Global Health

Question 1

Global Health

Answer 1

• Health within the borders of each nation
• Health within population groups with unique cultures and languages
• Health across international borders and cultures
• Focus on health for all people worldwide

Question 2

Globalization

Answer 2

Globalization- “the process of increasing social and economic dependence and integration as capital, goods, persons, concepts, images, ideas, and values cross state boundaries” (Nies& McEwen, 2019)

Question 3

Global Threats to health

Answer 3

• Population Growth (patterns)
• Environments (Stressors)-pandemics/pollution
• Lifestyles and Behaviors

Question 4

Population Growth

Answer 4

2016- 7.4 billion (Nies & McEwen, 2019).
2022- 7.9 billion (U.S. Census, 2022).
Projected to reach 8 billion by 2022 (United Nations, 2022)

Question 5

10 most populous nations

Answer 5

1. China 1,410,539,758
2. India 1,389,637,446
3. United States 332,838,183
4. Indonesia 277,329,163
5. Pakistan 242,923,845
6. Nigeria 225,082,083
7. Brazil 217,240,060
8. Bangladesh 165,650,475
9. Russia 142,021,981
10. Mexico 129,150,971

Question 6

Population Growth – Threat to health and health care systems

Answer 6

Population growth (99%) is expected in resource- poor countries

• Malnutrition
• Disease
• Death

Question 7

Environmental Factors (Stressors) on Health

Answer 7

Directly assault a persons health
* Lead poisoning
* Air pollution
Consequences of neglect or failing infrastructures
* High level of lead
* Legionnaire disease
Stressors that may impact quality of life
* Crowding
* Noise
* Violence
Ecological Balance
* Wildfires
* Global Warming/climate change
Natural Disasters/wars/terrorism

Question 8

Patterns of health and Disease

Answer 8

Developing vs Developed Countries
* Cause of disease differ
* Racial, ethnic, and access disparities exist
Developing Countries
* Infectious disease contribute to high mortality rates
Developed Countries
* Infectious disease profile → Chronic disease profile

Question 9

How has the COVid-19 Pandemic Impacted Global Health

Answer 9

Global Health Security Index

• Overwhelmed health care systems
• Mental Health/psychological
• Health care workers
• Others?

Question 10

Global HIV epidemic by the numbers

Answer 10

Question 11

Malaria

Answer 11

Plasmodium falciparum
* Cases- 241 million estimated malaria cases in 85 malaria endemic countries in 2020
* Incidence- 5% global increase in malaria incidence between 2019 and 2020 due to service disruptions during the COVID-19 pandemic
* Mortality-12% global increase in estimated malaria deaths between 2019 and 2020;
* Deaths-47,000 additional deaths in 2020 were due to service disruptions during the COVID-19 pandemic
* https://www.who.int/data/gho/data/themes/malaria

Question 12

Tobacco Use and Tobacco Control

Answer 12

• Global- 29 countries developed tobacco free policies/banned all forms of tobacco advertisement, promotion, and sponsorship
• World Framework Convention
• WHO (2008)- Mpower Monitor/Protect/Offer/Warn/Enforce/Raise
• State and Federal Mandates
• 1998 Tobacco Master Settlement
• Tobacco companies targeting youth and increasing international exports

Question 13

International Agencies and Organizations

Answer 13

World Health Organization (WHO)
Pan American Health Organization (PAHO)
Non-Governmental Organizations
* Carter Center
* Bill and Melinda Gates Foundation
* United National International Children’s Emergency Fund (UNIFEF)
* Centers for Disease Control and Prevention (CDC)
* International Council of Nurses (ICN)
* U.S. Department of Health and Human Services (USDHHS)

Question 14

International Health Care delivery system

Answer 14

• A single model of health care delivery may not be acceptable for every country
• Participatory approach to health care delivery with societal commitment to address complex issues of poverty, disparity, and health care inaccessibility.
• We learn from each other

Question 15

Delivery systems

Answer 15

Market based versus Population based
Re-engineering nursing roles and health care delivery
* NP specializations
* DNPs
* Solving complex health problems globally

Question 16

Role of the Community Nurse- Global Health

Answer 16

Less Traditional
https://wwwnc.cdc.gov/travel
Research- evidence-based practices

Example-Model of Community Empowerment-Purpose= community assessment, education, and health care delivery.
If community is not fully engaged, the project will be unsustainable.

Community Assessment
Planning/intervention
Implementation
Evaluation
Health Service Delivery
Example-Home health care bridging the gap between hospital and community-based care.
Disaster preparedness and emergency response

Question 17

Take Home Points

Answer 17

• Global Health requires commitment from society to address the complexities of poverty, disparity, and inaccessibility (Nies & McEwen, 2019).
• Nurses must be willing to have hands-on experiences with diverse populations. In doing so, they will learn to partner with other disciplines and organizations to solve emergent health problems worldwide.
• Global Health Nursing from the community health perspective requires specialized skills and broad/diverse knowledge of healthcare practices and systems.

Question 18

Environmental Health

Answer 18

“All the physical, chemical, and biological factors external to a person, and all related behavior, but excluding those natural environments that cannot reasonably be modified.” (WHO, 2016).

Question 19

Environmental Health - 5 pillars

Answer 19

Disease control,
Water, sanitation and hygiene (WASH),
Built environment,
Occupational health and
Food safety and hygiene (FSH)

Question 20

Areas of environmental health

Answer 20

• Built environment
• Work-related exposures
• Outdoor air quality
• Healthy home
• Water quality
• Food safety
• Waste management

Question 21

Healthy People 2030 Environmental Health Objectives

Answer 21

Reduce the number of days people are exposed to unhealthy air — EH‑01
Increase the proportion of schools with policies and practices that promote health and safety — EH‑D01
Increase trips to work made by mass transit — EH‑02
Reduce diseases and deaths related to heat — EH‑D02
Increase the proportion of people whose water supply meets Safe Drinking Water Act regulations — EH‑03
Reduce blood lead levels in children aged 1 to 5 years — EH‑04
Reduce health and environmental risks from hazardous sites — EH‑05
Reduce the amount of toxic pollutants released into the environment — EH‑06
Reduce exposure to arsenic — EH‑07
Reduce exposure to lead — EH‑08
Reduce exposure to mercury in children — EH‑09
Reduce exposure to bisphenol A — EH‑10
Reduce exposure to perchlorate — EH‑11

Question 22

Critical Theory Approach To Environmental Health

Answer 22

Upstream Thinking

Ask the tough questions

Involve the community

Implement change

Monitor for the effects of the change

Question 23

landmark federal environmental legislation

Answer 23

1970-Clean Air Act

1971-Lead-based Paint Poisoning Prevention Act

1972-Clean Water Act

1974-Safe Drinking Water Act

Question 24

Flint Water Crisis

Answer 24

Water Decisions taken by emergency managers - switching from Lake Huron to the Flint River
Outbreak of legionnaire’s disease
incidence of lead poisoning in children doubled
56% population is black, 40% living below poverty line
only a fraction of white inhabitants living under EM
PTSD related to water supply, wanting to leave
decrease in home values - adversely affecting residents