HP 270 Final
What is Universal Health coverage defined by?
"Universal health coverage is defined as ensuring that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation and palliation) of sufficient quality to be effective while also ensuring that the use of these services does not expose the user the financial hardship." WHO
What are the Universal Health coverages three objectives?
"equity in access to health services - those who need the services should get them, not only those who can pay for them; that the quality of health services is good enough to improve the health of those receiving services; and financial-risk protection - ensuring that the cost of using care does not put people at risk of financial hardship." WHO
What was revolutionary about Virchows report on typhus epidemic?
(Education) Education, Liberty Properity-> Mass mortality from typhus
What are the challenges of Global Health inequalities?
-Continued focus on biomedical solution (can be limiting as there is more factors that influence health) - Addressing inequalities requires multisectoral action -Recent focus on neoliberalism and individualism minimizes the view of society as a social and collective phenomenon.
Why do differences/inequalities exist?
-History, politics, culture etc shape the distribution of wealth and health between and within countries -Structural and social determinants of health -All of these factors operate at the global level
SDG 3.1
3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.
SDG 3.2
3.2 By 2030, end preventable deaths of newborns and children under 5 years of age.
SDG 3.3
3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.
SDG 3.4
3.4 By 2030, reduce by one third premature mortality from non-communicable diseases.
What is population health?
A conceptual framework for thinking about why some people are healthier than other, as well as the policy development research agenda and resource allocation that flow from it
What is the health adjusted life expectancy at birth HALE?
Average number of years that a person can expect to live in full health by taking into account years lived in less than full health due to disease and or injury
How do we measure the population at risk over time?
Census/samples of the population
How were colonial medical interventions, including examinations and procedures, justified during the era of tropical medicine in the late 19th century?
Colonial medical interventions were often justified in the name of the 'civilizing process,' which encompassed the moral and racial superiority of white populations. The interventions, despite gross violations of human rights, were framed as a means of improving the health and well-being of native populations within the context of the broader civilizing mission.
Why are low income countries low income?
Colonialism Subjugation (Under control) Exploitation Exclusion
What is neoliberalism?
Coming out of economic recession, neoliberalism - individual freedom, with the freedom of the market and the entrepreneurial spirit of individuals as central to ensuring it - was appealing
Early days: Tropical Medicine in Colonies?
Concern for US/European citizens living in colonies Concern that ill-health hampered productivity of the local workforce, damaging US/European economies New knowledge about infectious disease transmission and treatment Investment focused on medical interventions in urban areas where 'colonials' lived The locus of power and decision-making was, and still is, the global north Us vs. them
What are the social determinants of health?
Conditions in which people are born, grow, live, work and age. These social determinants are key factors that influence health outcomes and disparities.Include economic stability Job, income, socioeconomic status. Also education, access to healthcare, physical environment, genetics etc
What was created after World War 2 for International health?
Creation of the UN and World Health Organization
What is cumulative disease incidence?
Cumulative incidence is simply the total number of new cases of a disease so far - this is what has been widely reported for COVID
What does decolonizing global health mean?
Decolonizing global health" is a concept that emphasizes challenging and transforming the historical and structural inequities embedded in the field of global health. It involves reexamining and reshaping the power dynamics, narratives, and practices that have traditionally marginalized certain populations, often rooted in colonial histories. Decolonizing global health seeks to promote equity, inclusivity, and partnership in addressing health challenges worldwide. Here are key elements of what decolonizing global health entails:
What is the defintion of Life expectancy?
Definition: Average number of years that a newborn is expected to live if current mortality rates continue to apply.
What measure do we use to track the populations health? For morbidity?
Disease Incidence Disease prevalance Medical care usage
What does SDG 3 aim to do?
Ensure healthy lives and promote well-being for all at all ages
What do annual rates assume?
Everyone is followed for 1 year
What does global health focus on and what problems does it emphasize?
Focuses on reducing inequalities; Often emphasizes problems that transcend national borders or have a global political and economic impact; and
What does Global health focus on?
Focuses on the impact of global interdependence on the determinants of health, the transfer of health risks and the policy response of countries, international organizations and the many other actors in the global health arena.
What is the significant reversal observed in the post-war history of epidemics regarding the countries most heavily affected by the COVID-19 pandemic? Reading 1
For the first time, the world's richest countries, including China, Brazil, and Iran, accounted for over 90% of reported deaths from COVID-19 by early May 2020, marking a reversal from the historical pattern.
What does Global health frameworks refer to?
Global health frameworks are organized plans or guidelines that outline strategies for addressing health issues worldwide through collaboration among countries and organizations.
Is life expectancy in the US increasing or decreasing?
Going down
Who gathers periodically to review progress of SDGs?
Heads of State
What is health?
Health is a state of complete physical, mental, and social well being and not merely the absence of disease or infirmity - WHO 1958
What is symptoms of Typhus?
High fever Rash Chills Muscle pain Headache Mental confusion
What do disease occurence rates show and calculatoin?
How fast a disease is occurring?
What do the disease occurence number show and calculation?
How much disease is occurring? It is a number
What epidemic affected Upper Silesia, as described in the provided excerpt?
Hunger-typhus.
What are some proposed solutions for Global Health inequalities?
Improve daily living conditions Combat the unequal distribution of power, money and resources, e.g., through redistributive policies such as income transfer and micro-credits Measure the magnitude of the problem and evaluate the impact of actions
What is the Alma Ata decleration 1978?
In simple terms, it is a promise to make sure that basic health services are accessible to everyone, focusing on prevention and treatment of common diseases. The declaration was adopted in Alma-Ata, Kazakhstan, in 1978.
Neocolonialism and Structural adjustment programs?
In summary, the imposition of Structural Adjustment Programs by the World Bank and IMF is cited as a prominent example of neocolonialism, as these policies shaped the economic destiny of low-income countries in ways that often maintained control and influence by high-income nations and institutions. The effects of these policies continue to be felt, contributing to discussions about economic justice and global economic governance.
What also occurred after WW11 which is related to international health of certain countries such as those in Africa?
Independence from colonization
How does typhus spread?
It is a bacterial disease spread by fleas
What are key principles of Global health?
Key principles of global health are context and equity.
What does life expectancy at birth reflect?
Life expectancy at birth reflects the overall mortality level of a population and summarizes the mortality pattern across all age groups children and adolescence adults and the elderly
What was the US vision on health following WW11
Market-delivered health services. n simpler terms, it means that health services, such as doctor visits, medical treatments, and medications, are offered and obtained through a system where healthcare providers and consumers engage in transactions based on market principles.
What is neocolonialism?
Neocolonialism is the use of economic, political, cultural, or other pressures to control or influence other countries, especially former dependencies."
SDGs?
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 Inequality 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
Do one or two factors influence health and how can we address global health issues?
No aa multitude of factors influences health at an individual and population level Disentangling these factors helps us address global health issues
Does Global Health focus on improving health of specific populations?
No its about improving the health of everyone
What is a inequality?
Perceived differences that exist in health conditions or are related to differences in the access to prevention, cure or rehabilitation of death
What measure do we use to track the populations health? What do risk factors track?
Prevalence
What impact did racial hierarchies and the 'civilizing mission' have on the application of tropical medicine in colonial contexts?
Racial hierarchies and the 'civilizing mission' provided moral justifications for medical interventions in colonies, reinforcing the belief in the superiority of white populations. These ideologies contributed to coercive and exploitative practices, with forced examinations, injections, and procedures imposed on native populations in the name of progress and civilization.
What is needed to understanding inequalities and key takeaways?
Requires context specific data Adressing them requires multi sectoral actions Not only is addressing inequalities the right thing to do but it has a clear positive impact on health
What does international health focus on?
Rural areas Infectious diseases Development and delivery of vaccines and other basic services
Why do African Americans tend to have worse health outcomes?
Slavery Red-lining (Labeled high risk- cant get mortgage) Racism Exclusion
How do we find cases of disease and death in the population?
Surveillance/vital registration surveys
What is intersectionality of HIV?
The "convergence of multiple, concurrently existing identities" shapes people's experiences of stigma and discrimination and determines their vulnerability to HIV and influences their ability to access services.
What is the UN family include?
The 'UN family', is made up of the UN itself and many programmes, funds, and specialized agencies, all with their own leadership and budget. WHO, UNDP, UNFPA, UN Women, UNICEF, UNAIDS, WFP, World Bank...
What are predominant global health frameworks?
The Sustainable Development Agenda and the Sustainable Development Goals (SDGs) Universal Health Coverage
What are SDGs and when were they adopted and when do goal timeline end?
The Sustainable Development Goals (SDGs) are a set of 17 global goals established by the United Nations to address various social, economic, and environmental challenges. They were adopted in 2015 with the aim of achieving a more sustainable and equitable world by 2030.
What has played a huge role in determining global health frameworks?
The United Nations
What is the United Nations made up of?
The United Nations is currently made up of 193 Member States.
What is Global Health?
The application of the principles of public health to health problems and challenges that transcend national boundaries and to the complex array of global and local forces that affect them
How do the authors criticize the one-size-fits-all approach to COVID-19 guidance and interventions, particularly in the context of less-resourced countries? Readings 1
The authors argue that strategies such as widespread lockdowns and a focus on sophisticated tertiary hospital care and technological solutions may not be appropriate for less-resourced countries due to their distinct demographics, public health needs, limited resources, and fragile economies
What alternative strategies do the authors propose for less-resourced countries in managing the COVID-19 pandemic, and why do they emphasize the importance of context and equity? Reading 1
The authors propose a community-based approach that involves active case finding, community health workers, and primary care providers. They emphasize the importance of context-specific strategies, community engagement, and addressing socioeconomic inequalities to align with the principles of global health and avoid unintended negative consequences.
How is global health colonized?
The concept of the "colonization of global health" refers to the historical and ongoing influence of powerful and often Western entities in shaping the global health agenda and policies.
What is proposed as the driving force behind research efforts in global health? Reading 1
The driving force behind research efforts in global health is proposed to be the quest for equity in health within and among nations. Research on diseases affecting the poor is considered a priority, as addressing structural determinants of health, especially poverty, can contribute to reducing the global burden of diseases.
What are the four main themes of Global health research? Reading
The four main themes identified in global health research by Salm et al are: (1) a multiplex approach to worldwide health improvement, (2) an ethical initiative guided by justice principles, (3) a form of governance with national and international influence, and (4) a polysemous concept with historical antecedents and emergent future.
What was the focus of the new science of tropical medicine in the late 19th century, particularly in addressing epidemic diseases in colonial contexts?
The new science of tropical medicine in the late 19th century focused on controlling the economic effects of epidemic diseases by targeting nonhuman vectors, such as the Anopheles mosquito transmitting malaria. The emphasis was on population-centric approaches rather than providing direct curative services to native populations.
What is disease incidence?
The number of new cases of a disease in a given population.
What do we need to know if a population is well/not well?
The overall goal of a population health approach is to maintain and improve the health of the entire population and to reduce inequalities in health between population groups."
What key solution does Rudolf Carl Virchow propose to prevent similar crises in the future in Upper Silesia?
The promotion of education, liberty, and prosperity, along with the removal of hierarchical and bureaucratic structures, democratic self-government, and separation of church and state.
Who is responsible for implementing UHC?
The responsibility for implementing Universal Health Coverage (UHC) primarily lies with individual countries and their respective governments.
Who is responsible for implementing the SDGs?
The responsibility for implementing the Sustainable Development Goals (SDGs) rests primarily with individual countries and their respective governments. When the United Nations adopted the 2030 Agenda for Sustainable Development in 2015, it recognized that the success of the SDGs would require a collective effort involving governments, civil society, the private sector, and other stakeholders.
Why study the history of Global health?
The social, economic, and environmental conditions that shape the health of populations are not just the products of contemporary circumstance; they are part of a historical continuum. (Dr. Sandro Galea). What are the historically-determined power dynamics, politics, racism and economics that have led to such drastic economic and health disparities around the world?
What is international health?
The sum of nation States and their structured interactions through international fora and governance mechanisms relevant to health.
Why do global frameworks matter?
They bring attention to the range of issues to be addressed for sustainable development They can guide national and sub-national planning and action They allow us to monitor progress (and lack thereof) They create a sense of urgency
What do SDgs build upon?
They build on the Millennium Development Goals (MDGs), introduced in 2000 with goals by 2015.
What measure do we use to track mortality?
Total, age and cause specific
What happened after World War II in regards to Global health frameworks?
UN came into existence and countries came together committed to improving the world as a whole
What does evolving global health focus?
Urban and rural health Health systems Aging populations Chronic as well as infectious diseases Increasing population mobility Climate change COVID-19 and its implications Interactions between state and non-state actors
There are 40 students in HP270.If 20 students develop flu over the course of the semester, what is the cumulative incidence of flu?
We could just say it's 20 students. Or we could calculate per 1,000 population to make it a proportion and standardize it:
What does the proportion tell you about disease occurrence and how is it calculated?
What proportion of the population is affected?
What is white savior complex?
White savior complex is a term that's used to describe white people who consider themselves wonderful helpers to Black, Indigenous and People of Color (BIPOC) — but they "help" for the wrong reasons (and sometimes end up doing more to hurt than help).They believe it's their responsibility to support and uplift communities of color — in their own country or somewhere else — because people of color lack the resources, willpower, and intelligence to do it themselves. White saviors often speak passionately about their desire to "do the right thing." Yet their actions usually involve very little input from the people they're attempting to help.Their intentions may be noble... In reality, though, white saviorism tends to emphasize inequality, because it continues to center the actions of white people while ignoring (or even invalidating) the experiences of those they're claiming to help. (Raypole, 2021)
What percent of people with typhus will die if they don't get treatment?
With no treatment, 10-60% of people with typhus will die
Where does Global health imply action on?
Within and beyond the health sector
What was the Russian Vision on international health following WWII?
centralized, state-led provision of health services. . In simpler terms, it's a system where the government is heavily involved in running and managing healthcare services for everyone
What are inequities?
inequalities that are considered to be unjust or that stem from some form of injustice.