Exam 1 Flashcards
Low income
less than $995 per person
Low-Middle income
$996-3945 per person
Upper-Middle income
$3946-12,195 per person
High Income
$12,196+ per person
Millenium Development Goals
- UN set these goals in 2000 to be met by 2015
- not met, now have Sustainable Development Goals
Sustainable Development Goals, how many?
-17
Key Determinants of health (7)
- individual (genetics, sex, age)
- physical enviro
- employment and working conditions
- access to health services
- health behaviors
- healthy child development
- social enviro (education, culture, gender norms..)
Health status for a country generally has to do with what?
- wealth of a country
health disparities w/in a country closely linked to:
- social disadvantage: how people live, work, & health systems that serve them
- life circumstances & health related to political, social, and economic forces
Infant mortality rate
- # of deaths of infants per 1000 live births in a given yeardeaths
Life expectancy at birth
- av. # of years a newborn could expect to live if current mortality trends were to continue for rest of his/her life
- US: 77 (#28)
- Japan: 82 (#1)
Maternal Mortality Rate/Ratio
- # of women who die as a result of pregnancy & childbirth complications per 100,000 births in a given year
- US 8/100,000
Neonatal mortality rate
- # of deaths of infants under 28 days in a given year per 1000 live births
- neonatal deaths/live births *1000
- US: 5/1000
Under 5 mortality rate
- probability that a newborn baby will die before reaching age 5, expressed as # per 1000 live births
- US 8/1000
Morbidity
- sickness or any departure, subjective or objective, from psychological and physiological states of well-being
Disability
- suffer temporary or long term reduction in person’s capacity to function
prevalence
- # of people suffering from a certain health condition over a specific time period
incidence rate
- rate at which NEW cases of a disease occur within a population
- chance of getting a disease
Measuring burden of disease (2)
- HALE
- DALY
HALE
- health-adjusted life expectancy
- # of years to be lived in the equiv of good health
DALY
- disability adjusted life years
- measure of premature deaths and losses due to illness and disabilities in a population
Leading causes of DALYs for low & middle income countries
- much higher communicable disease rate
- perinatal conditions
- lower resp infection
- ischemic heart disease
Leadign causes of DALYs for high income countries
- ischemic heart disease
- cerebrovascular disease
- unipolar depressive disorder
Life expectancy has risen in all regions of the world since 1990 except (3)
- Europe
- Central Asia
- Subsaharan Africa
Communicable diseases continue to contribute largely to the burden of disease in (2)
- s asia
- subsaharan africa
Elderly Support Ratio
- ratio between share of population that is working and the share of the population 65+
highest income countries generally have: (3)
- low fertility
- declining populations
- aging populations
Demographic Transition
- shift from a pattern of high fertility, high mortality to low fertility, low mortality
- usually shifts as income of country raises
Epidemiological Transition (what it is and 3 steps)
- shift in PATTERNS of disease
- high & fluct mortality b/c of poor health conditions, epidemics, and famine
- progressive decline in mortality, epidemics less frequent
- further declines in mortality, increase life expectancy, and predominance of non-communicable disease
GAVI
- Global Alliance for Vaccines & Immunizations
Why are govs of wealthy countries concerned about health of poorer countries?
- places often traveled by their citizens
- enlightened self-interest
Agencies of the United Nations (3)
- WHO
- UNICEF
- UNAIDS
Which Multilateral Development Bank largely focused on link between health and poverty?
- World Bank
IAVI
- international AIDS Vaccine Initiative
- largely funded by world bank
Bilateral Agencies
- development assistant agencies of developed countries that work directly with developing countries to improve health of their people
Foundations
- fund research and aid projects for improving global health
- talked about Rockefeller Foundation, Wellcome Trust, and Bill & Melinda Gates Foundation
Largest Research Funder
- NIH
- Bill & Melinda Gates Foundation also large
NIH funds:
- national GH research but also funds research of other international groups (i.e. Haiti group for AIDS research)
NGOs (talked about 4)
- non-governmental organizations
- raise money from private sources or receive grants
- BRAC, Doctors w/o borders, Save the Children, Oxfam
Save the Children
- NGO
- work with poor families & communities to identify most important health needs
Oxfam
- NGO
- focused on injustice and poverty
Advocacy Orgs
- advocate on behalf of global health issues
- carry out research and policy studies and use to spread the word about issues
Think Tanks & Universities
- Think Tanks: body of experts who generate knowledge and provide advice and ideas
- Universities: set up institutions and programs for GH
Consulting Firms
- for-profit and non-profit
- expertise in one field
- often hired through development banks
Specialized Technical Orgs
- CDC
The Global Fund
- fights AIDS, TB, & Malaria
- primarily a financing agency
Partnerships related to WHO (3)
- Stop TB
- GAVI
- The Global Fund
World Health Assembly
- put on by WHO 1x/yr
- brings attention to pressing issues & ways to address them
Public-Private Partnerships for Health
- main goal is to develop new vaccines/products for overall improved GH
ex. ) - TB drug development
- AIDS (IAVI)
UNITAID
- housed in WHO
- financed by tax on airline tickets
- purpose is to increase access of low & middle income countries to treatment of TB, malaria, HIV/AIDS
Debt2Health
- 3 party agreement between a creditor, beneficiary, and a Global Fund
- cancel a party’s debt in exchange the equivalent amt of money put into the beneficiary’s global health work in their own country
Financing for GH from 1990-2007
- increased by 4x
onchocerciasis
- river blindness
- caused by worm
yield gap
- difference between current productivity and the best that can currently be achieved using available genetic materials & technology
Poor Countries doomed to stay poor (why wrong)
- many countries making substantial progress in last 50 yrs
- middle class of nations that didn’t previously exist
- % of poor people has dropped >50% since 1990
- Africa big strides in health and education (big variations between countries/states)
Foreign Aid is a waste (why wrong)
- US spends 1% of budget on aid
- aid diminishes disease, increases production & economic growth, and gets country OFF aid
Saving lives leads to overpopulation (why wrong)
- as child mortality decreases, people have less children because expectation is they will survive
- w/ less children, families have more resources, children get better education, de better for themselves and future families
1990: ____ world
now: ______ world
- used to be camel world ( large 3rd world hump, smaller soviet hump, then 1st world)
- now dromedary world (one large hump, most in middle)
UNFPA
- also agency of the UN
- fund for population activities
- focuses on women’s and girls health
BOND
- biomarkers of Nutrition for Development
- project funding currently stopped
- four major nutrients mapped, idea was website for all major nutrients
CARIG
- Carotenoid Group research of American Society of Nutrition
- Sherry involved in this
Wealth Improves ____ and poverty breeds ______
Nutrition, undernutrition
Wealth vs. live expectancy, infant mortality
increase life expectancy
decrease infant mortality
Nutrition –> Height –> Income
- higher nutrition as a child leads to taller stature..
- taller men tend to be better educated
- stunting is a sign of undernutrition
wages rise as ____ rises
- calorie intake rises
effects of undernutrition span at least how many generations?
- 3
Remitances can improve _____
- health and labor productivity (more money)
need interventions for nutrition that take into account:
- socioeconomic and gender inequals
- ex. education about consumption, improved infant feeding
quality protein maize fortified with?
- tryptophan and lysine
- not transgenic
in poor household what is necessary for food consumption?
- unequal allotment of food to feed the one who needs to go out and earn money
indonesian health clinic experiment
- when they had to pay for clinic, less people went, more sicknesses, and less labor force participation
Iron deficiency affects productivity findings
- anemia: less productivity
- when given supplements, work productivity increased
- placebo group productivity also increased but possibly because they were being paid for participating in experiment
mother’s education can also stunt children because?
- lower education of mother usually equals lower nutrition for children
underweight prevalence has (increased/decreased) in all regions
- decreased
undernutrition is the underlying cause in how much of under 5 deaths?
about half
Top three regions of wealth in the world
- Japan
- N america
- w europe
under 5 mortality and underweight prevalence greatly affecting what types of countries?
- poor ones
USA women more than ____ x likely to die from childbirth complications than counterparts in Germany, Britain, or Japan
more than 3x as likely
2003-2013 USA was one of only 8 countries to see their maternal mortality rates _____
increase