Human- Health Flashcards

1
Q

Where are the worlds highest mortality?

A

LDC- Sub-Saharan Africa.

Liberia, Niger and Sierra Leone all have death rates above 20 deaths per 1000 per year.

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2
Q

Where are some of the worlds lowest mortality rates?

A

Mexico- improved medical facilities and standards of living but not affected by diseases of affluence.

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3
Q

What is the pattern of HIV/Aids?

A

25/40 million of people with Aids live in Sahara- Africa.

5/7 million Aids cases in Asia are in India

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4
Q

What diseases affect MDC’s?

A
  • Affluence (lifestyle choice)

- Obesity increasing in North America and Western Europe

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5
Q

Why is coronary heart disease decreasing?

A
  • Better diagnosis
  • Increased public awareness
  • Better treatment
  • Significant reduction in number of smokers. 60% cases occur in Newly industrialised countries such as India and China because of smoking.
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6
Q

What is the biggest cause of death in developing countries?

A

HIV-AIDs

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7
Q

What is the biggest cause of death in developed countries?

A

Heart disease

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8
Q

What is health?

A

A state of complete physical, mental and social well-being and not merely the absence of diseases and infirmity

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9
Q

What is morbidity?

A

Illness and the reporting of disease. In the Uk 2001 census respondents were asked how well they felt and whether they had a limiting long-term illness. Some diseases are so infectious that they must be reported by law e.g. Cholera, plague

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10
Q

What are the causes of death in developing countries?

A

1) Poor health infrastructure
2) Lack of education on how diseases are spread
3) Low incomes result in poor health choices/diet- compromised immunity

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11
Q

What are the main reasons for death in developed countries?

A

1) Longer lifespan- diseases of old age
2) Lifestyle- food style, sedentary
3) Healthcare- well developed

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12
Q

What is mortality?

A

The death of people. It is measured by a number of indices including death rate, infant mortality, case mortality and attack rate

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13
Q

What is infant mortality?

A

The number of deaths of children under the age of 1 per 1,000 live births per year. It is a useful direct measure of social and environmental conditions as it is sensitive to changes in either.

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14
Q

What is crude death rate?

A

The number of deaths per 1,000 people per yeart

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15
Q

What is a disease?

A

A bodily disorder preventing good health

  • Characteristics signs and symptoms
  • Simple or multifactorial cause
  • Acute or chronic
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16
Q

How can we categorise disease?

A
  • Part of the body affected
  • Where it is found in the world
  • Who it affects
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17
Q

Define endemic

A

An infectious disease that is always present in an area

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18
Q

Define epidemic

A

When a disease spreads quickly to affect large numbers of people in an area.

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19
Q

Define pandemic

A

An epidemic that spreads over a large area such as a continent or the world.

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20
Q

What does YLDs stand for?

A

Years lived with disability

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21
Q

What does DALYs stand for?

A

Disability adjusted life years- The sum of potential life lost due to premature mortality and the years of productive life lost due to disability.

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22
Q

What are some impacts of disease on health?

A
  • Reduced life expectancy

- Death

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23
Q

What are some impacts of disease on economic development?

A
  • Insurance and benefit costs
  • Less taxes
  • Net migration
  • No employment
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24
Q

What are some impacts of disease on lifestyle?

A
  • Dependence
  • Community disruption
  • Disability access
  • Limitations e.g. driving
  • Stress on family
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25
Q

When did Ebola first appear?

A

1976

Sudan and DR of Congo

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26
Q

How is Ebola spread?

A
  • Close contact with the blood, secretions, organs or other bodily fluids of infected.
  • Consumption of infected meet.
  • Touching objects that have been in contact with someone infected.
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27
Q

What is the source of Ebola?

A

Fruit bats and then through the food chain.

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28
Q

What are the first symptoms of Ebola?

A
Fever
Weakness
muscle pain
Headache
Sore throat
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29
Q

What are the initial symptoms of Ebola followed by?

A
Vomiting
Diarrhoea
Rash
Organ impairment
Internal and external bleeding
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30
Q

What is the incubation period for Ebola?

A

2-21 days

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31
Q

Why has Ebola spread so easily in Sierra Leone?

A

Civil war- 1991-2002
Lack of infrastructure
Urbanisation
3 borders

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32
Q

Give some facts about Sierra Leone?

A
  • 70% of its capital is a slum
  • In 2010, only 13% of people had access to a proper toilet
  • Only 43% of adults are literate
  • 120 doctors provide for 6 million people- 50,000 patients per doctor.
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33
Q

Talk about the distribution of Ebola?

A
  • No more than 10 cases in any individual country outside of Africa
  • Nearly 10,000 people in Sierra Leone have had Ebola.
  • No more than 100 cases in parts of Africa other than the West.
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34
Q

What are infectious diseases caused by?

A
  • Pathogenic microorganisms such as bacteria, viruses, parasites and fungi
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35
Q

What are the impacts of Ebola on health?

A
  • 50% people infected with Ebola die
  • Patients contagious once they show symptoms
  • Extremely unpleasant symptoms
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36
Q

What the impacts of Ebola on the economy?

A
  • West Africa has urged tourists to keep visiting

- Safari tours down even in Kenya and tourism lower in South Africa.

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37
Q

What are the impacts of Ebola on lifestyle?

A
  • People don’t want to go outside for fear of contracting Ebola
  • Tribes separated by border and refugees from the civil war- borders closed- causes great anxiety as people cannot visit friends and family.
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38
Q

What have been the economic impacts of Ebola in Sierra Leone?

A
  • UN estimates 47% of farmers work has been considerably disrupted by Ebola.
  • 40% of farmers have abandoned their land.
  • Seasonal workers not participating in harvest- push rural communities into poverty and create food shortages
  • Most seriously affected area responsible for 18% rice output- 30% price increasep
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39
Q

What are the management strategies for Ebola?

A

1) community awareness/ acceptance
2) Safe burials
3) Contact tracing
4) Alert and surveillance
5) Medecins Sans Frontieres
6) Protective equipment

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40
Q

What are the key messages for community awareness (Ebola)?

A

Protect yourself
Protect your family
Protect your community

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41
Q

How do safe burials help the management of Ebola?

A

Health facility staff:

  • prepare body safely
  • Aware of family’s cultural and religious practices
  • Help family understand practices
  • Counsel
  • Identify head family member to give instructions
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42
Q

What is contact tracing (Ebola)?

A
  • Finding everyone who has come into contact with a sick Ebola patient
  • Contacts watched for signs of illness for 21 days after they have been in contact with an Ebola patient
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43
Q

What is Medecins Sans Frontieres

A

Deployed 3,900 medical staff.

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44
Q

What is malnutrition?

A
  • Condition resulting from dietary deficiency.
  • Can be caused by the quantity of food, measured in calories per day. It may be too high or too low because certain important nutrients are absent or in oversupply in the body.
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45
Q

What is overnutrition?

A
  • Choosing to eat more food than you need, even if you don’t realise it.
  • The frequent or habitual overconsumptions of nutrients by eating too much food to the point that it becomes dangerous to your health.
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46
Q

What is undernutrition?

A
  • Condition caused by consuming too little food over a period of time.
  • Occurs when people do not eat enough nutrients to cover their needs for energy and growth, or to maintain a healthy immune system.
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47
Q

What is periodic famine?

A
  • A repeated decline in the access to food due to a number of causes rather than there not being enough food.
  • Can be localised and affect just one group or social class of people.
  • Widespread scarcity of food, caused by several factors including crop failure, population unbalance or government policies.
  • Not uncommon to see food available in markets and agricultural products being exported.
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48
Q

What were the causes of famine in Ethiopia 2000?

A

1) Drought
2) Conflict
3) Overpopulation

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49
Q

How did drought cause famine in Ethiopia?

A
  • Prior to 2000, Ethiopia had suffered 3 years of drought- pastoral society dependent on agriculture.
  • Ethiopia rarely manages to grow enough food to feed its population anyway.
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50
Q

How did conflict cause famine in Ethiopia?

A
  • Dependent on food aid, which is delivered to ports in Eritrea before being transported to Ethiopia. As a result of war, Eritrea stopped the food trucks at they feared they would be used for the military.
  • Due to war, there is a lack of investment in roads, healthcare, water supplies and electricity.
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51
Q

How did overpopulation cause famine in Ethiopia?

A
  • Ethiopia’s population is rapidly increasing, so land is divided into increasingly small parcels.
  • More marginal land is being used to grow crops therefore the soil has become exhausted of nutrients and soil erosion is a big problem.
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52
Q

What are the economic impacts of the Ethiopian famine?

A
  • Shortage of food led to price rises. No money for healthcare and forced to sell key assets.
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53
Q

What are the lifestyle impacts of the Ethiopian famine?

A
  • Children were removed from school as fees couldn’t be paid and they needed them to work.
  • 1000’s of families moved to camps outside the cities due to the insupportable land.
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54
Q

What was the impact on health of the Ethiopian famine?

A
  • 43% of population are affected, particularly children and the elderly
  • death
55
Q

What were the short term solutions of the Ethiopian famine?

A
  • Foreign aid
  • Donation of clothing and dry food from the West.
  • Initially, it was non-government organisations such as Oxfam offering aid.
56
Q

What were the long term solution to the Ethiopian famine?

A
  • Us government funded establishment of a new early warning system to enable Ethiopian to be more alert to impending shortages.
  • Rural transport and roads improved to enable quicker delivery of food.
  • Increase and restore the 350,000 metric tonnes of food that is in reserve.
  • In the north, soil conservation projects have been developed to conserve water and prevent overgrazing from occurring.
57
Q

Define obesity

A

Overweight and obesity are abnormal or excessive fat accumulations that may impair health. Anyone with a BMI of more than 30 is obese.

58
Q

Define overweight

A

A BMI between 25-30

59
Q

How do you calculate BMI?

A

w (kg)/ h2 (kg/m2)

60
Q

What are some of the causes of the rapid increase in obesity?

A

Convenience foods
Labour-saving devices
Motorised transport
Sedentary jobs

61
Q

Give some facts about childhood obesity?

A
  • 20 million children under 5 years were overweight in 2005.
  • No standard definition of childhood obesity.
  • Higher chance of premature death and disability.
62
Q

What are the main causes of obesity?

A
  • Energy imbalance between calories consumed and calories expended.
  • Global shift in diet to high fats and sugars, but low in vitamins and minerals.
  • More processed foods.
  • Less physical activity.
63
Q

What are the consequences of obesity?

A
  • cardiovascular disease kills 17 million people each year.
  • WHO suggests diabetes will increase by 50% in the next 10 years.
  • Increased risk of cancer
  • Coronary heart disease
64
Q

What are some of the economic consequences of obesity?

A
  • bariatric ambulance costa up to £90,000
  • In the USA they have ‘triple width coffins’ capable of holding 300Kg bodies.
  • Airline seats are increasing
  • Loss of earnings
  • Long term sickness
  • Inability to support oneself and family
  • Benefits
  • R & D
65
Q

What are some of the tactics used to reduce obesity?

A
  • Reduction in calorie intake and more exercise
  • EU legislation and UK government healthy eating campaign e.g. change for life.
  • By 2050, overweight and obese people could cost the taxpayer in England £50 billion.
  • Campaigning for clearer packaging
  • Celebrity involvement e.g. Jamie Oliver
  • Colour-coded labelling-red, amber, green
66
Q

What is the case study for obesity?

A

Nauru, Pacific island

67
Q

What are the causes of obesity in Nauru?

A
  • Imported food shows wealth
  • Increased use of transport. e.g. canoes for boats
  • Buy cheap foods rather than nutritionally beneficial ones.
  • Sedentary jobs
  • Don’t take advantage of healthcare
  • Average calorie intake for a male 20-39 is 8,700 calories.
  • Large size is considered a mark of beauty and social status.
68
Q

What are the effects of obesity in Nauru?

A
  • It takes 20 years for diabetes to appear in populations that adopt a lifestyle of high calorie intake and little or no exercise.
69
Q

What are the responses to obesity in Nauru?

A
  • The West is unlikely to help because they believe they need to take responsibility.
  • Health minister is leading the way through a government-sponsored exercise program.
  • Government drive to substitute imports for local foods which would also help the economy.
  • Prizes given in ‘total weight loss’ and ‘maintaining weight loss’ with the local media involved.
  • People are told to walk 3 miles every day.
70
Q

What type of healthcare system does the USA have?

A
  • Pluralistic
71
Q

What are the advantages of the American healthcare system?

A
  • 250 million people insured

- Very advanced technology

72
Q

What are the disadvantages of the American healthcare system?

A
  • Medicare and medicaid- very basic healthcare for the very poor
  • Drugs are very expensive
  • People have to keep working in order to afford healthcare
  • Insurance policies don’t cover everything e.g. ambulance
  • Can be rejected for health insurance
  • Needs aren’t fully met
  • Run for profit
73
Q

How many people in the USA are without health insurance?

A

44 million

74
Q

What is Cuba’s health system?

A

Socialised

75
Q

What are the advantages of the Cuban health system?

A
  • 2nd highest number of doctors per head of population
  • Free universal healthcare
  • Lower infertility rates and longer life expectancy
  • Drug $120 in USA but only 5 cents in Cuba
  • Preventative methods
76
Q

What are the disadvantages of the Cuban healthcare system?

A
  • Not always the best technologies with little access to experimental drugs.
77
Q

What is healthcare?

A

The prevention, treatment and management of illness and the preservation of mental and physical well being through services offered by the medical, nursing and allied health professions.

78
Q

How does Cuba’s health service compare to the USA’s?

A

WHO ranks Cuba just below the USA despite depending ten times less per person.
21 medical schools providing free training, and many doctors are exported to other countries

79
Q

What is the case study for a disease of affluence?

A
  • A chronic disease which occurs when the pancreas doesn’t make enough insulin or when the body cannot effectively use the insulin it has created.
  • Insulin regulates blood sugar levels.
80
Q

What are the 3 types of diabetes?

A

1) Type 1
2) Type 2
3) Gestational

81
Q

What is type 1 diabetes?

A
  • Lack of insulin production
  • Fatal without daily insulin administration
  • Symptoms- excessive urination, thirst, hunger, weight loss, vision change and fatigue
82
Q

What is type 2 diabetes?

A
  • Body’s ineffective use of insulin.
  • 90% of diabetes
  • Result of excess body weight and physical inactivity
  • Similar symptoms to type 1 but less noticeable so complications may already have arisen by the time it is diagnosed.
83
Q

Give some facts about diabetes…

A
  • WHO estimates 180 million have diabetes, set to double by 2030.
  • In 2005, over 1 million people died from diabetes
  • 80% diabetes deaths occur in developing countries
  • WHO projects diabetes deaths will increase by more than 50% in the next 10 years particularly in developed countries.
84
Q

What are the health consequences of diabetes?

A
  • After 15 years 2% become blind and 10% develop a severe visual impairment due to accumulated damage to small blood vessels in the retina.
  • Damage to nerve affects 50%.
  • Reduced blood flow causes foot ulcers and even amputation
  • Increased risk of heart disease and stroke- 50% die from cardiovascular disease.
85
Q

What is the economic burden of diabetes?

A
  • WHO estimates over the next 10 years, China will lose $558 billion due to heart disease, strokes and diabetes.
  • Blood monitoring equipment, test strips, medication and insulin.
  • Life insurance more difficult to get.
  • Costs of changing diet, gym memberships and exercise equipment.
86
Q

What are the lifestyle impacts of diabetes?

A
  • Change in diet affects family meal times and going out.
  • Feeling thirsty and hungry
  • Not sleeping well
  • Women lose interest in sex
87
Q

How can the burden of diabetes be reduced?

A
  • Healthy body weight
  • Physically active- 30 minutes per day
  • Early diagnosis through inexpensive blood testing
  • Avoidance of tobacco
  • Blood pressure control
  • Foot care
  • Screening for blindness and kidney disease
88
Q

What is WHO doing to prevent and control diabetes?

A
  • Scientific guidelines for diabetes prevention.
  • Norms and standards for diabetes care
  • Awareness on the global epidemic of diabetes
  • Surveillance of diabetes and its risk factors
89
Q

What is a TNC?

A
  • Trans National corporation
  • Company operating in 2+ countries
  • HQ and R&D in country of origin but manufacturing overseas
90
Q

What are the different sections that TNC’s take part in?

A

Primary- Resource extraction e.g. BP
Secondary- Apple, HP, cereal deodorant
Tertiary- Banking, lawyers, marketing

91
Q

Describe generic drugs

A
  • Name of chemical
  • Hard to remember
  • Less sales
92
Q

Describe branded drugs

A
  • Anywhere from 3 to 30x more expensive
  • Same chemical as in generic
  • Marketing-catchy brand name
  • Companies pressure governments to use their products
93
Q

Describe essential drugs

A
  • ‘Essential drugs’ published by WHO are are generic drugs providing safe effective treatment for most communicable and non-communicable diseases such as diarrhoea.
  • Unpopular in countries with strong pharmaceutical industries and list is not published in the USA or any EU country after the USA was sued.
94
Q

Describe drug development?

A
  • More money on diseases of affluence e.g. cancer rather than tropical diseases which kill hundreds of millions of people.
  • Patents on drugs which are viewed a sintellectual property meaning no one can produce generic copies for up to 20 years.
  • Money comes from development- profit
95
Q

Describe the marketing and distribution of drugs

A
  • Consumers don’t often get to choose the drugs they are given.
  • TNC’s market to doctors using free trials, everyday items, advertisements in medical journals and the visits of sales representatives to surgeries and offices.
  • Drugs treat symptoms rather than the cause of the illness- benefit from illnesses
96
Q

How are TNC’s significant in the world

A
  • Control and coordinate economic activities and develop tarde in different countries
  • Exploit differences in the availability of capital and costs of labour, land and building
  • Locate for advantage such as reduced tax levels, subsidies/grants or less strict environmental controls.
97
Q

What is GSK?

A

Pharmaceutical company

GlaxoSmithKline

98
Q

Give 5 facts about GSK

A
  • Nearly 100,000 employees
  • £7.8 billion profits in 2007
  • 99 cities in 39 countries
  • 2nd largest research and pharmaceutical company
99
Q

What are the negatives of pharmaceutical research?

A
  • Diseases of affluence
  • Diseases like Malaria receive less money for research because the countries cannot afford them
  • Profit- 20 year patents stop generic production of life-saving drugs
100
Q

What is GSK doing regarding pharmaceutical research that is positive?

A
  • Only pharmaceutical company to prioritise development and research of medicines and vaccines for 3 priority diseases which include HIV and Malaria.
  • 1300 scientists investigating preventative diseases
  • 19 R&D projects in developing world
101
Q

What evidence is there that branded drugs are just a way to make profit and not to improve health?

A
  • Patent so the company who invents the drug controls the prices
  • Largest profits from branded drugs
  • In the US, government is not allowed to suggest the use of generic drugs.
102
Q

What evidence is there that GSK is actually trying to improve health and not just make a profit?

A
  • Has stated it will cut its prices for all drugs in the 50 least developed countries to 25% the cost in the UK and US.
  • More affordable drugs for middle-income countries like Brazil and India.
  • Puts chemicals and processes which are there intellectual property relevant for finding drugs for neglected diseases into a ‘patent pool’ so others may develop them.
103
Q

What is some evidence of the negative way drugs are marketed for profit?

A
  • Companies target doctors rather than patients
  • Symptoms are treated rather than the cause- curative rather than preventative
  • Drugs exist that are not accessible to sufferers in poorer countries because they cannot afford it
104
Q

What is GSK doing to reduce the bad image of big pharma marketing?

A
  • GSK provided 206 million tablets at special prices to poorer countries, including 120 million of which are generically made.
105
Q

What effect has the smoking bans in public places had?

A
  • Smokers have reduced their consumption by 15%

- Smokers chances of quitting have increased by 84%

106
Q

Give some general facts about cigarettes?

A
  • The smoke contains 4,000 chemical agents
  • 5.5 trillion cigarettes smoked every year.
  • 1.1 billion smokers in the world, 800 million of them in developing countries.
107
Q

What consequence has smoking and advertising bans in MEDCs had?

A
  • Market sin MEDCs have declined

- Tobacco TNC’s are looking towards developing countries like China to guarantee new smokers and continued profits.

108
Q

What are the effects of smoking on your health?

A
  • Greatest cause of death and disability than any singular disease.
  • Five million deaths per year.
  • Related to 25 diseases
  • 5x more likely to have a heart attack
  • Increases risk of cancers
  • During pregnancy it increases likelihood of miscarriages and inhibits child development
  • Sudden infant death syndrome
109
Q

Give some facts about BAT and smoking in Mauritius?

A
  • 1/3 of children aged 13-15 smoke.
  • Single sticks for 7p
  • Free pots to hold single sticks
  • Controls nearly 99% of market
  • Advertising banned but goes on in disguised forms
  • Music festivals with 120,000 people and also televised.
110
Q

Give facts about BAT and smoking in Malawi?

A
  • Less than 10% of people smoke but tobacco is the biggest commercial crop accounting for 60% of exports.
  • Farmer can make 8x more from tobacco than any other crop.
  • Children can’t read warning labels.
111
Q

What does BAT stand for?

A

British American Tobacco

112
Q

What was BAT’s response to criticism?

A
  • Disappointed with evidence found.
  • Since 2006 they have withdrawn the free pots
  • Repainted the shops which were in brand colours
  • Concerts are not targeted at youths and police check age verification.
  • BAT encourages criticism
113
Q

What are the positives of tobacco TNCs like BAT?

A
  • Revenue from tobacco companies generated via tax can fund healthcare. Income from tax is greater to the cost to the NHS from smoking.
  • Extra taxes spent on other things e.g. schools, infrastructure, NHS
  • BAT generates jobs and increases well being in agriculture and factories especially in LEDCs.
114
Q

What has happened to life expectancy in the UK?

A
  • Over 15 years longer than in 2005

- In 1986, difference in male and female was 4 years but by 2005 2.8 yrs.

115
Q

What are some of the causes for patterns of morbidity?

A
  • Age- coastal areas, high health problems due to old people
  • Income and occupation- Blackpool- drinking, North smoking
  • Education
  • Environment
  • Population
116
Q

What is the case study for how health care is provided?

A
  • Sheffield
117
Q

How many people does the healthcare in Sheffield provide for?

A
  • 520,000
118
Q

What are the three hospital groups in Sheffield?

A
  • Sheffield Children’s NHS Foundation Trust
  • Sheffield’s Teaching Hospital NHS Foundation Trust Hallamshire
  • Sheffield’s care trust Northern General
119
Q

Other than the NHS who provides healthcare?

A
  • Private healthcare

- Charitable organisations

120
Q

Give some information about the Sheffield Teaching Hospitals NHS Foundation Trust?

A
  • Five adult hospital services
  • Northern general, Hallamshire, Jessops
  • 900,000 appointments and operations per year
121
Q

Give some information about the Sheffield Children’s NHS Foundation Trust?

A
  • Sheffield, South Yorkshire and beyond.

- Locations throughout city but main hospital is on Western Bank

122
Q

Give some information about the Sheffield Care trust?

A
  • Mental health
  • Elderly, psychology and therapy
  • Learning disabilities
123
Q

Give some information about private healthcare?

A
  • Increasing use
  • Speedy
  • BUPA, insurance, employers
124
Q

Give some information about charitable healthcare?

A
  • Macmillan
  • Wider support
  • Welfare
  • Unpaid volunteers
125
Q

What is the case study for solutions to health problems?

A

Doncaster

126
Q

What is the problem associated with age and nutrition in Doncaster and the solution?

A
  • Child obesity rates are very high

- Scheme Eat Healthy- school meals initiative with fizzy drinks and snacks banned.

127
Q

What is the problem associated with age and healthcare in Doncaster and the solution?

A
  • High rates of teen pregnancy
  • More than a number- Provides advice and information on sexual health and drug abuse.
  • The Jigsaw House- Provides advice, information and counselling for 15-25 on health and wellbeing of young people.
128
Q

What is the problem associated with age and exercise facilities in Doncaster and the solution?

A
  • Under 16’s find it difficult to gain access to health clubs
  • Active Doncaster- Get more people participating and organising sports and physical activities.
  • Over 60’s given free access to health facilities.
129
Q

What is the problem associated with wealth and nutrition in Doncaster and the solution?

A
  • Lowest income groups have the lowest life expectancy

- Health wise Doncaster- 12 week course for adults who want to lose weight.

130
Q

What is the problem associated with wealth and healthcare in Doncaster and the solution?

A
  • 40th of 254 most deprived areas with 600 deaths from smoking per year.
  • Doncaster NHS Stop Smoking services
131
Q

What is the problem associated with wealth and exercise facilities - in Doncaster and the solution?

A
  • High rates of deprivation in Doncaster with low car ownership
  • Active Doncaster scheme and over 60’s provided with free access to health facilities.
132
Q

What is the problem associated with gender and healthcare in Doncaster and the solution?

A
  • Teenage girls and high incidence of pregnancy
  • Contraceptive clinics- STD, teenage pregnancies and breast screening services
  • Year 8 HP Vaccine
133
Q

What is the problem associated with gender and exercise facilities in Doncaster and the solution?

A
  • Under 16 girls in particular
  • Active Doncaster- girl only classes to encourage young girls to participate in sport with Jessica Ennis used as a role mode.