavior/ Persuasion

responsibilities approach

Fulfilling the rights is legally obligatory (whether perfectly or imperfectly) to states and other non-state actors

Tuskegee Syphilis Study

Government study from 1932-1972 which investigated effects of untreated syphilis on African American males. Men were lied to and told they were being treated for "bad blood."

National Health Service

Health as a Right- fundamental Ownership of facilities - public insurance - overwhelming public insurance financing- tax based

National Health Insurance

Health as a Right- fundamental Ownership of facilities- public and private + NGOs insurance - largely universal public financing- mostly employers and employees some taxes

pluralistic

Health as a Right- health as a personal good Ownership of facilities - public, private, for profit or not for profit insurance - public and private, for profit and not for profit insurers financing- taxes, employers and employees + out of pocket

3 main types of private development assistance providers

NGOs, foundations, corporations

Treaty procedure

Signature entered by state Ratification where head of state signs treaty with intent to be bound Accession- state gives consent to be bound by treaty Reservations- state does not agree to be bound by specific articles of treaty

Phillip Zimbardo Stanford Prison Experiment

a mock prison set up by Stanford researchers to study the effect of prison systems upon "guards' and "prisoners" alike

demographic transition

a shift from high birth rates and death rates found in agrarian societies to much lower birth and death rates in developed countries

health

a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity

what does the right to health include

access to timely, acceptable, and affordable health care of appropriate quality

what is the broad goal of public health

achieving social justice and equity

positive effects of globalization

advances in science and tech, increased longevity, greater freedom and prosperity for many, popularization of the concept of human rights

Special Rapporteur

are independent experts appointed by the Human Rights Council to examine and report back on a country situation or a specific human rights theme

Treaties

binding agreement between two states or international organizations ex: WHO framework convention on tobacco control

mortality refers to

causes

systems of disease classifications

communicable diesease, noncommunicable disease , injuries

how does globalization relate to health

countries that integrate more fully into the global economy grow faster and are therefore better able to reduce poverty but it id bad for poorer countries

how does health relate to wealth

countries with higher LE have lower levels of poverty and as income increases infant mortality rate decreases

objective of development

create an enabling environment for people to live long, healthy and creative lives

right to development approach

development is a right not charity

justice

distributing benefits and risks of research fairly

nuremberg war crime trials

exposed horrific medical experiments conducted by 23 Nazi doctors and others in the name of science

GDGs

global development goals which help provide a focus for development efforts and a lens through which to assess government plans, budgets, and poverty reduction strategies

Global Burden of Disease

is a monumental study that reveals the complexities of measurements, the extent of diseases, trends and disparities in mortality and morbidity distribution across the globe

what went wrong in the tuskegee syphillis study

men were misled and did not have informed consent, penicillin existed but was not offered to subjects and they were not given the choice to quit the study

Benefience

minimizing possible harms and maximizing benefits

Measures of Population Health

mortality, morbidity, and disability

Global Burden of Disease Study

most comprehensive assessment of human health ever done thatreveals the complexities of measurements, the extent of diseases, trends and disparities in mortality and morbidity distribution across the globe

policy documents

non-binding ex: consencual UN global conference action plans

declarations

nonbinding ex: Universal Declaration of Human RIghts

7 HR requirements for health services

nondiscrimination availability accessibility acceptability ( appropriate for intended populations) quality accountability universality

what does epidemiology ask

person (who), place(where), time(when)

public health core sciences

prevention effectiveness, epidemiology, laboratory, informatics, surveillance

how did bangladesh reduce poverty

reduced child death by training families to formulate oral rehydration solution, expanded financial inclusion by microloans, increased primary school completion rate

examples of secondary sources

reports by governments and agencies + published studies by researchers

Belmont Report (1979)

respect for persons, beneficence, justice

morbidity refers to

risk factors

why does global health matter

security, development, human rights

environmental health

set of public health efforts that "is concerned with preventing disease, death, and disability by reducing exposure to adverse environmental conditions and promoting behavior change

how is disability measured

social preferences

examples of primary data

surveys, census, birth and death certificates (VRS), health facility reporting systems

what do we need to understand in order to address global health issues

the factors that influence health status, the indications used to measure health status, and the key trends that have occurred historically

disease burden

the gap between a population's actual health status and some ideal or reference status

Globalization

the interactive co-evolution of multiple technological, cultural, economic, institutional, social and environmental trends at all conceivable spatiotemporal scales

Incidence

the number of new cases with the condition/behavior in a defined population over a specified period of time

Epidemiology

the pillar for disease interventions, the foundations of which are evidentiary data

enlightened self-interest

the realization that by helping others we are really helping ourselves in the end

Prevalence

the total number of people with a particular condition/behavior at a specified time with a defined population

respect for persons

treating persons as autonomous agents and protecting those with diminished autonomy

WASH

water, sanitation, hygiene

if we cannot measure it...

we cannot change it

if we cannot define it...

we cannot measure it

Negative effects of globalization

widening economic disparities between rich and poor within and between nations, generalized insecurity, accelerates increase in chronic disease in poor countries while trend in rich reverses

world regions

world bank, UN, WHO, GBD