For Final Flashcards
Toxicity
the degree to which a chemical substance or a particular mixture of substances can damage an organism
can refer to the effect on a whole organism as well as the effect on a substructure of the organism (such as cell (cytotoxicity) and the liver (hepatoxicity)
Toxicology
the study of harmful effects of substances on the environment, humans, animal health (the science of safety)
harmful effects on living things
Ecotoxicology
impact of exposures on population/communities/ecosystems
central concept of toxicology is that the effects of a toxicant are …
…dose-dependent
Will someone definitely get sick if exposed to a harmful substance?
No
also there are periods in a person’s life when he or she may be more susceptible to chemicals
____ often determines the toxicity of a substance
the route of exposure
dermal, inhalation
“the dose makes the poison”
LD50
Toxicity can be measured by its effects on the target
The value of LD50 for a substance is the dose required to kill half the members of a tested population after a specified test duration
LD50 figures are frequently used as a general indicator of a substance’s acute toxicity
A lower LD50 is indicative of increased toxicity
Usually determined by animal tests (sometimes conflated w the concept of mouse unit (MU)) (the amount of toxin required to kill a 20g mouse in 15 min)
usually expressed s the mass of substance administered per unit mass of test subject (typically as mg per body mass (usually kg))
*The choice of 50% lethality as a benchmark avoids the potential for ambiguity of making measurements in the extremes and reduces the amount of testing required…however this also means that LD50 is not the lethal dose for all subjects; some may be killed by much less while others survive doses far higher
Limitations of Measuring Toxicity
- lethal dosage often varies depending on the method of administration; for instance, many substances are less toxic when administered orally than when intravenously (opioid epidemic relevance)
- length of exposure (time)
- age/life stage of organism exposed
- LD50 somewhat unreliable and results may vary greatly between testing facilities due to factors such as the genetic characteristics of the sample population, animal species tested, environmental factors and mode of administration
- can be wide variability between species as well (what is safe for rats may not be for humans and vice versa)
Environmental Racism
used to describe environmental injustice that occurs within a racialized context both in practice and policy
“racial discrimination in environmental policy-making, the enforcement of regulations and laws, the deliberate targeting of communities of color for toxic waste facilities, the official sanctioning of the life-threatening presence of poisons and pollutants in our communities, and the history of excluding people of color from leadership of the ecology movements”
It is a form of systemic racism whereby communities of color are disproportionately burdened with health hazards through policies and practices that force them to live in proximity to sources of toxic waste - as a result these communities suffer greater rates of health problems attendant on hazardous pollutants
Bhopal Chemical Disaster
AKA Bhopal gas tragedy was a gas lead incident in 1984 at the Union Carbide India Limited Company
was a majority US owned company
over 500,000 exposed to methyl isocyanate (MIC) gas
caused by poor maintenance and insufficient safety protocols
few if any efforts at remediation have been enacted or enforced
2 decades after initial explosion:
4,000 gas victims required hospital treatment every day
reproductive health outcomes - birth defects, genetic abnormalitties, social relationship disruption
Remaining organochlorines: CNS impairment, thyroid, liver, kidney damage, eye irritation, skin, respiratory tract, endocrine disruption
Endemic toxins (remaining heavy metals): miscarriage, nervous system impairment, behavioral + learning impairment in children, digestive tract irritation, kidney damage, infertility
Bhopal Chemical Disaster
AKA Bhopal gas tragedy was a gas lead incident in 1984 at the Union Carbide India Limited Company
was a majority US owned company
over 500,000 exposed to methyl isocyanate (MIC) gas
caused by poor maintenance and insufficient safety protocols
few if any efforts at remediation have been enacted or enforced
2 decades after initial explosion:
4,000 gas victims required hospital treatment every day
reproductive health outcomes - birth defects, genetic abnormalitties, social relationship disruption
Remaining organochlorines: CNS impairment, thyroid, liver, kidney damage, eye irritation, skin, respiratory tract, endocrine disruption
Endemic toxins (remaining heavy metals): miscarriage, nervous system impairment, behavioral + learning impairment in children, digestive tract irritation, kidney damage, infertility
What is a syndemic or synergistic epidemic?
the aggregation of 2+ concurrent or sequential epidemics or disease clusters in a population w biological interactions, which exacerbate the prognosis and disease burden
develop under health disparity, caused by poverty, stress, or structural violence and are studied by epidemiologists and medical anthropologists concerned w public health, community healht, and the effects of social conditions on health
Superfund Sites
CERCLA is informally called superfund… the act allows the EPA to clean up contaminated sites…also forces the parties responsible for the contamination to either perform cleanups or eimburse the government for EPA-led cleanup work
Love Canal
Hooker Chemical co dumped toxic chemicals
in 1950s, site was sold to become a public school
lots of leukemia, birth defects, high morbidity + mortality rates
protests began in the 1970s
in 1988 the NY dept of health described love canal as “a national symbol of a failure to exercise a sense of concern for future generations”
Epidemiological Transition
a shift from infectious diseases to chronic noncommunicable diseases being the primary cause of deaths and disability in a population
Noncommunicable diseases (NCDs)
conditions that are not contagious
most noncommunicable conditions are chronic diseases that develop gradually and last for a long time
*the percentage of deaths from NCDs in a pop generally increases with economic growth
“diseases of affluence”
- false dichotomy since NCDs are the primary cause of disease burden in adult populations globally regardless of country income level
modifiable risk factors are thought to be responsible for at least two thirds of all worldwide deaths from these conditions
NCDs that can be prevented through behavior change are sometimes called lifestyle diseases
Self efficacy
an individuals confidence in their ability to successfully complete a difficult task
The Health Belief Model States that…
individual behavior change is a function of personal perceptions of the severity of the disease, their own susceptibility to it, and their likely benefits of adopting healthier behaviors as well as perceptions about the barriers to action and their own self-efficacy to enact change
cues to action are important for triggering behavior change
Examples of NCDs
Chronic Respiratory diseases (CRDs)
Asthma
Chronic Obstructive Pulmonary Disorder (COPD)
- bronchitis
- emphysema
diabetes
other top NCDs worldwide
Digestive diseases
liver and kidney disease
CRDs
chronic respiratory diseases = diseases of airway, bronchi, and lungs (doesnt include chronic TB nor lung cancer)
Asthma
chronic, but reversible inflammation of the airways, attacks can be fatal
increasingle linked to environmental pollution
COPD
a chronic progressive disease that limits airflow and causes shortness of breath and productive coughing
causes over 3 mil deaths annually
primary risk factor: tobacco use
two of the most common presentations of COPD are bronchitis and emphysema
Diabetes
Type 1: occurs when body does not produce enough insulin
- typically sudden onset in childhood
- people w type 1 are rarely overweight
Type 2: occurs when the body develops insulin resistance and stops responding appropriately to insulin even when the hormone is still being produced
- typically gradual onset in adulthood
- considered preventable
- “diabesity” since people w type 2 are usually overweight or obese
Gestational diabetes
Diabetes + its complications have become major causes of disability and premature death in high-income and middle-income countries
between 1980 and 2015 the global diabetes prevalence rate doubled from 4.7% to 8.5% after standardizing the 1980 rates to the age distribution in 2015
The prevalence is expected to continue to climb in the coming decades to 10.4% in 2040 as more people worldwide become obese
Example of Obesity Report Cards
in 2016, Arkansas instituted an obesity surveillance campaign
a state mandate that all public schools provide weights + measurements of their students to offer parents essential info about their childrens health
model in Arkansas is being used to create new programs in states like Ma and Wy
Food Security exists when…
…people have access to enough food to be healthy, active, and productive
food security is about the distribution and affordability of food as much as it is about food production
Global Hunger Index (GHI)
a metric that estimates the burden from undernutrition in a population with a focus on young children
- residents of lower-income countries spend a much higher proportion of their incomes on food than people who live in higher-income countries spend
Food Deserts
regions where people have limited access to healthful and affordable food. May be due to having a low income or having to travel farther to find healthful food options
without access to healthful foods, people living in food deserts may be at higher risk of diet-related conditions, such as obesity, diabetes, and cardiovascular disease
#1 cited reason = lack of transport
Nutrition transition
the shift in diet and energy expenditure that coincides with economic/demographic/epidemiological changes
Genetic changes do not explain why obesity has become so much more prevalent in recent decades; it takes generations for genetic adaptations to occur, but only take a short time to change dietary and exercise habits
the nutrition transition is also related to a variety of globalization processes, including changing perceptions of beauty/health
Overnutrition
a form of malnutrition caused by excessive intake of calories and nutrients
Body Mass Index (BMI)
a measure of body composition calculated by taking weight in kg and dividing by the square of the height in meters
Obesity is associated with increased risk for many other diseases including…
type 2 diabetes, hypertension (high bp), heart disease, strokes, gallstones and other digestive disorders, back pain, arthritis of the back and hip, and several types of cancer
Adults living in high income countries are more likely to develop cancer than are adults living in low income countries… why?
The life expectancy is higher in high-income countries, so more people live long enough to develop cancer, but this trend is present even after adjusting for differences in the age structures of pops
people who live in high income countries are significantly more likely to receive a cancer diagnosis than are people of the same age who live in low-income countries
- People in low-income countries who have cancer are more likely to die from the disease than are people the same age who live in high-income countries
- diagnosed at an advanced stage
- lack of treatment access
What is the percentage of men/women who live to age 80 who will have developed some type of cancer?
30% of men and 20% of women
about 1/8 deaths worldwide each year is caused by cancer
Cancer epidemiology
across income groups
- cancer mortality rates are fairly similar across income groups
- people in high-income countries have higher likelihood of receiving cancer diagnosis and are more likely to survive
- people in low-income countries have lower likelihoods of being diagnosed with cancer and are less likely to survive - so if you can afford to get screened, your chances of survival are much greater
Types of screening
Case detection: prescriptive screening
Control of disease: prospective screening
Research Purposes
What is screening?
a type of secondary prevention in which all members of a well-defined group of people are encouraged to be tested for a disease based on evidence that members of the population are at risk for the disease and that early intervention improves health outcomes
What are some common screening tests?
pap smear for cervical dysplasia or cervical cancer
mammography for breast cancer
PSA test for prostate cancer
Fecal occult blood for colon cancer
HIV screening test
Validity of a test
refers to accuracy
Reliability of a test
may be consistent but may be innacurate
Sensitivity of a test
the proportion of people who truly have the disease who test positive for the disease
the amoung of true positives over the amount of positive results
the ability of a test to identify correctly those who have the disease (a) from all individuals with the disease (a+c)
SEN = the proportion of cases that test positive
Specificity of a test
the proportion of people who are truly free of the disease who test negative for it
the amount of true negatives over the amount of negative results
= the ability of the test to identify correctly those who do not have the disease (d) from all individuals free from the disease (b+d)
Predictive Value of Tests
PVP = proportion of positive tests that are true cases
- true positives / (true positives + false positives)
PVN = proportion of negative tests that are true non-cases
- True negatives / (true negatives + false negatives)
Screening vs Diagnostic tests
Principles in Public Health (ethical aspects of screening)
Principle: Potential Harm
Beneficience: screening program may have benefit on population level for those offered treatment but not every case will benefit
Non-malfeasance: psychological harm from false positive (before confirmatory testing), preventable deaths resulting from FN test, Iatrogenic harm from subsequent diagnostic testing, false reassurance from FN
Justice: ensure equality in uptake and linkage to care pathways among deprived and affluent poulations (harm = access)
Privacy: during screening and confirmatory testing
Autonomy: communicating risk to patients is notoriously difficult
Cancer in the global south
(BC)
BC is the leading cause of cancer death in low- and middle-income countries and for women globally - cervical cancer is a much larger share of all cancers in Africa than elsewhere
growing awareness; e.g. breast cancer walk in Nigeria
BC 2nd most common cancer type among women in Uganda after cervical cancer
late-stage detection - women only go to health facilities once the disease has progressed to late stage - making treatment longer + more difficult
Malawi also struggles to stem cases
BC rates on the rise - country only has one treatment center
median survival rate seems to be dropping
Prevention strategies:
PAP smear - need speculum, lamp, cytobrush, slide, microscope, pathologist, 2-week followup
VIA: visual inspection after acetic acid (more accessible)
- women will gravitate more toward this
- need speculum, lamp, cotton swab, vinegar, no pathologist, quick turnaround w digital camera photography of cervix
Risk factor =
an exposure or characteristic that increases the likelihood of developing a particular disease
What is the strongest risk factor for cancer?
Age
- nearly 60% of cancer diagnoses and 70% of cancer deaths worldwide occur in people at least 60yrs old
Aging is a nonmodifiable risk factor (cannot be changed through health interventions)
define: Cancer modifiable risk factors,
behavioral risk factors, causal factors
modifiable risk factors: risk factors that can be altered
Behavioral risk factors: tobacco smoking, exercise habits, and other lifestyle practices
Causal factors: an exposure that has been scientifically tested and shown to occur before the disease outcome and to contribute directly to its occurrence (ex: HPV)
Many diseases are multicausal, which means that many different risk factors contribute to the disease occurring, and many possible pathways for the primary prevention of cancer
What is The Risk Transition
occurring in which the risk factors accounting for the largest proportion of preventable morbidity and mortality globally are shifting
pre-transition: undernutrition, unsafe water, indoor air pollution, other factors that increase risk of childhood infectious disease
Post-transition: obesity, physical inactivity, tobacco use, and other exposures that increase risk of chronic disease
Tobacco/Vaping as risk factors
“the re-normalization of smoking in the community”
WHO concerned that electronic nicotine delivery systems ar ebeing marketed toward adolescents
JUUL School
- designed to be taught by a Juul consultant
- curriculum included science of e-cigs, social pressures, and using mindfulness to combat e-cig use
- offered school stipends if they adopted this
Is it possible to know with certainty which factors led to a particular case of cancer developing?
No, it is rarely possible
the existence of prevention methods for some types of cancer doesnt mean all cancers are preventable
Individual blame does not help
screening is handy - next best option to prevention
It is/is not?
screening when diagnostic tests are conducted in people who already have signs and symptoms of cancer in order to confirm the presence of cancerous cells
is not.
Injury =
physical damage to the body inflicted by an external force
not synonymous with the word accident
most injuries could have been prevented with safety measures
Accident =
an unfortunte event that happens by chance, implying that nothing could have been done to prevent the misfortune
Unintentional injury=
an unplanned injury that happens very quickly
Intentional injury =
a purposefully inflicted physical trauma
Why is injury an area of concern for global public health workers?
global public health is a business of prevention
Road traffic injuries (RTIs)
RTIS = injuries sustained in collisions involving at least one moving motor vehicle ( as opposed to, for example an injury sustained when someone falls off a bicicyle)
much higher in low-income and middle-income countries than in high-income countries
What really matters is if you can get treatment
-most vehicle collisions in high-income countries involved 2 vehicles crashing together
- in lower-income countries the victims of a collission of often motorcyclists or pedestrians who are struck by a car or truck
- the difference in mortality rates is exacerbated by people in lower-income countries having limited access to lifesaving care
A fall is
an event that causes a person to land on the ground or floor
Burn =
an injury to skin or deeper tissues that is caused by contact with fire, boiling water, or other very hot substances, or less often, by radiation, electricity, friction, extreme cold, and some types of chemicals
(not just fire, but toxicity)
Gun Violence
CDC cant do research on gun violence, need funding, which is sometimes based on langauge used?
leading cause of premature death in the US
Burden of gun violence in US vastly outpaces that in comparable countries
Think abt the language we us
Drowning =
the process of experiencing respiratory impairment due to being submerged or immersed in water or another liquid
- can occur in a large body of water or a very small amount of water, such as a bathtub or bucket
- drowning often results in death, but it is possible to resucitate some victims who have been underwater for only a few minutes and are still alive when they are rescued
percentage of deaths due to drowning peacks in childhood (also a bit in older adults)
Black children ages 5-14 are 3x more likely than white children to drown - think about who has access to learning how to swim
Violence =
the use of force or power to threaten or inflict physical, sexual and/or psychological harm on another person
What are the three main categories of violence?
self-directed violence = physical trauma inflicted by an individual on his or her own body, such as cutting and suicide attempts. Suicide is the intentional taking of ones own life
Interpersonal violence = trauma inflicted on an individual by a family member, intimate partner, friend, or stranger
- occurs when one person threatens to harm or actually harms another individual through power and control
- can occur across the lifespan (child abuse –> elder abuse)
Collective violence = violence perpetrated by members of a group as part of a shared plan to accomplish a political, social, or economic goal, such as war, armed conflicts, mob violence, gang violence, terrorist acts, and other acts of group violence
Globally, how many suicide attempts/other potentially fatal acts of self harm are there for every reported suicide death?
20
Is suicide the leading cause of increased risk of premature death among people with mental health disorders?
No
Intimate Partner Violence (IPV) =
physical or sexual violence by a current or former spouse or partner
About 1/3 women worldwide have experienced physical IPV, sexual OPV, and/or non-partner sexual assault. This number may be higher for LGBTQ communities
Gender-based violence (GBV) =
physical, emotional, and/or sexual abuse inflicted on an individual because of that individual’s gender
-mostly involves victimization of females
-females may have little power over their own bodies both because of gender norms that give men authority over women and because women tend to be smaller and physically weaker than men…ex: young girls may be subjected to female genital mutilation (FGM)
How many people meet the criteria for a mental health disorder in any 1-year period?
About 1 in 5
Mental health disorders are the leading cause of disability worldwide, accounting for 1/5th of the worlds disability
Did Covid-19 affect mental health?
Covid-19 had a profound effect on prevalence of anxiety and depression worldwide
Depressive disorder AKA depression
characterized by sadness, hopelessness, loss of interest in usual activities, fatigue, poor concentration, and other negative thoughts, feelings, and physical symptoms that interfere with normal daily thoughts
Sometimes called unipolar depressive disorder to distingish it from bipolar disorder
…people with unipolar depressive disorder experience depression without the cycles of mania experience by people with bipolar disorder
Mental Health Burden basic facts
critical gaps!
Every region in the woorld bears a significant burden from mental health issues
Mental health is a human rights issue - there are therapies/treatments/supports available, but access is not always there
Critical Gaps:
-limited knowledge of the causes of mental health disorders
significant limitations in our ability to prevent mental health disorders through interventions across the lifespan
-major barriers to accessing mental health diagnosis and effective treatment
(true B4 covid, Covid just heightened it)
Is mental health both a human rights and a global health issue?
Yes
The global burden from mental health disorders will not be reduced without vigorous international commitments to working together to develop effective new treatments, increase access to speciality care, and reduce the stigma associated with mental illnesses
(Medications and various types of therapy, support, and training are effective at improving quality of life for people with neuropsychiatric conditions, but most people who would benefit from these interventions are unable to access them
In many communities, people with mental illness are treated badly
Schizophrenia
=a mental health disorder characterized by distorted perceptions of reality
Delusions = false beliefs that are irrational but seem very real to the person experiencing them
Hallucinations = sensory distortions that cause the affected person to hear, see, feel, smell, or taste something that isnt present
also, disorganized thinking and speech and impaired decision making and memory
Bipolar Disorder
formerly called manic depression, is characterized by alternating periods of depression and mania or hypomania
It is likely that 1% to 2% of adults have bipolar disorder, but it is difficult to assess the actual prevalence because diagnosis can be clinically challenging because of comorbid conditions
Depressive disorder burden
Depression is a leading cause of disability globally because it affects so many people worldwide and it causes significant reductions in productivity at work, home, and school
There is considerable variation in country-specific prevalence rates of depression:
- countries with higher depression prevalence rates tend to include milder case of depression in their statistics, while countries with lower depression prevalence rates tend to include in their analyses only moderate and severe cases of depression associated with significant impairment
Anxiety Disorders
characterized by disproportionate fear of imminent danger and anxiety about potential future threats
Generalized anxiety disorder = persistent excessive worrying about numerous concerns, often accompanies by sleep disturbances, muscle tension, and fatigue
Panic disorder = repeated attacks that last for several intense minutes and cause a racing heartbeat, dizziness or weakness, and other disturbing symptoms
among the most common mental health issues globally, one of the leading causes of disability worldwide
Addiction
= a cognitive and neurological condition characterized by adverse behaviors related to physical or psychological dependence
Alcohol Use disorders
excessive alcohol use causes cirrhosis and other forms of liver damage, cancers, andother NCDs, unintentional injuries and intentional injuries, and premature mortality
Men have a particularly high rate of adverse effects from alcohol use
- more likely to report binge drinking and alcohol use disorders
There is no other consumer product as widely available as alcohol that accounts for as much premature death and disability
The African Region is faced with a growing burden of harmful alcohol consumption and its disasterous effects
Drug Use Disorders
cannabis products are the most widely used illicit drugs worldwide, but the greatest disability is associate with injectable drugs
-a person who injects drugs (PWID) also called an injecting drug user (IDU), faces numerous negative health outcomes, including an increased risk of viral hepatitis, HIV infection, and premature mortality
Few policies and programs have been proven to be effective at reducing the burden from illicit drug use
Prevention of use is still key but recognition that these are syndemic issues - recall 2016 outbreak of HIV in Scott Co, IN linked to shared needles
Obsessive-Compulsive Disorder
OCD involved anxiety-inducing recurrent thoughts (obsessions) and/or repetitive behaviors intended to reduce distress or prevent bad events (compulsions)
Posttraumatic Stress Disorder (PTSD)
occurs after a traumatic incident leads to nightmares or other types of distressing recollections of the event; avoidance of reminders of the traumatic event; and pysiological signs of hyperarousal, such as hypervigilance and insomnia
Mental Health GBD
caused 7.1% of DALYs lost in high income countries and 4.6% of DALYs globally in 2016
often start at young ages and are chronic, often cannot be cured, produce large amounts of disability
Nutrition =
the consumption and processing of foods that allow the body to survive, grow, heal, and be healthy
Nutrition Transition =
the shift from having undernutrition and nutrient deficiencies as the most prevalent nutrition concerns to having overweight and obesity as the dominant nutritional disorders (and co-incident NCDS)
water is not a nutrient but it is ____
an essential part of the diet
Undernutrition =
malnutrition resulting from deficiencies in the amount of food or types of nutrients eaten, or from poor absorption of the nutrients that have been consumed
Anthropometry =
the measurement of the human body
height, weight, waiste circumference, body fat percentage, and other meaurements
Stunting =
a child with low height for age, and indicator of chronic malnutrition
Underweight =
a child with low weight for age
Wasting =
a child with low weight for height, a sign of acute malnutrition often characterized by rapidly decreasing nutritional health status
Severe Acute Malnutrition (SAM) =
a child with a weight for height z-score below -3, a condition requiring urgent medical care
Mid-upper-arm circumference (MUAC) is another indicator of wasting, and children with a MUAC of less than 11.5 cm have SAM
Protein Energy Malnutrition (PEM)
a severe form of chronic malnutrition that presents in 2 diff forms
- Marasmus: children who are emaciated, weak, and lethargic because of long-term calorie deprivation
chronic wasting away of fat, muscle, and other tissues in the body - Kwashiorkor = children lacking protein in the diet who develop edema, fluid retention in extracellular spaces that causes swelling of the tissues in the arms, legs, and face
Severe PEM is a form of severe acute malnutrition
How is Kwarshiorkor treated?
antibiotics to treat infections
gradual increase in dietary calories from carbs, sugars, and fats
gradual increases in dietary proteins
IV fluids to correct fluid and electrolyte imbalances
lactase to assist in digestion of dairy products
vitamin and mineral supplements to treat deficiencies
Prevention of Kwarshiorkor
make sure diet has enough carbs,fats, and proteins
sounds simple but.. globally 150mil U5 children have stunted growth
Culturally-bound syndromes
culture-bound syndromes include a broad array of psychological, somatic, and behavioral symptoms that are present in certain cultural contexts, and are readily recognized as illness behavior by most participants in that culture. may not exist elsewhere or be labeled as a disease condition or illness elsewhere
e.g. koro in parts of PNG
Takeaways from Watters reading
-we can encounter ‘self-fulfilling prophecies’ and undermine our own best efforts if we do not adequately account for cultural context
-PTSD is a diagnosis that fits a Northern/Western world, in which people see themselves as autonomous individuals first and members of groups and social networks second. In a so-called traditional culture, the diagnosis just doesn’t make sense.
How many adults with severe mental illnesses receive any mental healthcare services?
less than half
Compulsive conditions =
anorexia, bulimia, binge eating
Neurodevelopmental disorders =
neurological and development disorders that present in childhood and require early intervention for the best outcomes
e.g. ADHD, autism, etc
Autism= a lifelong neurodevelopmental disorder that begins in early childhood and causes challenges with social communication
Neurocognitive disorders =
neurological and cognitive disorders such as dementia that typically develop in older adulthood. Also TBI as a result of injury is on the rise.
Dementia - a chronic syndrome characterized by memory loss, confusion, and other signs of impaired cognitive function
Alzheimer’s disease - the most prevalent dementia, accounting for about 2/3 of diagnosed dementia cases
Human rights =
entitlements that are due to every person simply because that person is human
Standard of Health =
targets that govts set for improving the health of the population they govern - this is where culture may play a role
think: how does this look diff in diff places?
rank the following in terms of scale
disaster, emergency, catastrophe, crisis
Catastrophe > disaster > emergency > crisis
What is the Sendai Framework For Disaster Risk Reduction?
a global agreement that aims to significantly reduce the # of deahts and the magnitude of destruction caused by natural disasters
Emergency management
AKA disaster management
oversees all resources and responsibilities related to emergencies and disasters, including prevention, preparedness, response, and recovery
Mitigation =
the process of implementing preemptive measures to protect people and property from hazards
resilience = the ability ot resist, survive, adapt to, and recover from adverse events
What are the 4R’s of emergency management?
- reduction of risks
- readiness
- response
- recovery
What is a complex humanitarian emergency (CHE)?
occurs when civil conflict or war cause mass migration of civilian populations, food insecurity, and long-term public health concerns
Natural disasters usually create an immediate period of acute need but quickly transition into recovery mode: CHEs may remain in acute phase for years or even decades
2 key pops are often central to CHE studies: migrants and refugees
Migrants vs refugees
Migrants: choose to move not because of a direct threat of persecution or death, but mainly to improve their lives by finding work, or in some cases for education, family reunion, or other reasons. Unlike refugees who cannot safely return home, migrants face no such impediment to return. If they choose to return home, they will continue to receive that protection of ther gov
Refugees: are persons fleeing armed conflict or persecution. There were 21.3 million of them worldwide at the end of 2015. Their situation is often so perilous and intolerable that they cross national borders to seek safety in nearby countries, and thus become internationally recognized as “refugees” with access to assistance from States, UNHCR, and other orgs. They are so recognized precicsely because it is too dangerous for them to return home and they need sanctuary elsewhere.
Key Responders to Disasters/Crises,etc
International Committee of the Red Cross (ICRC) - officially sanctioned by the Geneva Convention and international law to provide specific humanitarian services to civilian and military victims of conflicts. Deems itself neutral
MSF provides medical care to people harmed by violence no matter what the victims’ races, religions, or political affiliations
- however they have taken stances against organizations and conflicts
