HHD CH10

Impact of individuals income on Health status

~ In developing countries many families live in poverty. ~ Living in poverty is more than just a lack of money. Every year many children are born into poverty, a life of poor health, missed education and increased violence, insecurity and discrimination. ~ Poverty means that people do not have their needs met in relation to basic human requirements such as food, clean water, healthcare and education, nor do they have the opportunity and choice to improve their living standards. ~ Families living in poverty or who have low incomes (even when members are in employment) have few opportunities and choices to improve their situation. Often the children are not able to attend school (or only for a few years) because they are needed to help the family to earn money to survive. → Links to human development ~ Without an education, children remain in poverty throughout their adult lives. ~ The cycle of poverty, and the deprivation that results, is very difficult to break.

Influence of global marketing - Developing countries

~ In developing countries non-communicable diseases are detected late due to: Lack of access to healthcare Cost; The unaffordable medical expenses for households ~ Which all significantly impacts on the economies of the countries ~ Double burden of disease as companies like cocola and tobacco companies are targeting people in developing countries as they view these things as glamorous western culture and without the education, health promotion of the risk factors involved like obesity and lung cancer or the access to adequate health care facilities it is causing an increase in mortality and morbidity rates.

Long term consequences of conflict

~ Injury (Physical health, mental) ~ Loss of life (Physical, dying prematurely can't live to full potential) ~ Increases anxiety & depression (mental) ~ Military action consumes large amounts of money of GDP local population may be forced to leave their homes and farms in search of safety - becoming refugees in their homeland meaning no longer able to grow their own food or earn money by selling their crops => loss of food and income means hunger and often undernutrition → Disabled persons ~ Homes, schools, medical facilities and other public buildings may also be lost ~ Landmines - remain functional for up to 50 years, and continue to kill and injure innocent civilian men, women and children long after conflict ended (all health and development) ~ Unexploded mines prevent the local people from being able to use land to replant crops or rebuild their community ~ People who are permanently disabled by exploding mines due to loss of limbs may find it difficult to find employment or to produce food for their family ~ Children can mistake landmines for colourful toys.

Key Features of primary healthcare strategies

~ It is cost-effective - it trains local healthcare workers rather than doctors to educate the community, provide immunisation and treat common health concerns. ~ It takes the needs of the community into account, with the community involved in implementing the strategy - this increases acceptance of the strategy and means it will be more successful ~ It focuses on preventative healthcare, this helps the community to become self-sufficient.

HDI - The Gender Inequality Index

~ It is used by the United Nations as part of the HDI to measure gender in three dimensions and 5 indicators\ ~ Dimensions Labour Market Empowerment Reproductive Health ~ Indicators Labour force population (Labour Market) Educational attainment; Secondary school and above (Empowerment) Parliamentary representation ( Empowerment) Adolescent fertility ( Reproductive health) Maternal Mortality (Reproductive health)

Issues that impact the effect of primary healthcare strategies

~ Lack of funding in some communities, ~ lack of acceptance of the strategy within the community ~ Difficulties in training local workers

Global marketing - Fast food

(Low energy and low nutrient dense food) ~ In low and middle income countries consumption of unhealthy fast food (through companies such as such as Nestlé and PepsiCo) is reaching, and in some cases exceeding, the level witnessed in high income countries ~ More people in developing countries eating more saturated fats, sugar, salt and refined CHO ~ There is a decrease in the consumption of traditional unrefined grains ~ Childhood undernutrition and obesity are both health concerns in developing countries ~ In rural areas staple foods are cheaper but in urban areas processed foods are less expensive and more accessible ~ Not uncommon to find undernutrition and obesity co-existing within the same community ~ Common for rural/remote areas to eat healthier than urban cities as they don't have as much access to fast food joints

Influences on health Australia VS Developing Countries

AUSTRALIA ~ Low rates unemployment => income which increases options to healthcare, food, shelter => therefore reducing illness and promotes mental health ~ Higher GDP for a country = increased money spent on healthcare and education ~ Increases the money available for social security to support individuals with lower incomes increasing their access to healthy foods and health care to promote their health DEVELOPING COUNTRIES ~ No social security => low/no income => poverty ~ No social security reduces the income of individuals and families = poverty. ~ Poverty = ~ Lower literacy contribute to poverty meaning people are ~ Less likely to be able to break the poverty cycle. ~ Low GDP = less money is spent by governments on health and education. ~ Low incomes means reduced choices. ~ Low incomes means increased undernutrition. ~ Low-income countries are associated with reduced access to safe water and sanitation, education, healthcare and social security. As a result they have low immunisation rates, ~ Low literacy rates, and high infant and maternal mortality rates.

The influence of global marketing

Alcohol, tobacco and fast food ~ Many multinational corporations market products such as tobacco, alcohol, soft drinks, infant formula and fast food in developing countries. ~ Developing countries are 'soft' targets - Campaigns to warn about the dangers of tobacco, alcohol and processed foods are rare ~ Countries experiencing the highest exposure to unhealthy commodities are those most exposed to foreign multinationals such as McDonalds, Coca Cola (Globesity) ~ Changes in policy are critical in reducing these risks - basic regulatory capacity to address irresponsible advertising practices ~ Global marketing of tobacco, alcohol and fast food is contributing to the double burden of disease where individuals face the threat from communicable diseases like HIV/AIDS Malaria but also non-communicable diseases including CVD Obesity Type 2 diabetes Cancer

Marketing

An organisational function or set of processes designed for creating, communicating and delivering value to customers and managing customer relations to the benefit of stakeholders and the organisation as a whole

Why is DPT is a good indicator of access to health services in a particular country?

As it requires three immunisations within the year after born to be fully protected against it. If babies are lacking in the vaccination it shows that they are unable to access the injection from a health care service. As it is a routine vaccination which requires multiple injections. If families can not access the DPT then they are likely to not be protected against it however if they can access health services then they are likely to be immunised

Direct consequences of tobacco smoking

Contributing to an increased riskof respiratory disease, cancer and CVD

Gender Inequality

DEVELOPED COUNTRIES ~ In Australia, females experience most of the same opportunities as males, as laws protect the rights of both males and females ~ Both sexes to some extent have equal opportunities in relation to education, work and leisure. (Pay can be found to be different) DEVELOPING COUNTRIES ~ The status and treatment of women in many developing countries is lower than men in almost all areas, including access to education, income, employment and legal rights. ~ Women have fewer opportunities in life, which means they are often denied access to resources that will keep their families and themselves healthy.

Primary Healthcare (PHC)

Definition: The first level of contact individuals, families and communities have with the healthcare system E.G a GP (General practitioner) Other: It is a strategy that involves the individual, family and community, with the aim of providing essential healthcare to everyone, not just those in the cities.

Governments in developing countries - Tobacco/global marketing

Govts in developing countries: Earn money from the sale of tobacco Do not have health promotion organisations to advocate against or educate people of the risks of tobacco

Factors influencing health status in developed countries

In Australia, many of these are lifestyle factors that can be said to be within an individual's control, such as diet and exercise.

Global

Refers to the advertising and selling of goods and services all across the world

Globalisation

The interconnectedness of the world through the transfer of goods, services, capital, people and information

Adult Literacy Rates

The percentage of people over the age of 15 who can read and write

Food security

The state in which all persons obtain nutritionally adequate, culturally appropriate, safe food regularly through local non-emergency sources

Impact of countries income on Health Status

~ A lack of money being spent on vital resources such as education and health can contribute to the ongoing poverty of some nations. ~ A country that is experiencing poverty is typically unable to provide for its citizens such resources as safe water and sanitation, education, social security and adequate healthcare. ~ The consequences are low literacy and immunisation rates, high maternal and infant mortality, and high rates of infectious disease

Global Marketing - Tobacco

~ Australians laws Not smoking in door ways, public places, indoors and 4 meters nears/around schools Plain packaging and dangers Must be over 18 Hidden ~ Promoting smoking as a western lifestyle as they view it as glamorous and not telling developing countries about the dangers of smoking ~ Govts in developing countries: earn money from the sale of tobacco do not have health promotion organisations to advocate against or educate people of the risks of tobacco

The influence of physical environments - Sanitation

~ Being able to live in a sanitary way is also closely linked with an adequate water supply ~ Factors contributing to an unsanitary environment include: poor access to amenities for washing, cooking and going to the toilet; overcrowded living conditions; inappropriate housing; poor drainage; a lack of developed sewerage systems; (Water supply) insufficient knowledge about the spread of infectious diseases ~ The regular collection and safe disposal of garbage are also vital to a sanitary environment. ~ he regular collection and safe disposal of garbage are also vital to a sanitary environment. ~ People living in rural areas in the least developed countries have significantly less access to clean water and sanitation in comparison to those in urban areas ~ The number of people living without sanitation in urban areas is increasing due to rapid urbanisation

The effects of climate change - physical environments

~ Burning of fossil fuels such as oil, coal and gas clearing forests, which have increased the amount of carbon dioxide (CO2) and other greenhouse gases in the atmosphere ~ Causes more natural disasters Developing countries can not afford to rebuild after a natural disaster Do not have resources/money to cope after a disaster Many children are stolen for trade as they are separated from their parents and considered orphans Do not have access to warnings before a natural disaster like a cyclone to prepare and protect themselves and their homes

Maternal and child health - Growth charts

~ Changes in growth can be important signs in detecting an illness in the early stages and preventing any long term damage which can be caused by protein energy undernutrition, lack of other nutrients, or ill health. This can detected through constant check ups with the baby and mother during pregnancy and after but in developing countries this is not happening. ~ Even though growth is only one aspect of physical development, measuring a child's weight and height gain is a very effective method of assessing their health and development. ~ Keeping growth charts means that mothers and health workers see if the child is growing within the 'norms' and identify any changes such as a sudden loss of weight. There is no growth charts in developing countries

Influence of access to healthcare continued

~ Contributing to inequalities in healthcare between developed & developing countries is: Lack medical resources Unable to afford healthcare ~ The barriers to healthcare access in developing countries can include: Culture Cost Distance/ location Availability Knowledge Gender inequality

Reasons for having a large family

~ Cultural barriers to family planning (Can't tell males to use protection) ~ A large proportion of children die under the age of five children viewed as a form of social security for parents in old age ~ More children mean more people to work for the family to provide food.

The influence of peace and political stability

~ Democracy is important for health ~ Democracy is often seen as political freedom and a pathway to social and economic opportunity ~ A stable government is important in the promotion of development Effective governments: Develop laws, Maintain order and stability, Provide for the protection and advancement of human rights Generate revenue → TAX that we pay to the government Provide education and health services ~ Political instability results in war or conflict in a nation, which in turn contributes to an increase in poverty and decrease in health status ~ Politics plays a significant role in the growth of the economy of a nation and the provision of services. ~ Political instability can result from authoritarian rule, conflict or corruption ~ During political instability essential services such as education and healthcare are the first to suffer e.g. children living in areas with political unrest are more likely to be deprived of an education ~ It is in Australia's best interest to promote political stability within its own region, as having political unrest within the neighbouring regions is not good for regional security e.g. East Timor.

Influence of access to healthcare

~ Developing countries have far fewer doctors per capita in comparison with developed countries ~ Access to healthcare is related to funding & availability of services ~ Urban areas in all parts of the world have a much higher ratio of doctors and hospitals to residents than do rural areas ~ Money spent on healthcare is often used to fund well-equipped hospitals that focus on curative care in urban areas. ~ Few developing countries have instituted a government-funded healthcare scheme like Medicare in Australia, so the population has to pay directly for medical care.

Alma Ata and primary healthcare (Developing initiatives)

~ Essential healthcare based on practical, scientifically sound and socially acceptable methods and technology ~ Universal access to and coverage of health services based on health need ~ Commitment, participation, and individual and community self-reliance ~ Inter-sectoral action for health ~ Cost-effectiveness and appropriate technology, as the available resources permit ~ Health service provision and health promotion.

Developed countries - Tobacco smoking

~ Govts have employed a range of strategies to control tobacco use, such as: imposing taxes on tobacco products passing new legislation advertising bans warnings on packaging control of smoking in public places health education quit-smoking programs

Maternal and Child health

~ Greatest health divide in the world between the gap in risk of maternal deaths between developed and developing countries, particularly the least developed countries according to UNICEF ~ As Infant and maternal mortality are obviously closely related, improvements in healthcare such as improved antenatal care; skilled attendants at births; emergency obstetric care; adequate nutrition; post-partum care; newborn care; and education about health, infant feeding and care, and hygiene behaviours can assist to reduce both infant and maternal mortality. (Improving maternal mortality rates will improve infant mortality rates) ~ To further reduce the number of maternal deaths, WHO believes women need access to good quality reproductive healthcare and effective interventions (Seeking medical attention while pregnant and if the mother can't deliver the baby by herself then a c sections is used as an intervention)

Education continued

~ Illiterate Limits employment meaning the type of employment available is long hours of labour-intensive work which impacts on health such as physical strain on bodies ~ Education is a key factor in the fight against poverty. ~ Children who attend school will have more employment options as adults and usually experience better health ~ MDG 2 Achieve Universal Primary Education has resulted in primary school enrolments and in the gap between the number of boys and girls attending primary school ~ Aim to ultimately improve adult literacy rates

What reasons do you think contribute to the low number of children being immunised in developing countries?

~ Immunisation is mostly funded through aid agencies however once these agencies leave there is still children who are not vaccinated ~ No/low access to health care ~ Uneducated parents who are concerned when aid agencies inject their babies

Factors influencing health status in developing countries

~ In developed countries, some of the major influences on health status include smoking, stress and food intake that is high in fat, salt and sugar. ~ In developing countries resources such as a safe water supply, are not readily available or are totally absent. ~ These are largely outside an individual's control. The absence of a resource like clean, safe water can have serious impact on the health of individuals and entire communities. ~ Health status is also affected by political situations such as war/conflict, unfavourable trade arrangements, poverty, low literacy rates, unemployment, poor access to sanitation and health care, lack of immunization and social and cultural factors, such as the treatment of women

Influence of Gender inequality

~ Life starts unequally for females in many parts of the world, and stays that way e.g. The birth of a boy is celebrated with joy in many developing countries, while the birth of a girl is considered to be a disappointment, leading to feelings of guilt in the mother. ~ Women and children help the family to survive. One task of many is to collect water for drinking, cooking and washing. Often the nearest source of water is a long way from home, which makes the transportation (on foot) an exhausting and time-consuming task. ~ Domestic duties leave little or no time for children, especially girls, to attend school. ~ Girls are often earning a living by the age of 10, and expected to work as many as 12-16 hours a day, this leads to health problems, including chronic exhaustion. ~ The practice of women tending to feed their husband and sons first in times of food shortages contributes to the likelihood of females being malnourished. ~ Women in developing countries do not have a great deal of control over their lives. ~ They are usually economically dependent, and lack the freedom to live and work as they might wish ~ Women in developing countries find it more difficult to get paid work. ~ Socio-cultural attitudes, employment policy, a lack of options to balance work and family, and the timing of births contribute to some of the inequalities for women in relation to employment. ~ They tend to marry young and give birth to many children, for whom they must work very hard to support. ~ As well as having fewer legally protected rights and suffering varying forms of social, political, cultural and economic discrimination, many women in developing countries face a lifetime of violence and exploitation ~ Gender inequality in households, workplaces and communities can foster violence, making violence common and accepted in many communities. ~ According to UNICEF, a study of rural villages in India found that 16% of all deaths among pregnant women were due to partner violence; also, there is a high percentage of males and females who justify wife beating and use violent discipline. ~ Violence has obvious implications for: Physical health including chronic pain, genital bruising and broken bones, it also has social, emotional and psychological implications. ~ Combating violence against women and girls in many developing countries remains a serious and challenging issue due to many cultural barriers.

Gender Inequality - Child Labour

~ Many girls aged 5-17 years in developing countries are involved in child labour. ~ Working in dangerous conditions is a common situation for many of these children - resulting in injury, disability or death. ~ Other types of very labour-intensive work can affect physical health and development. ~ Being forced into paid work from a young age also denies many girls an education and the opportunity to have a childhood, both of which will impact on their health and development at various stages throughout their lives.

Gender Inequality - Marriage

~ Many girls under 18 are married and forced to assume the adult role expected of a wife: sex, motherhood and household duties. ~ Marriage can put an end to educational opportunities and trap women who have few rights into a life of domestic and sexual compliance. ~ Early marriage can also have a significant impact on a girl's physical health and development due to pregnancy and childbirth. ~ Both pregnancy and childbirth carry an increased risk of infant mortality and may cause devastating physical damage on the body of a young girl whose body is not yet developed enough to carry and deliver babies safely to term ~ Girls who give birth under 15 years of age are five times more likely to die in childbirth than women in their 20s

Access to healthcare - Developed country; Australia

~ Medicare, PBS and early detection ~ Although everyone has 'access' the quality of healthcare is better in cities rather than in rural/remote areas

Immunisation

~ Millions of children in developing countries die each year from diseases such as measles, whooping cough, tetanus, polio, tuberculosis (T.B.) & diphtheria - all easily prevented with immunisation ~ Is an inexpensive & effective procedure, as it builds the body's resistance to infection ~ Can be an injection or as an oral dose ~ Children who are not immunised run a greater risk of being infected and also of potentially spreading the disease in their community ~ Immunisation can also protect individuals from visual impairment, paralysis, brain damage ~ Malnourishment makes it harder to fight infection and increases children's risk of permanent damage to growth and development ~ An adequate and nutritious diet, and access to clean water can help to protect against these diseases

Peace

~ Peace and political stability are closely related. ~ Democratic and stable governments promote peace In times of peace, governments tend to be more stable. ~ Peace is an important factor that contributes to good health. ~ People that live in peace have more freedom, opportunities and choice about their own lives → Human development

Influence of primary healthcare (PHC)

~ Primary healthcare has been seen as one of the keys to reducing health inequalities ~ The focus of primary healthcare is to prevent illness and promote good health, and to provide affordable curative care for those in need. ~ According to WHO - improvement has occurred the provision of primary healthcare ~ This has included increases in immunisation rates & numbers of local health workers and trained attendants at births ~ Primary healthcare, follows a community-development approach whereby the needs of the local community are considered and the community is involved at all stages of the program ~ Many people in developing countries live in rural areas - little access to healthcare services. ~ Primary healthcare helps to overcome this through training local health workers, who are able to treat common injuries and illnesses and educate the community about the prevention of disease.

Peace definition

~ Refers to the absence of violence, and the presence of wellbeing, justice, equity and human rights

The influence of physical environments - Shelter and housing

~ Shelter is a vital aspect of the physical environment contributing to differences in health status between those living in Australia and developing countries. ~ Most Australians live in homes that have access to safe water and sanitation as well as electricity and gas to provide cooling and heating and to run appliances for cooking. ~ In the least developed countries many families do not have access to the most basic forms of shelter to provide protection from the elements and many do not have access to safe water and sanitation

The influence of physical environments - Urbanization

~ The impact of urbanisation is a lack of housing, infrastructure and services to cope with population growth. ~ This results in thousands of people living in urban slums with poor living conditions

Influence of income - Individual

~ The income an individual or family receives for the work they perform can have a significant impact on their health status, including their ability to access adequate health services

Influence of income - country

~ The income of the country itself and how this can impact on health status i.e. Low GDP and lack of trade profit, means pressure on governments to provide resources such as education and healthcare with limited money

The influence of physical environments - Food security

~ The world produces enough food for everyone ~ The problem lies in the distribution of the global food supply and access to the food that is produced. ~ The problem is getting worse due to the impact of climate change and high fuel costs. Developed countries ~ the abundance of food sees people suffering from health conditions and diseases associated with excessive consumption of foods rich in fats, salt and sugars. Developing countries ~ a lack of food also leads to a variety of health issues associated with hunger and undernutrition. ~ There are many people, especially in rural areas, who are hungry and suffer from the effect of undernutrition, while there are others in urban areas who are suffering the same 'lifestyle' diseases caused by an increase in the availability of processed food ~ No money to address issues affecting their food supply like irrigation and pests ~ Can't afford to buy more expensive crops

The influence of physical environments - Access to clean water

~ There are over 1 billion people living in developing countries who lack the assurance that the water they need in order to live a healthy life is free from contamination. ~ Unsafe drinking water can result in the spread of illness such diarrhoea, cholera, malaria ~ WHO has estimated that 80% of all sickness and disease in the world is attributable to inadequate water or sanitation ~ Water born diseases like malaria and typhoid which can cause diseases like diarrhoea and death ~ Young children suffer more as they don't have the energy to fight it off

Income as a summary

~ There is a direct link between a lack of income, poverty and ill health. ~ Poverty is one of the major causes of ill health, as people who live in poverty have lower levels of Nutrition, Education Healthcare. ~ Healthier people are more productive and able to contribute to economic growth, which helps to reduce poverty. (Healthy people = healthy economy) ~ Being unhealthy traps people in poverty; Investing in health is clearly an effective way to address the issue of poverty in developing countries

Indirect consequences of tobacco smoking

~ Tobacco users who die prematurely deprive their families of income, raise the cost of healthcare and hinder economic development. ~ When money is spent on tobacco, less money is spent on food, leading to undernutrition in some cases. impacts on the environment wood needed to cure tobacco is leading to deforestation land used to grow tobacco in developing countries is depleting the soil of nutrients using up land that could be used to grow food.

Gender Inequality - Exploitation

~ Trafficking of children is a serious concern. ~ Children are forcibly abducted, tricked or allow themselves to be trafficked to make money. (They could also be sold by their parents to make money or stolen when they are thought to be an orphan) ~ Most vulnerable - after or during times of conflict or natural disaster (when children may be separated from their families and/or orphaned) ~ Forced into sex work, hazardous labour or domestic service ~ Girls at greater risk ~ Often malnourished, suffer physical abuse and punishment, are at extreme risk of sexual abuse, forced into hazardous physical labour ~ They are viewed as property not as people

The influence of physical environments - Climate change

~ due to global warming ~ Refers to more than the increasing temperature of the planet ~ Contributing to the expansion of deserts through poor rainfall, rising sea levels, increase in flooding, a change in weather patterns such as those causing cyclones ~ Increased health risks, due to the increased spread of diseases such as malaria - all from increasing temperatures

Access to healthcare - Developing countries

~ limited access to healthcare ~ lower immunisation rates ~ higher infant, child and maternal mortality rates due to poor antenatal care, a lack of skilled attendants at births and poor maternal and child care post-delivery.

Developing countries - Tobacco smoking

~ lower level of public awareness about the consequences of smoking ~ few people understand the specific health risks of tobacco use ~ lack of funds and resources at a government level to go into public education programs ~ Low SES & low education levels increase the likelihood of an individual smoking

Globalisation - Global marketing

~ transformative process that has lead to a more unified and interconnected world. The interdependence and interconnectedness through the increased flow of goods, services, people and information have benefitted many countries, seeing an increase in their incomes. ~ Globalisation has led to the global marketing of a range of products ~ Globalisation includes an increase in the trade of goods and services, integration of financial markets through investments and the stock exchange & access to advanced technology e.g. Internet ~ For some countries globalisation has magnified inequalities in relation to trade and technological advancement.

Education

~ ¼ world's population illiterate and 2/3 female ~ Rural areas present challenges like: Lack access to schools High rates poverty High demand child labour ~ Being illiterate means a reduction in health status especially for females ~ The percentage of females attending school in developing countries significantly lower than the percentage of males In Australia Education is compulsory until 16 (Including primary school and kinder) Literacy rates high