Week 2 - Readings

Question 1

What is the dangerous myth that surrounds global health?

Answer 1

That the HIV/AIDS epidemic is responsible for the emergence of global health and that it should serve as a model for future global health responses

Question 2

What does the author argue that global health is actually about?

Answer 2

It is a way of looking at our world that observe, document, monitor, interpret, and eliminate the harms from forces that impact health
e.g. political, commercial, legal, military, cultural

Question 3

What does the author claim global health was really born out of?

Answer 3

decolonization

Question 4

Who is Frantz Fanon?

Answer 4

An intellectual and writer from Martinique who wrote on the topics of colonialism, de-colonization. Sought to define a new theory of humankind.

Question 5

What is the aim of a Global Burden of Disease study?

Answer 5

to quantify the burden of premature mortality and disability for major diseases or disease groups

Question 6

What summary measure do Burden of Disease studies use?

Answer 6

Disability-Adjusted Life Year (DALY)

Question 7

What are Summary measures of population health?

Answer 7

Measures of the health of a population that combine data on mortality and non-fatal health outcomes into a single number

Question 8

What are 4 Summary measures of population health?

Answer 8

1. Disability-Adjusted Life Year (DALY)
2. Quality-Adjusted Life Year (QALY)
3. Disability-Adjusted Life Expectancy (DALE)
4. Healthy Life Year (HeaLY)

Question 9

What does the DALY measure?

Answer 9

It measures health gaps as opposed to health expectancies.

It measures the difference between a current situation and an ideal situation where everyone lives up to the age of the standard life expectancy, and in perfect health

Question 10

What are some advantages of using summary measures of population health?

Answer 10

ddd

Question 11

How is DALY calculated?

Answer 11

DALY = YLL + YLD

YLL = years of life lost due to premature mortality
YLD = years lived with disability.

Question 12

How is DALY calculated?

Answer 12

Sum of measures of YLL and YLD
DALY = YLL + YLD

YLL = years of life lost due to premature mortality
YLD = years lived with disability.

Question 13

How is YLL calculated?

Answer 13

YLL = N x L

N = number of deaths.
L = standard life expectancy at age of death (in years).

Question 14

What premise is the DALY based on?

Answer 14

the best approach for measuring the burden of disease is to use units of time

Question 15

What are the 2 main value choices that must be made to calculate DALYs?

Answer 15

1. how long “should” people in good health expect to live?
2. how should we compare years of life lost through death, with years lived with poor
   health or disability of various levels of severity?

Question 16

How do you quantify time lived with a disability? (2 ways)

Answer 16

1. point prevalence measures of disability and express them as an annual prevalence
2. measure the incidence of disabilities and the average duration of each disability

Question 17

How does the DALY quantify time lived with a disability?

Answer 17

measure the incidence of disabilities and the average duration of each disability

the number of disability cases is multiplied by the average duration of the disease and a weight factor that reflects the severity of the disease on a scale from 0 (perfect health) to 1 (dead)

Formula: YLD = I x DW x L

YLD = years lived with disability.
I = number of incident cases.
DW = disability weight.
L = average duration of disability (years)

Question 18

What is a disability weight?

Answer 18

To place a value on the time lived in non-fatal health states, health state weights are used to formalize and quantify social preferences for different states of health

Question 19

How is disability defined in burden of disease calculations?

Answer 19

departures from good or ideal health in any of the important domains of health

Question 20

What are 3 additional value choices made in calculating DALYs?

Answer 20

1. Is a year of healthy life gained now worth more to society than a year of healthy life gained sometime in the future, for instance in 20 years?
2. Are lost years of healthy life valued more at some ages than others?
3. Are all people equal? For a given age, do all people lose the same amount of health
   through death, even if current life expectancies vary between population groups?

Question 21

How are years of healthy life valued by age in DALYs?

Answer 21

a year of healthy life lived in adulthood is valued more than one in old age or very young ages

Question 22

What is a discount rate?

Answer 22

People generally prefer a healthy year of life immediately, rather than in the future

• to account for this a (usually 3%) time discount rate is applied to years of life lost in future
• > a healthy year of life gained 10 years from now is worth less than one gained immediately