Chapter 16: Global Public Health Nursing: Population Health Around the World (EXAM 1)

What are the 4 different healthcare systems? which one is used in the united states?

*-Entrepreneurial Health Care Systems* (traditionally what is used in united states) below 3 are typically used in other parts of world *-Welfare-Oriented Health Care Systems* (Western Europe, Japan, Australia) *-Comprehensive Health Care Systems* ( Scandinavian countries, Great Britain, New Zealand) *-Socialist Health Care Systems* (Russia, Eastern Europe, China, Korea, Cuba)

What are the 3 Era's in Healthcare?

*-Era of Infectious Disease *(was prominent in the early 1900s & earlier when infectious disease was major cause of death) *-Era of Chronic Long-Term Health Conditions* (started once we developed antibiotics/tx people lived longer and then chronic long term conditions developed) *-Era of Social Health Conditions* (things like addictions, overdoses, obesity, and mental health issues)

Give example when the motivation may be financial which affects the health of citizens?

*eg. threat of tourism when tourism is the major industry* >>NOTE: the government may withhold information even to the healthcare workers so the word wont spread about this disease=they do this in hopes that it wont stop tourists from coming

It is important to note what about International migration of nurses?

*w/ nursing shortages around the world and that upcoming worsening of nursing shortage in America-so need to see the difference between international nurse and know how those nurses understand/do things differently* (Nurses - difference in background, age @entry to nursing, curricula in nursing programs, and international migration of nurses Also difference in home country support of nursing development (eg. education, research, "voice")

Tor F There is a centralized public health system.

FALSE; *No centralized public health system* (note: its really made up of a network of organizations: some governmental some are not=work together to do the things we were talking about and especially the procedures)

T or F The era's of healthcare are a strict timeline.

FALSE; *This is not a strict timeline and you could be having all these 3 eras at the same time* (in some countries simultaneously happening ex: in Africa when outbreak of elbolia, start living longer now with more medical care=chronic conditions, and due to wars they have lots of social health conditions) *All Three Era's are happening NOW - Simultaneously around the Globe !*

*So, what's different about the SDG's- Sustainable Development Goals?* [comparing to MDGs-Millennium Development Goals] -who do they target? -what types of appraches(2) -The foundation of the SDGs are known as...

First, the SDGs encompass specific targets for each goal. In total for the 17 SDGs there are 169 targets and these are *not just for low resource countries to aim for, but they are goals for all of us.* -In fact, the *SDGs move beyond a global approach to a planetary approach.* -They are a *whole-person approach to confront and deal with problems that threaten the planet.* -The foundation of the SDGs are what is known as the *5 P's or, pillars: People, Planet, Peace, Prosperity, and Partnership*

*WHICH GLOBAL HEALTH PROMOTION IS BEING DESCRIBED BELOW?* This was the first health promotion Conference held in a developing country. Here the participants acknowledged that health is a basic right and is essential for social and economic development of a country and nation The participants set priorities for 21st century health including --to promote social responsibility for health --to increase investments for health development --to consolidate and expand partnerships for health --to increase community and empower the individual --to secure an infrastructure for health promotion. (Governments were called on to promote health within their own countries and work together to create alliances.)

In 1997 the 4th International Conference on health promotion occurred in Jakarta and is called the Jakarta declaration to lead health promotion into the 21st century.

What is known as the 5 P's or, pillars

People, Planet, Peace, Prosperity, and Partnership ( compare above to the 3 p's talked about later)

SIDE NOTE: -there is no truly centralized global public health system. -There are some heavy hitters in international public health, like the World Health Organization and Amnesty International, but the *global health system is a patchwork of governmental agencies, private relief organizations, faith-based charities, international cooperatives, local-level networks, and other global health organizations*

SIDE NOTE: -there is no truly centralized global public health system. -There are some heavy hitters in international public health, like the World Health Organization and Amnesty International, but the *global health system is a patchwork of governmental agencies, private relief organizations, faith-based charities, international cooperatives, local-level networks, and other global health organizations*

SIDE NOTE: -Fortunately there are many governmental and nongovernmental organization's with a goal of both nationwide and global health -For more information on each of these visit pages 584-585 of your Rector book. NOTE: don't forget the organizations with religious affiliations (especially in community projects—because a lot of church offer health promotion activities, parish nurses, etc)

SIDE NOTE: -Fortunately there are many governmental and nongovernmental organization's with a goal of both nationwide and global health -For more information on each of these visit pages 584-585 of your Rector book. NOTE: don't forget the organizations with religious affiliations (especially in community projects—because a lot of church offer health promotion activities, parish nurses, etc)

SIDE NOTE: -Geography can decrease access to appropriate health care (eg. remote and rural) -Population and migration impact the environment.

SIDE NOTE: -Geography can decrease access to appropriate health care (eg. remote and rural) -Population and migration impact the environment

Providers of healthcare can be local & in some underdeveloped nations, explain how this is acheived?

Starts at village/disctrict level *to interpret the global issues in the context of the specific population and how interventions will be developed based on that specific area.* (they also *develop a CHW*)

*Era of Infectious Diseases* -______________________ (whether due to lack of medications, unsanitary conditions, etc it will still be an issue we have to deal with) -______________________ (Ex: recently measles in northwest of US due to a heavy population who did not do vaccinations) -________________________ (meant by when things change and come more resistant, and we must think of new ways to deal with it)

-*Certain diseases continue to be an issue* (whether due to lack of medications, unsanitary conditions, etc it will still be an issue we have to deal with) -*Unexpected or unusual outbreaks* (Ex: recently measles in northwest of US due to a heavy population who did not do vaccinations) -*Novel outbreaks of diseases* (meant by when things change and come more resistant, and we must think of new ways to deal with it) side note: >Polio, SARS, new human influenza sub-type, smallpox, >(see Ch. 16 p.562-567 for the types of issues that continue to be a concern

*SIDE NOTE-PROVIDERS OF CARE* -__________ with differences in education, licensing and background. TEAM= Researchers, policy makers, "bedside" team, physicians, nurses, midwives, Community Health Workers (CHW) -___________ is key as well as understanding the differences of team players even in terms of nurse to nurse.

-*Interdisciplinary* with differences in education, licensing and background. TEAM= Researchers, policy makers, "bedside" team, physicians, nurses, midwives, Community Health Workers (CHW) -*Collaboration* is key as well as understanding the differences of team players even in terms of nurse to nurse.

*Interventions/Procedures (remember this include policies and clinical interventions) "WHAT YOU HAVE TO UNDERSTAND ABOUT GLOBAL HEALTH IS....* -No _________ public health system -(2) organizations are best known <<best known as global level(talk more about in upcoming slides) -___________ with __________ (that agree to work on international level) -also _________ Organizations

-*No centralized public health system* (note: its really made up of a network of organizations: some governmental some are not=work together to do the things we were talking about and especially the procedures) -*World Health Organization, Amnesty International are best known* <<best known as global level(talk more about in upcoming slides) -*International Governmental Organizations with National Governments* (that agree to work on international level) -*Nongovernmental Organizations*

When looking at A Global Framework, what are the 3 P's?

-*Population:* community rather than individual -*Provider:* health care team -*Procedure:* interventions (policies or clinical interventions) [3 p's coincide with the eras in healthcare]

*A NOTE ON Wars, Civil Uprisings, Financial Collapse* -_________ is another long-process and may continue much longer than the war itself -_________ for widowed, prisoners, disabled, abandoned children, homeless / displaced, and refugees to name a few. (these people are also overwhelming the resources of the country)

-*Recovery* is another long-process and may continue much longer than the war itself -*Recovery* for widowed, prisoners, disabled, abandoned children, homeless / displaced, and refugees to name a few. (these people are also overwhelming the resources of the country)

*Context - Population growth* -2015 - Population of the world at 7.325 billion -Estimated 8.501 billion by 2030 -WHAT OCCURS TO COUNTRIES WHEN THEIR POPULATION GROWS? -Cause of WHAT 3 THINGS?(due to increase of humans)

-2015 - Population of the world at 7.325 billion -Estimated 8.501 billion by 2030 -*Using natural resources and straining even "richer" nations* *>>So now richer countries may not be able to help other countries because they too out struggling* -Cause of *pollution, depletion of ozone layer, climate change* (due to increase of humans)

*Political, Cultural, Religious Practices* -A country's ________ orientation and practices affect the ways in which community health nurses are educated and function daily -The _______ may be financial or beliefs and practices

-A country's *political* orientation and practices affect the ways in which community health nurses are educated and function daily -The *motivation* may be financial or beliefs and practices

U.N. Sustainable Development Goals - an urgent call for action by all countries in a global partnership. Includes: (17)

-No poverty -Zero hunger -Good health and well-being -Quality education -Gender equality -Clean water and sanitation -Affordable and clean energy -Decent work and economic growth -Industry innovation and infrastructure -Reduced inequalities -Sustainable cities and communities -Responsible consumption and production -Climate action -Life below water -Life on land -Peace, justice and strong institutions -Partnerships for the goals

*Population - migration* -Number of migrants has increased or decreased? -Some predict this will... -Can migration become deadly?

-Number of migrants *has doubled internationally to 231 million* (so increasing) -Some predict this will *impact future more than environmental or weather patterns* -When migration *becomes deadly - EX: West Nile Virus* (shows more about example below)

*EXPLAIN HOW NURSES ARE AFFECTED BY CULTURE?* -Nursing ________ criteria is very different in different parts of the world< this is due to that countries policy. -Cultural/religion: can determine what you can/cannot do and who is allowed to do it in terms of _________.

-Nursing *licensure* criteria is very different in different parts of the world< this is due to that countries policy. -Cultural/religion: can determine what you can/cannot do and who is allowed to do it in terms of *women.*

*Procedures and Interventions: Global Health Promotion-OVERVIEW* "It is not enough to strive to protect individuals from disease or adverse events, but health promotion is also vital" Increase in Global Communication and the Conquering of certain diseases increased in the 1900s and the idea of global health promotion was developed. ---what 3 other health promotions were developed that have had an impact?

-Ottawa Charter for Health Promotion - 1986 -Jakarta Declaration on Leading Health Promotion - 1997 -Global Conference on Health Promotion - 2013

Era of Chronic Long-Term Health Conditions -Survive infection but remain with _________ -________________________ [DALY]

-Survive infection but remain with disability; -Disability Adjusted Life Years [DALY]

*The organization and structure of healthcare systems within a country* -The ways in which people expect to.... -How to provide people with..... -Determines who gets __________...and who does not -Establishes lines of _______ and _________. -Establishes __________ for healthcare (huge issue in united states)

-The *ways in which people expect to govern others* (whos in charge? Who makes decisions?= ex: in us states and federal make decision) -How to *provide people with what they need* -Determines *who gets served*...and who does not -Establishes *lines of authority and communication* -Establishes *payment system for healthcare* (huge issue in united states)

*That hodgepodge system means that, comparing global health vs public health(in notes)* -effective global health initiatives require..... -Just as domestic public health requires....

-effective global health initiatives *require political and cultural diplomacy that can be difficult. * -Just as domestic public health *requires strong communication and trust between different agencies and organizations* (so does global public health: except that the communication and trust across national, cultural, and language barriers.)

*LINK FOR The World Health Organization* For universal health coverage, we: -focus on .... -work towards ... -improve ... -train the ... -support ... -improve...

-focus on primary health care to improve access to quality essential services -work towards sustainable financing and financial protection -improve access to essential medicines and health products -train the health workforce and advise on labour policies -support people's participation in national health policies -improve monitoring, data and information.

Explain collaboration in global health?

COLLABORATION is essential in global health

Explain what COMMUNITY HEALTH WORKER (CHW) does once trained by nurse?

COMMUNITY HEALTH WORKER (CHW)= Local, respected member of community. Serves village/district people 1-2 hours per day with health service. Paid or unpaid. Trained in fundamentals of promoting health, *preventing and treating most common health care issues.* Instructed in basic first aid and assistance on simple treatments. Educated in areas of health teaching in areas of personal hygiene, safe water supplies, safe disposal of human waste/refuse, and nutrition. <NOTE: *THESE PEOPLE ARE VERY HELPFUL IN TERMS OF LOCAL MEDICAL CARE FOR EDUCATION AND PREVENTION* (because couldn't afford/have enough to get docs/nurses out there, and clinics often too far away for locals to go)

*WHICH GLOBAL HEALTH PROMOTION IS BEING DESCRIBED BELOW?* -The prerequisites going into that meeting where ideas such as *peace, shelter, food, income, education, stable ecosystem, sustainable resources, social justice, and equity.* (NOTE: because all of those thing mentioned impact health) The conference ended with pledges for -advocating a *clear political commitment* to health inequity -counteract the *pressures toward harmful products, resource depletion, unhealthy living conditions, environments, bad nutrition.* -*respond to the health Gap* within and between societies to tackle inequities -to reorient health services and their resources toward the *promotion of health* -to *share power* with other sectors, disciplines, and most importantly with the *people themselves* -to recognize health and its maintenance as a *major social investment* and challenge to address the overall ecological issue of our ways of living.

The Ottawa Charter is the result of the first International Conference on health promotion in 1986.

*WHAT IS LISTED BELOW?* -Mortality: -Morbidity: -Daily Functioning -Decision-Making -Cost: -Access:

Universal Imperatives of Care

When wars and uprisings occur it is the job on the global health nurse to do what?

When wars and uprisings occur it is the job on the global health nurse to *seek help from outside sources such as World Heath Organization/EURO or other international health care teams and ministries* -These affiliations can find a safe haven to assist in countries during conflict. (ex: red cross) -Places for refugees of war are set up that allow temporary food, shelter, and basic health care, however these can place an additional strain on the countries resources

What is Global Burden of Disease (GBD)?

a term framed by the World Health Organization [WHO] as it tries to calculate the financial cost and lost resources of disease -on a individual level the insurance companies do this, theres a devastating injury they calculate the life that the person might have lived and number of days and severity of the disability and the impact= loss of life days, loss of resources <<this is done all all type of levels and done on a global burden (they look at the large amount of health issues in a country-what are the lost resources?)

What are the SDG's (U.N. Sustainable Development Goals)?

an urgent call for action by all countries in a global partnership.

Political, Cultural, Religious Practices do what to heathcare?

can either aid/ help or go against healthcare. The first thing to understand is the countries political orientation and practices that affect the way community health nurses are educated and function daily.

Talk about global mental health: (hint: can range from.....)

can range from providing clinical services to participating in policy making at an international level (context is critical, and need to understand that each country is different)

It is important to note what about differences in education, licensure, and training, and home country forces that support nurse development?

curriculum in college may be different, may be higher up/lower due to past education

There are multiple factors that affect a person's health and that can impact a nations health? (7)

geography, history, culture, religion, and the nations wealth (in addiction current events such as civil wars), natural disasters, or financial collapses

LINK TO VIDEO ON World Health Organization

https://www.who.int/about/what-we-do/en/

What is Disability Adjusted Life Years [DALY]? and what is it used for?

is related to the global burden of disease, *combination of years of life lost by disability and adjusted for severity of disability* -*used to determine impact in particular the long-term health conditions with disability*

What is Nationalism? how is nationalism different w health? and give an example of nationalism regards to pandemic flu?

is thinking for your own country and wanting them to come first -hard to do w health because in health there is a concept that has to with interdependency >>Now what affects one soon affects many EX: pandemic flu w/ rapid and easily accessible of transportation a flu can spread very rapidly and if countries don't communicate with each other and have policies in place to help contain it the results would be catastrophic.

When affiliations around world help refugees, it shows what concept mention in class?

so you can see the *interdependency* here—so in times of war the country needs help/is dependent on rest of world to help them get resources for basic needs

What is Burden of Disease on a individual level (the insurance companies do this) if theres a devastating injury, they calculate what? and then explain *gloabal* burden of health(GBD)?

they calculate the *life that the person might have lived and number of days and severity of the disability and the impact = loss of life days, loss of resources* -this is done all all type of levels and done on a global burden (*they look at the large amount of health issues in a country-what are the lost resources?*)

What are MDGs (Millennium Development Goals)? and who initiated them? and what are the 8 goals? >>Eradicate (2) >>achieve universal.... >>promote (2) >>reduce... >>improve.... >>combat (2) >>ensure _________ sustainability >>and, develop a __________ for development

were initiated by the UN(united nations) and in effect from 2000-2015; there were *8 goals and they were focused on developing or low resource countries.* *-These goals included: * >>Eradicate extreme hunger and poverty >>achieve universal primary education >>promote gender equality and empower women >>reduce child mortality >>improve maternal health >>combat HIV/AIDS, malaria, and other diseases >>ensure environmental sustainability >>and, develop a global partnership for development

*LINK FOR The World Health Organization* For health and well-being we: -address.... -promote... -prioritize health in....

-address social determinants -promote intersectoral approaches for health -prioritize health in all policies and healthy settings.

*Universal Imperatives(crucial/vital) of Care* -____________: keeping people alive by understanding what causes death -____________: conditions that make people sick, sometimes leading to death/sick (look at those and come up with interventions) -___________ : include being able to live and participate in a society, and be able to take care of others. -___________: Now more options due to resources and accessibility the inidivudal is making more of the decisions, and the policy makers/ones in control also make decisions=MULTI LEVELED (in hx this was all they had for healthcare, some places have no access to healthcare) -____________: its important w social justice in healthcare there should be an equity, and that goes as well as access too) -____________: sometimes access is due to where a person lives or how many healthcare workers they have (Ex: if live in a very remote place-access can be difficult)

*-Mortality:* keeping people alive by understanding what causes death *-Morbidity:* conditions that make people sick, sometimes leading to death/sick (look at those and come up with interventions) *-Daily Functioning:* include being able to live and participate in a society, and be able to take care of others. *-Decision-Making:* Now more options due to resources and accessibility the inidivudal is making more of the decisions, and the policy makers/ones in control also make decisions=MULTI LEVELED (in hx this was all they had for healthcare, some places have no access to healthcare) *-Cost:* its important w social justice in healthcare there should be an equity, and that goes as well as access too) *-Access:* sometimes access is due to where a person lives or how many healthcare workers they have (Ex: if live in a very remote place-access can be difficult)

*Context - Wars, Civil Uprisings, Financial Collapse-OVERVIEW* -Devastation of War -Lack of resources -Allocation of resources -Seeking International help -Recovery

*Context - Wars, Civil Uprisings, Financial Collapse-OVERVIEW* -Devastation of War -Lack of resources -Allocation of resources -Seeking International help -Recovery

*MATCH EACH HEALTH CARE PAYMENT SYSTEM* -Entrepreneurial Health Care Systems -Welfare-Oriented Health Care Systems -Comprehensive Health Care Systems -Socialist Health Care Systems -A step away from the welfare-oriented types in that substantial modifications exist in delivery and financing that result in universal entitlement. This system abandons separate and complex sources of financing found in the previous two (NOTE: every body has the system and they have to follow steps/rules regardless; complaints about this system: long waits, rationing, approval system of whether you're going to get this or not=not much choice in that type of system) - "national health insurance" "healthcare for all (or most). Statutory programs where half of all health-related expenditures are covered by government sources (although many physicians and dentists remain in private practice) (NOTE: statutory program mean that providers have to follow policies/program< so providers are more watched/governed than in united states) - Came about through social revolutions that abolished free-market economies. Health systems viewed as a social entitlement and a government responsibility. These systems are also starting transitions towards democratization and redesign. (NOTE: totally federally controlled, "just because think its their responsibility doesn't mean they have any resources to do things") -Typically found in industrialized countries with free-market economies, abundant resources, large amounts of money allocated to health care and decentralized governments. As resources aren't limitless, there is a current move to consider health care reform(note: so don't bankrupt system, and continue to be able to use it)

*Entrepreneurial* -Typically found in industrialized countries with free-market economies, abundant resources, large amounts of money allocated to health care and decentralized governments. As resources aren't limitless, there is a current move to consider health care reform (note: so don't bankrupt system, and continue to be able to use it) *Welfare-oriented* - "national health insurance" "healthcare for all (or most). Statutory programs where half of all health-related expenditures are covered by government sources (although many physicians and dentists remain in private practice) (NOTE: statutory program mean that providers have to follow policies/program< so providers are more watched/governed than in united states) *Comprehensive Health Care Systems* -A step away from the welfare-oriented types in that substantial modifications exist in delivery and financing that result in universal entitlement. This system abandons separate and complex sources of financing found in the previous two (NOTE: every body has the system and they have to follow steps/rules regardless; complaints about this system: long waits, rationing, approval system of whether you're going to get this or not=not much choice in that type of system) *Socialist* - Came about through social revolutions that abolished free-market economies. Health systems viewed as a social entitlement and a government responsibility. These systems are also starting transitions towards democratization and redesign. (NOTE: totally federally controlled, "just because think its their responsibility doesn't mean they have any resources to do things")

WHICH LISTED BELOW IS GOVERNMENTAL AND WHICH IS NONGOVERNMENTAL ORGANIZATIONS THAT HELP WITH GLOBAL HEALTH? -United States Agency for International Development -The Centers for Disease Control and Prevention -American International Health Alliance -World Bank -Global Health Council -Center for International Humanitarian Cooperation -CARE -The Carter Center -Bill & Melinda Gates Foundation -International Council of Nurses -National Governments working alone -Organizations with Religious Affiliations

*GOVERNMENTAL* -United States Agency for International Development -The Centers for Disease Control and Prevention -American International Health Alliance -World Bank *NONGOVERNMENTAL* -Global Health Council -Center for International Humanitarian Cooperation -CARE -The Carter Center -Bill & Melinda Gates Foundation -International Council of Nurses -National Governments working alone -Organizations with Religious Affiliations

*Introduction* -Understand the various ways different countries and nations are impacted by factors determining health status. -In attempting to work together, consider those differences and the ways in which we can work through them -Consider your own biases, thoughts, opinions when learning about different societies as it relates to health.

*Introduction* -Understand the various ways different countries and nations are impacted by factors determining health status. -In attempting to work together, consider those differences and the ways in which we can work through them -Consider your own biases, thoughts, opinions when learning about different societies as it relates to health.

*Providers of Care* -Global - policy makers, researchers -Local - Physicians, nurses, midwives, Community Health Worker [CHW] -Differences in education, licensure, and training, and home country forces that support nurse development -International migration of nurses

*Providers of Care* -Global - policy makers, researchers -Local - Physicians, nurses, midwives, Community Health Worker [CHW] -Differences in education, licensure, and training, and home country forces that support nurse development -International migration of nurses

*SIDE NOTE-HEALTH CARE PAYMENT SYSTEM* these systems are also transitioning to democracy type of redesign (they are inching closer to what we have in the united states and we are inching back into having more people covered under certain conditons)>>SO IMPORTANT TO KNOW WHAT HEALTHCARE SYSTEM YOU ARE DEALING WITH GLOBALLY

*SIDE NOTE-HEALTH CARE PAYMENT SYSTEM* these systems are also transitioning to democracy type of redesign (they are inching closer to what we have in the united states and we are inching back into having more people covered under certain conditons)>>SO IMPORTANT TO KNOW WHAT HEALTHCARE SYSTEM YOU ARE DEALING WITH GLOBALLY

*SIDE NOTE:* Things that are looked at in every nations (no matter the wealth of nation its looked at) -Understanding these you have to understand the concept of "first things first"-like triage Mortality and morbidity is most important because want to keep people ALIVE AND WELL!

*SIDE NOTE:* Things that are looked at in every nations (no matter the wealth of nation its looked at) -Understanding these you have to understand the concept of "first things first"-like triage Mortality and morbidity is most important because want to keep people ALIVE AND WELL!

*WHICH ORGANIZATION IS BELOW?* -Leading global agency focuses specifically on health -Headquarters in Geneva, Switzerland -6 regional offices

*The World Health Organization* (so is this governmental or non governmental??) WANT US TO TAKE A GOOD LOOK AT WORLD HEALTH ORGANIZATION -in textbook it tells their purpose (SAYS IMPORTANT TO LOOK IN BOOK TO SEE IN DEPTH OF THE TOPICS SHE BROUGHT UP)

SIDE NOTE: -what occurred during the Syrian Civil War in regards to migrants? -what occurred in New York Fall of 1999 in regards to migrants?

-Example During the Syrian Civil War *thousands of refugees poured into neighboring countries as well as into European countries straining their economies and systems of health care, in addition to increasing tension politically* [NOTE: she said there is a little bit of anti migrant backlash in Europe and also in United States due to the countries feeling that migrants may take a lot of resources) -New York Fall of 1999, *61 severe cases and seven deaths were reported from a mysterious illness later identified as the West Nile Virus* which had not been previously reported in the U.S. At its peak in 2003, a reported 9,862 cases and 264 deaths had occurred in 46 states.4 (NOTE: this is due to migrating and traveling) NOTE: Mass migration can/has been due to poverty, civil war, etc.

*EX/NOTE: Mass dense living areas in poor countries* -Example when people use streams and rivers to dispose of body wastes and then use the same body of water for cleaning and washing their clothes, they are exposed to... -When a high density area develops around water sources, what occur? -In migration, people may move to an area where they are unable to use the same knowledge and skills because those things are different (give example?) Note: another thing w environment, as we become more industrialized, we have a lot of pollutants going into the air (as far as plants/chemicals in the air and water)

-Example when people use streams and rivers to dispose of body wastes and then use the same body of water for cleaning and washing their clothes, they are *exposed to infections* -When a high density area develops around water sources, *mosquito-bourne diseases occur such as malaria* -In migration, people may move to an area where they are unable to use the same knowledge and skills *(eg. farming, hunting)* because those things are different *(ex: what grows well in their countries soil may not grow well in US soil=their resources become diminished)* Note: another thing w environment, as we become more industrialized, we have a lot of pollutants going into the air (as far as plants/chemicals in the air and water)

*Geography and Environment* -Includes (3) -Each can undergo changes that turns natural elements into __________. (4 examples?) -People are exposed to pollutants in two basic ways - (2)

-Includes *air, climate, soil, water* -Each can undergo changes that turns natural elements *into hazardous ones (ex: air pollution, climate change, soil no longer produce plants, water pollution)* -People are exposed to pollutants in two basic ways - *(1)exposure to the source or (2)release of pollutants into water or air*

*A closer look -- Health in Population* (hint: what nurses look at/do when consider health in population) -Includes (5) -Concept of ___________ plays a part in the impact (eg. mass migration<creates issues for host regions) -Issues such as (4) are included

-Includes *concerns, values, beliefs, and physical symptoms, health history * -Concept of *interdependency* plays a part in the impact (eg. mass migration<creates issues for host regions) -*Issues such as population growth, mass migration, geography, and environment are included* (she also stated: access to healthcare, language, political, culture, and religion) The concept of population encompasses many things in additional to the things stated!!!!!!!

SIDE NOTE: CONTEXT-POPULATION GROWTH: -Increased population strains resources (financial, social, natural) and............DOES WHAT TO FINANCES? AND HEALTH NEEDS? -Areas of high density population increase risk of WHAT?

-Increased population strains resources (financial, social, natural) and *increases poverty and decreased access to meet needs(as well as healthcare needs).* -Areas of high density population *increase risk of communicable and infectious diseases* (due to people living closer together).

*Context - Wars, Civil Uprisings, Financial Collapse * -It is not uncommon for the population of a country to become the target of an uprising or a war. (NOTE: due to wars creeping into civilian territory) -Innocent people are brutally murdered or wounded in the name of "the cause" *The countries with long-standing conflicts have what type of access to health care and why?*

-It is not uncommon for the population of a country to become the target of an uprising or a war. (NOTE: due to wars creeping into civilian territory) -Innocent people are brutally murdered or wounded in the name of "the cause" -Countries with long-standing conflicts(ex: middle east, seria, yemin, etc) *suffer the most as health care needs are not addressed.* >>>They are *not observing any of the universal imperatives of care due to lack of resources and continued war.* (NOTE: lack of money/resources=focus on replenishing wars instead of healthcare and education for citizen) MORE DETAILS BELOWWWWWW -An example given by the book is Mozambique were conflict has spanned 2 decades and young people are brought up with no education and are merely groomed to be soldiers. -What resources are available are focused on replenishing armies, leaving women and children devastated -As well, many uprising destroy or damage health care facilities as they raid for supplies or do not want their enemies treated.

*What is Global Health and Why Is It Important?* -Life in the 21st century is global -_______________- what effects one now affects many (ex. pandemic) -_______________ (GBD)

-Life in the 21st century is global -*Interdependency*- what effects one now affects many (ex. pandemic) -*Global Burden of Disease* (GBD)

*LINK FOR The World Health Organization* what do they do? and what is their goal?

-WHO works worldwide to *promote health, keep the world safe, and serve the vulnerable. * -Our goal is to *ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and well-being.*

-While these 7 goals were seen as important, they were also considered to be more limited in scope and again, what countries are they used more in? -So the UN ratified the Sustainable Development Goals or SDGs for short in January 2016 and they are being promoted through 2030.

-While these 7 goals were seen as important, they were also considered to be more limited in scope and again, *something for other countries to achieve, not so much the US or more high resource countries. Of course, there were some successes especially in the area of maternal mortality and AIDS, but certainly not enough to take global focus off these goals.* -So the UN ratified the Sustainable Development Goals or SDGs for short in January 2016 and they are being promoted through 2030.

You should be aware of and ask what questions about their *view of women* in their culture when working with other countries?

-Women in most societies are viewed in ways that require close scrutiny -Do they have legal status? Are they seen as "less important than males"? Do they have a say in decision-making? Can they be employed or are they expected marry and give birth only? Do religious taboos endanger their health (eg. female circumcision) -How are female health care providers viewed? Will makes listen to them? -DO WOMEN HAVE A VOICE? ARE WOMENS NEEDS AND ISSUES BEING MET? -in many countries and even sometimes in the united states women are viewed as second class citzens (they may not make as much as men even tho doing the same job, there opportunities may be poor-this is especially true around the world<in some societies like middle eastern countries woman have a role and are restricted in what they allowed to do)

*LINK FOR The World Health Organization* Through our work, we address: WHAT 6 THINGS?

-human capital across the life-course -noncommunicable diseases prevention -mental health promotion -climate change in small island developing states -antimicrobial resistance -elimination and eradication of high-impact communicable diseases.

*LINK FOR The World Health Organization* For health emergencies, we: -prepare for... -prevent .... -detect and respond to... -support delivery...

-prepare for emergencies by identifying, mitigating and managing risks -prevent emergencies and support development of tools necessary during outbreaks -detect and respond to acute health emergencies -support delivery of essential health services in fragile settings.

*WHICH GLOBAL HEALTH PROMOTION IS BEING DESCRIBED BELOW? of concept to health in all policies (note: all policies should be made referencing the health of the nation)

2013- Promotion