Global public health

Question 1

high-income countries

Answer 1

> 12.000 dollars/person/year

Question 2

upper-middle-income countries

Answer 2

4.000-12.000 dollars/person/year

Question 3

lower-middle-income countries

Answer 3

1.000-5.0000 dollars/person/year

Question 4

low-income countries

Answer 4

<1.000 dollars/person/year

Question 5

developing countries

Answer 5

• Poor supply of food to big groups of the population –> malnutrition and hunger
• Low per capita income, (absolute) poverty
• No/poor healthcare, high infant mortality rate, low life expectancy
• Low education opportunities and high illiteracy
• High unemployment, low standards of living
• Extremely unequal distribution of available goods

Question 6

relative poverty

Answer 6

poor relative to your environment

Question 7

absolute poverty

Answer 7

can not afford to life

Question 8

Indicators for health in a population

Answer 8

• Life expectancy
• Infant/ maternal mortality rate
• Causes of death/ prevalence of certain diseases
• Burden of disease/ disability-adjusted life years

Question 9

forms of financing health services

Answer 9

• social insurance model
• market model
• coverage by government services
• out-of-pocket payment

Question 10

social insurance model

Answer 10

Insurance system with largely compulsory insurance
- Based on contributions from employers and employees in formal employment relationships
- Triangular relationship between compulsorily insured persons, health insurers and health care; contributions staggered according to income

Question 11

market model

Answer 11

predominantly voluntary insurance
- Services are billed between patients and providers and (depending on the contract) reimbursed by insurance companies

Question 12

coverage by government services

Answer 12

• National health services
• Largely financed from tax money

Question 13

Indicators for health service quality

Answer 13

• Public health expenditure as % of GDP
• Doctors, other medical personnel
• % of population with access to clean drinking water
• % of population with access to sanitation
• Cost and quality of medical treatment
• Hospital beds per inhabitant
• Registration of births
• Registration of causes of death

Question 14

determinants for health outside of healthcare

Answer 14

• social policy orientation
• corruption control
• basic need securing
• working conditions
• energy supply

Question 15

social policy orientation

Answer 15

Basis for sound health policy financing; bridge to understanding of health policy as a human right

Question 16

corruption control

Answer 16

Preventing the increase in the cost of health care services through illegal appropriation of partial costs (e.g., hospital construction, procurement of drugs, medical facilities and equipment)

Question 17

basic needs securing

Answer 17

basic medical care that ensures social participation (orthopedic devices, dentures, etc.)

Question 18

working conditions

Answer 18

Accident prevention, acceptable indoor air, no hazardous substances

Question 19

energy supply

Answer 19

Reduction of air pollution from unclean fuels, risk of catastrophes due to rupture or overflowing of dams

Question 20

environmental risk factors for health

Answer 20

• Air pollution: respiratory, lung and heart diseases, cancer
• Polluted drinking water: Various infectious diseases; chronic diseases due to insidious poisoning (heavy metals etc.)
• Disposal problems (household wastewater and insufficient waste disposal): Infectious diseases, parasites, air pollution due to waste incineration (see above)
• Ecological pollution at the workplace: Respiratory diseases, poisoning, cancer
• Exposure to pesticides in agriculture (farm workers, growing regions, food): Cancer and various chronic diseases, poisoning, hormonal disorders
• Use of drugs in livestock farming: Development of resistance in pathogens against the active substances of medicines

Question 21

factors influencing health development

Answer 21

• Access to quality care –> social inequality
• Infrastructure
• Urban/rural differences: considerable differences in the health situation between urban and rural, especially very remote areas, which is reflected in infectious diseases as well as maternal and infant mortality
• Ecological conditions:
  
  • Geography
  • Consequences of poverty-related practices (open fires in small rooms, inadequate hygiene)
  • Modernization-related developments (emission, electricity, transport)
• Political frameworks:
  
  • Power and interest structures in general
  • Corruption
  • Health care financing

Question 22

difficulties for the catch-up of developing countries

Answer 22

• Transfer of systems into completely different social contexts
• Medical innovations: not oriented to the needs of poor countries
• Investments in medical research and the development of drugs are based primarily on the ability to pay
  
  • Disproportionate spending on research into drugs for the typical diseases of the Global North
  • Phenomenon of the so-called “neglected diseases“
  • Problem of patent law: more or less a ban on imitation products and makes the catch-up development of innovation capacities more difficult

Question 23

sustainable development goals

Answer 23

17 goals to improve the world
health goes together with
- 1: end poverty
- 2: stop hunger
- 5: gender equality
- 6: acces to water and sanitation
- 11: sustainable cities and communities
- 16: peace, justice and strong institutions