final questions

Question 1

Why can humans be considered ‘parasitic bodies’?

Answer 1

Humans are considered parasitic bodies because they host 90 trillion microbes - these microbes are essential for survival

Question 2

What is Koch’s Postulate and germ theory? What is the significance of the germ theory in biomedicine and public health?

Answer 2

• Koch’s Postulate & germ theory (1891) isolated microorganisms as a cause of illness
• Biomedical approach - reduced the complexity of illness to a singular causative factor, reliance on empirical evidence
• Three interacting factors - pathogen, host, & environment

Question 3

List the types of pathogens

Answer 3

Virus, bacteria, protozoa, fungi, worms, & prions

Question 4

What are the factors that cause pathogens to emerge?

Answer 4

Demography & behaviors, ecological changes (natural and human-driven), globalization (travel and commerce), microbial adaptations (human population immunity), & public health infrastructure

Question 5

What are the two types of disease transmission and how do they work?

Answer 5

Direct transmission (host-to-host) and vector transmission (host to intermediary to host)

Question 6

What is the epidemic curve?

Answer 6

Life course of infection prevalence in a population - ‘flatten the curve’
Infected, immune (prior infection and/or vaccination), dead

Question 7

What is the difference between isolation and quarantine?

Answer 7

• Isolation - separation of sick person (individual isolation of symptomatic patients, community isolation of individuals NOT symptomatic)
• Quarantine - geographical separation of populations potentially exposed

Question 8

What are the primary conditions for isolation and quarantine?

Answer 8

Knowledge of disease, vector of transmission (water, air, etc), contagiousness, severity of disease (morbidity and mortality), temporality (permanent or treatable - transmission), moral panic (fear outweighs threat)

Question 9

What is the relationship between colonialism and infectious disease?

Answer 9

Colonialism increases infectious disease. As colonizers infiltrate

Question 10

What are the health legacies of colonialism?

Question 11

What are the major global epidemiological transitions?

Question 12

What is the McKeown Hypothesis?

Question 13

What is the Global Polio Eradication Initiative?

Answer 13

• Goal: total eradication of the polio virus, one of the largest coordinated global health projects in history
• Example of a vertical campaign

Question 14

What are some of the major reasons for vaccine hesitancy?

Answer 14

Religion/spiritual beliefs, history and politics (colonial/imperial legacies, biomedical health practitioners as representatives), health systems (inclusions and exclusions of health campaigns), health delivery (existing (dis)trust of practitioners)

Question 15

In the Closser article, what are some of the major findings regarding global vaccine hesitancy, and vertical approaches vs. other public health approaches

Answer 15

• Discourses about vaccines are both local and shaped by global forces
• Vaccine refusal is shaped by contrast between rigorous vertical campaigns (how many/year can define this) in the absence of public health infrastructure (or no improvement)
• Shaped by pre-existing trust in those who administer vaccines
• Lack of holistic approach hurts vertical approach to disease eradication

Question 16

What is the ‘spillover effect hypothesis’?

Answer 16

• Does a vertical approach improve other areas of public health systems?
• No, they can harm public health endeavors and vertical programs themselves

Question 17

What is the stress response in humans and what are the impacts of chronic stress?

Answer 17

• Natural physiological response to stressful situations, attempt to maintain allostasis (fight, flight, or freeze)
• Associated with increase in CVD, decrease in immune functioning, can stunt growth in children

Question 18

How does stress affect child development?

Answer 18

Can stunt their mental and physical growth

Question 19

How does inequality impact mortality rates?

Question 20

Wilkinson’s lecture discusses the impact of inequality on social cohesion, health, and
well-being (within and among nation-states). What is that relationship? What is relative
wealth/inequality and how does it relate to lifestyle incongruity?

Question 21

What is the relationship between race, stress, discrimination, and health?

Question 22

What is the relationship between race and maternal health?

Question 23

What are some of the major economic outcomes of colonialism?

Question 24

What impacts have neoliberal approaches to capitalism had on the global economy?

Question 25

What are the major economic approaches to global development (especially in the Global South)?

Question 26

What are some of the major benefits and risks to the globalization of economies? How do these political-economies influence health?

Question 27

What is ‘modernization theory’?

Question 28

Rylko-Bauer and Farmer 2008 article, what are some of the key structural reasons that explain healthcare inequality? What are the two approaches – health care as a right vs. health care as a commodity? What do the authors mean by the term ‘managed care’?

Question 29

What are the different types of healthcare available in Kakuma Refugee Camp?

Answer 29

• Comparative reports: reports of (sexual) violence are taken multiple times to compare them and determine if patients are ‘lying’, can determine future housing
• Medical pluralism: coexistence & use of multiple medical systems
• Biomedicine: operated by the International Rescue Committee (hospital & 4 satellite clinics) in camp, operated by the catholic church (hospital & private clinics) in town
• Informal healthcare: clandestine clinics are unregistered refugee-run biomedical healthcare, traditional healers are individual refugees that practice non-biomedical healthcare

Question 30

Why are refugee women in Kakuma no longer allowed to give birth at home with a traditional birth attendant?

Answer 30

• In 2010, UNCHR and Kenyan Government officials institute new policy preventing refugees from obtaining birth certificates from local government office
• Birth Certificates MUST be issues by IRC or Missions hospital, otherwise children did not legally exist

Question 31

How are healthcare systems used for surveillance and what are the outcomes of this?

Answer 31

• Public health systems used as points of access to collect information on populations, monitor behavior, and control behavior
• Used health care for non-medical agendas
• Contributes to distrust between (potential) patients and health care workers

Question 32

What is ‘hospital hesitancy’?

Answer 32

Individuals disenfranchised by hospitals are hesitant to go to them, prefer to deal with their illnesses at home

Question 33

Describe the cycle of maternal morbidity in Kakuma Refugee Camp

Answer 33

Obstetric violence → dislike and avoidance of hospital → late hospital arrival → ‘stupid deaths’/illnesses

Question 34

In what ways has pregnancy and birthing been medicalized? In what ways has male sexual dysfunction been medicalized?

Question 35

What are the biological underpinnings for menstruation and menopause?

Question 36

What are the major determinants of (in)fertility?

Question 37

What is ‘female genital cutting’? What are some of the reasons for the practice? What are potential health outcomes?

Question 38

What is the ‘obstetric dilemma’? What implications does it hold for experiences of pregnancy and birthing?

Question 39

What is the relationship between co-sleeping and SIDs?