Exam 1 Flashcards
Definition of health by WHO
a. Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity
difference between public health and medicine
a. Public health = communities and populations, public service, prevention and health promotion, broad
b. Health = medicine, individual, personal service, disease treatment, emphasis on medical care
Global health definition
the goal of improving health for all nations by promoting wellness and eliminating avoidable diseases
health indicators
a. Index: consider morbidity, mortality, and disability, calculated by age, gender, and region, and allow for comparison across regions measure burden of disease
eradication
complete removal in world, small pox
elimination
still around in some areas but don’t control in some area, polio
prevalence
commonness
incidence
occurrence, rate, or frequency of something undesirable
endemic
in a certain area
pandemic
over whole country or world
epidemic
an unexpected increase in the number of disease cases in a specific geographical area
life expectancy at birth
best is Europe, worst is Africa)
infant mortality
best is Europe, worst is Africa
under 5 mortality
best Europe, worst Africa
maternal mortality ratio
best Europe, worst US
neonatal mortality
best Europe, worst Africa
noncommunicable disease
highest in H, M, and L countries but not in the lowest countries
communicable diseases
comprise infectious diseases such as tuberculosis and measles, while non-communicable diseases (NCDs) are mostly chronic diseases such as cardiovascular diseases, cancers, and diabetes
HALE
health-adjusted Life expectancy
-Number of years a person of age can expect to live in good health
-Calculated by weighting (number of years of ill health according to severity) – (overall life expectancy)
-Accounts for morality and disability
DALY
disability – adjusted life year
-Sum of years lost due to premature death and years lived by disability
a. Premature = before life expectancy
- Has disability weight for each disease
- Years with DS * DS weight = years lived with DS
- years life lost + years lived with DS = DALYs
- YLD = DS years * DS weight
-Helps with comparison
demographic transition
o About fertility and mortality
o Shift from pattern of high fertility and high mortality to low both
o Mortality decreases due to better hygiene and nutria
a. Pop grows with younger share of pop
o Fertility decreases
o Change in women’s role
- Stage 5 = net population declines
o consequences for PH
epidemiologic transition
shift in mortality and morbidity patterns from com noncom
o Shifting from infection (increased death and fertility) to noncom (decreased death and fertility)
o Have both during transition
human development index
4 indicators
3 dimensions
1 result = HDI
4 HDI indicators
a. Life expectancy at birth
b. Mean years of school
c. Expected years of schooling
d. Gross national income per capita
3 dimensions of HDI
a. Health
b. Education
c. Living standards
Multi-dimensional poverty index
- Health
a. Nutrition
b. Child mortality - Education
a. Year of schooling
b. School attendance - Living standard
a. Cooking fuel
b. Sanitation
c. Water
d. Electricity
e. Floor
f. Assets
Relationship between ed, productivity, and health
o Health and education of parents effects health and education of kids
o Malnutrition and disease affect cog development
o Ed contributes to disease prevention
o Good health increases longevity and life earning
o Healthy workers = more productive
o Costs of health care = high
health inequality
diff in health outcomes between diff groups, not why but outcome
health disparities
a type of diff in economic disadvantage
health inequity
health status or in the distribution of health resources between different population groups
rural vs urban disparity
rural is harder
disparities between urban areas
o High population density
o Overcrowding
o Lack of safe water and sanitation
o Lack of education
o Poor health care access
o Pneumonia from sleeping in wet areas
definition of slum
- 3 of 5 = slum
a. Durable housing
b. Sufficient living space (<= 3 people per room)
c. Easy access to safe water
d. Access to adequate sanitation
e. Security of tenure - Usually from squatter settlements (informal)
Universal declaration of human rights
a. Governments are obliged to respect, protect, and fulfill the
rights they state
b. Resource-poor countries are required to “take steps” toward
realization of positive rights
right based approach to health
a. Assess
- Assess health policies, programs, and practices in terms of
impact on human rights
b. Analyze
- Analyze and address the health impacts resulting from
violations of human rights when considering ways to improve
population health
c. Prioritize
- Prioritize the fulfillment of human rights
limits to human right
a. Prohibitions on torture, on slavery, and on retroactive criminal laws
Patents
Intellectual property rights that grant the inventors (
pharmaceutical companies) the right to exclude others from
making, selling , etc. for a period of time
TRIPS
1994 = Provide incentives for R & D and the use of new technologies, sets minimum standards of protection for copyrights and related rights
Nazi experiment
Tuskegee experiment
Willobrook
study involved a group of children diagnosed with mental retardation, who lived at the Willobrook State Hospital in Staten Island, New York.
nuremberg code
First document to specify ethical principles that should guide physicians engaged in human research
1. “Voluntary consent of the human subject is absolutely essential”
declaration of helsinki
1964
The World Medical Association
Developed ethical principles to guide physicians conducting
biomedical research on humans
Principles apply equally to non-physicians
US national commission for the protection of human subjects of biomedical and behavioral research
Identified basic ethical principles
Developed guidelines for research
Social value
Scientific validity
Fair subject selection
Acceptable risk/benefit ratio
Informed consent
Respect for enrolled subjects
Belmont report
identifies basic ethical principles and guidelines that address ethical issues arising from the conduct of research with human subjects.
regional nutritional problem worst in Africa and South Asia
- Prevalence of underweight u5
- Prevalence of wasting, weight for height (not worst)
- Prevalence of stunting, height for age
- Low birthweight (not worst)
vA
dryness of eye, can lead to permanent blindness
iodine
growth on thyroid called goiter and failure to develop full intellectual potential
iron
anemia, associated with fatigue and weakness, pregnant increased risk of premature death
zinc
growth restriction, impaired immune function, skin disorders, hypogonadism, and cog dysfunction
folic acid and calcium
fa in preg neural tube defects, ca supplementation prevents hypertensive disorder
sodium
high sodium hypertension stroke and fatal coronary HD
added sugar
promote weight gain, type 2 diabetes, coronary HD
dietary fiber and refined carbs
prevent obesity, diabetes, CVD, and various cancers
basic causes of nutritional status
environment, tech, people, quantity and quality of actual resources
underlying causes at household/family level of nutri status
insufficient access to food, inadequate maternal and child care, poor water/sanitation and inadequate health services
immediate causes of nutri status
inadequate dietary intake, disease
outcomes of nutri status
child malnutri, death, and disability
stunting
failure to reach linear growth potential because of inadequate nutria or poor health. Height for age
wasting
dangerously thin, weight for height
undernourished
refers to those who lack sufficient energy or nutrients
window of opportunity
need nutri at growing points or you have serious delay
NPR article about breastfeeding
Less diarrhea, less lower respiratory infection
leading causes of neonatal death
- preterm birth
- intrapartum complications
- sepsis
- congenital anomalies
- other causes
post-neonatal causes of death
- other causes
- pneumonia
- diarrheal diseases
- injury
- malaria
Infant and u5 mortality is worse in
Africa
south asia
44% of under-5 child deaths occur among neonates
Very cost-effective way to combat diarrhea
Oral rehydration therapy (ORT)
What is essential to a child’s life
exclusive breast feeding
exclusive breastfeeding
mother’s milk has some antibodies that are crucial to the baby’s healthy development (both physically and mentally)
Polio near-eradication but still in
Afghanistan
Pakistan
Nigeria
Perinatal
1st week, highest risk of death
neonatal
first month
infant
first year
under 5
0-4, benchmark, immunity increases
If not specified, probably u-5
Key issues related to adolescent
Alcohol use
Unsafe sex
Lack of contraception
Iron deficiency
Illicit drug use
Unsafe water, sanitation, and hygiene
how to address adolescent health issues
a. Requires a life-course perspective to preventing and
treating health issues
Improve educational and employment opportunities
Promote universal health coverage to improve access of
adolescents
Make services more friendly to adolescents
reproductive and sexual health
Pre- and post-natal care for adolescent mothers and
newborns
Improve access to comprehensive contraceptive
information and services
Provide sexual and reproductive health services without
requiring parental involvement, especially safe abortion
care
HIV and other STIs
Promote awareness of risk factors
HIV testing and counselling
Voluntary medical male circumcision
PMTCT
ART
Contraceptive services
Mental health
Community-based approach to psychosocial support
Management of emotional, behavioral, developmental
disorders
Self-harm and suicide prevention
nutrition
Ensure food security and nutritional support for children
Iron and folic acid supplementation
Health education for adolescents, parents, caregivers
BMI-for-age assessment
tobacco and alcohol
Raise tobacco taxes and prohibit tobacco sales to minors
Encourage total elimination of smoking and tobacco smoke
in public places
Establish and enforce an appropriate minimum age for
purchase and consumption of alcoholic beverages
road injuries
Develop and implement policies to
prevent intoxicated driving
Set blood alcohol concentration (BAC)
limits to less than 0.05g/dl for the general
population and less than 0.02 g/dl for
young/novice drivers
Graduated licensing programs for
young/novice drivers
social suffering
results from what political, economic, and institutional power
structural violence
o social forces that harm certain groups of people, producing and perpetuating inequality in health and well-being
o What happened to them was out of their control embedded
o Violent because it causes pain, preventable and treatable
o Goes beyond individual control
farmer’s chapter on structural violence
- Deferential vulnerability = you’re susceptibility to disease is different based on what you are exposed to
a. Colonial forces used it to their advantage
b. Panama canal
c. Diseases aren’t new
d. Are new innovative ways to track disease
e. Rotation, use the history to prep for the future
f. Wreckage from the past more to navigate
