global patterns of health, mortality and morbidity Flashcards
non communicable deaths a yr
41 million (74% of deaths) WHO 2023
2016 WHO, X% between 30-65 age and Y % of NCD occur in low an dmiddle incoem ocuntries
36.5, 77
HIV/AIDS
cause of 1million deaths in 2016 but now outside top 10 causes of deaths (changin to NCD)
covid deaths
7 million
most unhealthiest city in UK
Peterborough
england LE
78.8 Male
norfloko study
1990-2008, 45% increase int akeway outlets
biggest expnasion in poorer areas - 58% of increase
4 million die a yr from undernourishment where?
subshara
who created theETM
Abdal Omran 1971
phases of the epdiemology transiton model
the age of infection and famine
the age of receding pandemics
age of degenrtave and man made deiseases
WHo added 4th stage
Olshansky and Ault- age of delaye ddegenrtaive diesease
possible fifth stages
age of reemergence of indefectious and paratsic disease (2002 Martens)
age of inactivyt and obesity
age of helahty lviing
malrai was nealry erdaicte din the mid X century bys praying DDT in infeste areas, but retruned in X - eolved ot be rsistant
20th cenutry, 1963
Flood
2004 flood Bnagldesh 17000 pateints
Coccidioidomycosis
oubreaks assoicated iwth wet weather - encourage growth of coccidiodes and then dry which increases transmission of the spores - inhaled to cause the disease
2018 unplanned flooding reposnbile for X % of all detahs from naturla diasters
24%
glasgow effect
X die from air pollution - indoor and outsoor
7 million a yr
X% of the world lives in places with air quality exceeds WHO guidelines
71%
delhi level of pollution
153 ug/m3- WHO guidlines 10
every X minutes someone dies in India
2
air pollution X% in 2017
9
2%- HICs
15%- south and east asia
greenpeace report
- A Greenpeace report published in 2019 analysed air pollution readings from 3,000 cities around the world and found that 22 of the 30 most polluted were in India, with Delhi ranked as the most polluted capital
- Every city in Africa and the Middle East measured in the report exceeded the WHO health guidelines for air pollution, as well as 99 per cent of cities in south Asia and 89 per cent in east Asia.
x% of outdoor pollution deaths in developing countries
91
indoor pollution deaths
2.3 million 2019
X% of premature deaths due to pnemouina among under 5s - cause by inhalign soot from household air polltuion
50
X many wihtout access to safe drinkign water
785 million
deaths from poor water quality
1.5 million 2019 WHO
diarrheaol cases a yr
829 000
x suffered from schistosmiasis
240 million
between 2000 and 2017, X gained access to imporved dirnkign water supply
1.6 billion
malaria cases 2022
249 million
number of deaths malaria 2022
608 000 (2000 down from 2021)
africa - X% of cases and X% of deaths
2022
94% , 95%
limits of tranmission
> 1500m alitide
<1000mm of rain
temp and humidity needed for malaria
16-32 degrees
60%
X of malria burden in in X poorest
2/3rd , 20%
study in Malawi
net ownerhsip largely absent in housholds with hea dof household not primary educated
malria accounts for X5 of public health expenditues in west and central africa
40%
global direct costs of malria
15-18 billion a yr
2001 - 2015 - malria stats
1.2 b fewer cases, 6.2 billion fewer deaths
the global fund to figths AIDs, TB and Malria provides X% of all fund to malria programs
65
gate sofundation
140 million for 4 yrs
bed nets can reduce transmiison by
90%
2018, X of people at risk were portected by ITNs
half
who got nobel peace prise in 2015 for discovering arteminism
Tu Youyou of China
new vaccine
Mosquirix
prevnted 4/10 cases in 4 yr period
2008 - in Kbale, Afro Alpine Pharma
hired 500 local famers to grow low cost drugs
number of CHD deaths a yr
9.4 million (leading cause worlwide)
number of CHD deaths UK a yr
94 000
since X more popel have died from CHD than anythign else
1990
opt temp for low CHD deaths
london 19.3-22.3 degrees
X-X% of those who died had at leats one major risk fatcir
75-85
how many deaths due to smoking a yr in developed
20 000
glasgow deaths
138 / 100 000
hart, hampshire
39/ 100 000
x% of detahs due to hypertension
47%
inactivyt accounts x% of chd deaths in us
35
ethincity uk
south asian more likley to die than white europeans
CHD cost uk x a yr
7.4 bn a yr
overall - 15.8 bn a yr
us cost of chd a yr
220 bn a yr
world heart day
29th sept
NZ
- NZ- using labels for healthier foods forces many food companies to reformulate products to be applicable for these lable s- lead to a large decrease in the slat content of processed foods
Mauritus
- In Mauritius, cholesterol reduction was achieved by a government led effort to switch the main source of cooking oil from palm oil to soya bean oil which contains significantly less cholesterol.
japan
- In Japan, government led health campaigns have greatly reduced general salt consumption in the diet of the Japanese people. Coupled with increased blood pressure treatment, the blood pressure of the population has been reduced nation-wide.
who
- WHO , established 1948
- Role is direct and coordinate international health with the UN system
- Top priorities in 1948 were
Combat communicable disease – influenza, malaria, TB and venereal disease
Address mother s and children’s health to help them survive to be healthy
Improve nutritional levels and environmental snatiation
o Now also provides advice and support in non communicable disease such as cancer and CVDs
o Recently its attention on HIV/AIDs and Ebola and COVID
o 194 member states and 6 regional offices
o It is responsible for
The international classification of diseases- the worldwide standard for clinical and epidemiological purposes
Advises national ministries of health
Advises on prevention and treatment on both communcibale and non -communcable dises
Works with other UN agencies, NGOs on health issues and crisi
o Crticism
Overbureacratic and lacking the practical front line application to health issues - However the organisation’s ability to focus, promote and co-ordinate efforts to tackle health problems on an international scale, using international experts and collating the most recent research, has achieved undeniable progress and success. Most notably
1970S- eradicted small pox – the only major infectious diesases ot every be compelty eraidcted
1988- lauhce dits global polio eradication itiave , by 2006 the number of cases reduced by more than 99%
Adoption of the MDGs in 200
WHOs strategy for women and childrens health – and the ‘every women, every child’ movement saved 16 million women and children - 2016- expanded to adolsecents
o Continuing challenges
Antimicrobial resistance
Promoting universal health coverga e]comabtign neglected tropical disease
other un agencies
Other UN bodies engaged
- Joint UN Programme on HIV/AIDs
UNAIDs – tries to achiev universal access to HIV prevntin, treatment care and support
Form edin 1994
- the UN Population fund – in support for reproductive, adolescent and maternal health
- UN Children’s Fund – UNICEF
o Prioties include
Reducing child mrotlaity
Ending preventable maternal ,newborn and child deaths by scaling up immunisation programmes
Supporting pneumonia, diarrhoea and malrai services
Tackling health emrgencie sin places with conflcist, natural diaster, migrnats, or political or economic instability
Helping to develop resilient health system that can withstand
- World Bank – vital source of financial and technical assistance to developing countries – investment in health
Has a $34 billion global health protfoloio of 240 porjects
Committed to helping governments to achive universal health coverge by 2030 – all people can obtain health services without suffering financial hardship
EXAMPLE – Medecins San Frotniers – Docotrs without bordeers
EXAMPLE – Medecins San Frotniers – Docotrs without bordeers
- Since 1971, MSF has cared for millions caught up in crises- natural diaster, conflict, fmaines, refugee exodus and people elxcued from healthcare
- employs 35 000
- 90% recruited locally by European manager ]majority are local doctors, nursers and othe rmidecial special – also recruit logistic experts and water and sanistion engineers
- Work in over 74 countries
What DOES It do?
- Tackle COVID, Cholera, Ebola, malaria, meningitis and HIV
- Also trats malnutrition with ready to use therapeutic food- RUTF – includes all the nutrients chidlrne need – mainly peanut buter paste
Has revoltuionsed treatment of serve malnutrition – can be stored for long epriods and ina variety of settings
o Invaluable field research to genrst evidence to improve effecitness and quality of clinical care they provide
Researching mulit-drug resistant TB, HIV/AIDS, neglected tropical disease – Chagas and kalaazar and mental health
o A watchdog to protect public health againt corpate interest
o Initated ‘Campiagn for Access to Essential Medcicines’ – since been joined by other NGOs
Lobbies ogvernments and pharmeitical – challenging the high cost of medicine and abcne of tratemnt for many of the diseases affecting pateints in developing countries
Pushed for price cuts and encourages proddcution of more afrorabel generic products
Funding
- 2019- 96.2% of funding came from 6. 5 million indivudal donours aorudn the world – ensures operational inderpeandce and fleixbity – remaing funds come from governments and IAs
- MSF does not accept codnitbutes from companies in industries who comprosie their ability rto provide indepdnt health care
E.g. tobacco, mining and pahrmacetucial idnsutries
Since 2016, it has resufed funding from the EY
In proets at the UEs reluctance to accept more migrnats fleeing sfrom conflicts in the Middles Eats and te EU ‘s deal with Turky to hold more refugees there
