Global Health Toolkit 1: Goals and Concepts

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Questions and Answers

How is global health defined?

  • A concentration on national health systems and local diseases.
  • An area prioritizing health improvement and equity for all worldwide. (correct)
  • An emphasis on improving mental health in developed countries.
  • A focus primarily on infectious diseases impacting the economy.

Which income classification is defined as countries earning between $1,136 and $4,465 per capita?

  • Upper middle income
  • Lower middle income (correct)
  • Low income
  • High income

What does the term 'hot pops' refer to in global health?

  • Populations living in urban settings only.
  • Groups affected by tropical diseases exclusively.
  • Individuals with high economic status.
  • People who are at increased health risk. (correct)

What is the primary classification measurement used in the Socio-demographic Index (SDI)?

<p>Income per capita, education, and total fertility rate (D)</p> Signup and view all the answers

What is the significance of the inverse care law proposed by Julian Tudor Hart?

<p>The best medical care is available to those who need it the least. (A)</p> Signup and view all the answers

Which of the following regions is NOT recognized by the World Health Organization (WHO)?

<p>East Asia and Pacific (C)</p> Signup and view all the answers

Which of the following countries was recently removed from the G8 group?

<p>Russia (B)</p> Signup and view all the answers

How is the incidence of a disease defined?

<p>Number of new cases per 100,000 people (C)</p> Signup and view all the answers

What historical phase follows Tropical Medicine and International Health in the evolution of global health?

<p>Global Health (B)</p> Signup and view all the answers

What is the focus of PEPFAR in relation to global health?

<p>Combating the global HIV/AIDS epidemic. (B)</p> Signup and view all the answers

Which group of diseases is classified as leading in both high and middle SDI countries?

<p>Group II diseases (B)</p> Signup and view all the answers

Which of the following reflects a concept within equity in global health?

<p>Distributing healthcare resources based on population disparities. (B)</p> Signup and view all the answers

What is considered a cost-effective intervention for averting one DALY?

<p>Costs less than 3 times GDP (B)</p> Signup and view all the answers

What is the mortality rate typically measured per?

<p>1,000 people (C)</p> Signup and view all the answers

Which ethical theories intersect in the concept of social justice within global health?

<p>Ethical Egoism and Altruism (D)</p> Signup and view all the answers

Which of the following is NOT a reason why DALYs are important in public health?

<p>They are simplified indicators of mortality only (A)</p> Signup and view all the answers

What does the disability weight indicate in the calculation of Years Lived with Disability (YLD)?

<p>The impact of a disease on an individual's life (A)</p> Signup and view all the answers

Which term describes the categories used to capture the overall burden of disease in DALYs?

<p>Years Lived with Disability (C)</p> Signup and view all the answers

What does the Social Demographic Index (SDI) incorporate?

<p>Income and education levels (A)</p> Signup and view all the answers

In Walt and Gilson’s Policy Triangle Framework, which factor is considered a protective factor?

<p>Exercise (B)</p> Signup and view all the answers

In the proximal/distal paradigm, which option represents a proximal risk factor?

<p>High blood pressure (D)</p> Signup and view all the answers

Which of the following is NOT a component of the Biopsychosocial Model of Health Status?

<p>Genetic engineering (C)</p> Signup and view all the answers

What does the paradigm of Structural Violence emphasize?

<p>Inequities and barriers to access (D)</p> Signup and view all the answers

Which overlapping paradigm focuses on the individual and community networks affecting health?

<p>Networks (C)</p> Signup and view all the answers

What demographic transition is typically observed in global health shifts?

<p>High birth/mortality to low birth/mortality (B)</p> Signup and view all the answers

What is a significant nutritional shift observed in global health?

<p>Shift towards high fat and sugar diets (A)</p> Signup and view all the answers

What environmental factors contribute significantly to global deaths?

<p>Air, water, and soil pollution (A)</p> Signup and view all the answers

How is the health and wealth relationship described?

<p>They are strongly correlated (A)</p> Signup and view all the answers

Why do some countries fail to comply with global health regulations?

<p>Insufficient resources for screening (B)</p> Signup and view all the answers

What type of intervention is strengthening primary health care categorized as?

<p>Horizontal intervention (C)</p> Signup and view all the answers

Which of the following best describes the current state of global health systems?

<p>A fragmented landscape of diverse actors (C)</p> Signup and view all the answers

What type of programs are considered vertical interventions in global health?

<p>Disease-specific programs like PEPFAR (B)</p> Signup and view all the answers

What is the primary focus of health policy within a society?

<p>To undertake decisions, plans, and actions for specific healthcare goals (B)</p> Signup and view all the answers

What percentage of total health spending in low-income countries comes from official development assistance (ODA)?

<p>27% (D)</p> Signup and view all the answers

What overall impact does inadequate sanitation have on global health?

<p>Accounts for one-fifth of the global disease burden (A)</p> Signup and view all the answers

What approach considers behavioral change and equity as key elements in improving sanitation?

<p>Community-led total sanitation (CLTS) (B)</p> Signup and view all the answers

What type of health services are essential during emergency response situations?

<p>Essential health services including reproductive and child health (D)</p> Signup and view all the answers

Which type of disaster can lead to the initiation of complex humanitarian emergencies?

<p>Natural disasters (C)</p> Signup and view all the answers

What is primarily the role of UNHCR?

<p>To assist refugees and internally displaced persons (A)</p> Signup and view all the answers

Which of the following is NOT a major consequence of disasters?

<p>Improvements in community infrastructure (D)</p> Signup and view all the answers

What does IDP stand for in the context of humanitarian crises?

<p>Internally displaced person (C)</p> Signup and view all the answers

Which of the following aspects is included in disaster response mechanisms?

<p>Water supply and sanitation services (D)</p> Signup and view all the answers

Which term is used to describe people who have been denied a nationality?

<p>Stateless people (D)</p> Signup and view all the answers

Which of the following is an essential element of preparation and risk management for disasters?

<p>Community education and preparedness (A)</p> Signup and view all the answers

What is a key component of essential health services during a disaster response?

<p>Reproductive and child health (C)</p> Signup and view all the answers

Flashcards

Global Health Definition

Studying, researching, and practicing to improve health and achieve health equity worldwide.

Health Equity vs. Equality

Equity focuses on eliminating health disparities; equality treats everyone the same.

Global Burden of Disease

The total impact of diseases and injuries on a population.

Inverse Care Law

Areas with higher health needs often have less access to good healthcare.

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Global Health History

Global health evolved through stages: Tropical Medicine, International Health, Globalization and transition.

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WHO Regions

The World Health Organization divides the world into regions for health programs.

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Global Health Focus

Prioritizes improving health and equity for all people worldwide; focusing on those at high risk or in specific areas.

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Health as Defined by WHO

A state of complete physical, mental, and social well-being, not just the absence of disease.

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Low-income country (LIC)

A country with a gross national income (GNI) per capita of US$1,135 or less.

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Prevalence

The total number of cases of a disease in a population at a specific time, usually expressed per 100,000 people.

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Incidence

The number of new cases of a disease in a population over a specific period, usually expressed per 100,000 people.

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DALY (Disability-Adjusted Life Year)

A measure of the burden of disease that combines years lived with disability and years of life lost due to premature death.

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G8 to G7

The G8 (group of eight leading industrialized nations) became the G7 when Russia was expelled following its invasion of Ukraine.

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SDI (Socio-Demographic Index)

A way to classify countries, considering not only income per capita, but also education and fertility rates.

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MDGs

Millennium Development Goals (8 goals to improve global living conditions, aiming to reduce poverty and improve health).

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SDGs

Sustainable Development Goals (17 goals for the present and future. Goal 3 is specific to good health).

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YLD (Years lived with disability)

A measure of the years lost due to illness or disability. Calculated by multiplying disease incidence, duration, and disability weight.

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Disability Weight

A value (0-1) reflecting the impact of a disease or illness on a person's life. A higher number means a more severe impact.

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Proximal Risk Factor

A risk factor that has a direct and immediate impact on health. Example: Smoking.

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Distal Risk Factor

A risk factor that indirectly affects health. Example: Poverty.

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Biopsychosocial Model

A model of health seeing health influenced by biological (genetics, age), psychological (stress), and social factors (education, income).

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Social Determinants of Health

Factors in society (e.g. income, education, environment) that influence people's health.

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Social Demographic Index (SDI)

A measure of a region's development, considering factors like income and education.

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Demographic Shift

A change from high birth and death rates to low birth and death rates, affecting population growth.

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Urban Shift

A movement of people from rural areas to urban areas, leading to growing cities.

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Nutritional Shift

A transition in diets from mainly cereals, fiber, and vegetables to more animal products, fats, and sugars.

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Epidemiologic Shift

A change in the pattern of diseases from infectious diseases to chronic diseases, like heart disease and diabetes.

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Health-Wealth Gradient

A strong correlation between health and wealth, with those having higher incomes generally having better health.

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Social Position Impact

A person's social position, such as socioeconomic status, significantly influences their health outcomes.

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Global Health System

A network of actors working independently, together, and across sectors to improve global health outcomes.

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Vertical, Horizontal & Diagonal Interventions

Different approaches to address health problems: Vertical focuses on specific diseases, Horizontal strengthens systems, and Diagonal combines both.

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Complex Disaster

A large-scale humanitarian crisis often triggered by natural disasters, conflict, or a combination of both, causing widespread disruption, displacement, and social, economic, and political instability.

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Refugee

A person forced to flee their country due to war, persecution, or natural disaster, seeking protection in another nation.

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Internally Displaced Person (IDP)

Someone forced to leave their home but remains within their own country's borders due to conflict, disaster, or other reasons.

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Stateless Person

An individual who lacks a nationality and is denied access to basic rights like education, healthcare, and freedom of movement.

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Asylum Seeker

A person who has applied for protection in a different country but is awaiting the outcome of their request for refugee status.

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Preparation and Risk Management

Strategies to reduce the impact of disasters by implementing preventive measures, strengthening emergency response systems, and educating communities.

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WASH

An acronym for Water, Sanitation, and Hygiene, crucial for disease prevention and public health, especially during emergencies.

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Response

Actions taken after a disaster to provide immediate relief, address basic needs, and promote recovery.

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Health Policy

Decisions, plans, and actions undertaken to achieve specific healthcare goals within a society.

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Health Systems Building Blocks

Six key components that make up a functional health system: Leadership & Governance, Health Workforce, Medical Products & Technologies, Financing, Information Systems, and Service Delivery.

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How Health is Financed?

The various sources of funding for healthcare, including private out-of-pocket spending, general government financing, employment taxes, and official development assistance (ODA).

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ODA's Role in LMICs

Official Development Assistance (ODA) contributes a small percentage (3%) of the total health spending in low- and middle-income countries (LMICs).

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Community-Led Total Sanitation (CLTS)

A community-driven approach to improve sanitation and hygiene practices by focusing on behavioral change and community participation.

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CLTS Success Factors

Key elements contributing to CLTS success: addressing behavioral change, ensuring equity, and involving the community in decision-making.

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Disaster Response Components

Key areas of focus during disaster response: WASH (water, sanitation, hygiene), food and shelter, safety, psychological support, essential health services, and infection control.

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Disaster Preparedness Steps

Actions taken to minimize the impact of disasters: regulations, community education, first responder training, strong medical systems, and pre-positioning of supplies.

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Study Notes

Global Health Toolkit 1 - Basic Goals and Concepts

  • Global health is a field focused on improving health and achieving equity worldwide
  • Health is defined as a state of complete physical, mental, and social well-being, not just the absence of disease (WHO definition)
  • Equity aims to eliminate health inequities and disparities
  • Global health considers all people worldwide, including those at higher risk
  • Global health includes domestic, international, and transnational issues
  • Public health is concerned with population-level health, whereas medicine focuses on individuals

Global Burden of Diseases

  • Infectious/communicable diseases, maternal/perinatal health, and nutritional deficiencies are categorized as Group I
  • Non-communicable and neuropsychiatric diseases are Group II
  • Injuries, both intentional and unintentional, are Group III
  • Global health regions are categorized and mapped (Africa, Americas, Europe, etc.)

World Bank Income Classifications

  • The World Bank classifies countries based on income levels (low, lower-middle, upper-middle, high)
  • Knowledge of these classifications is important for understanding global health disparities
  • Russia was removed from the G8, now G7.

Key Global Health Indicators

  • Prevalence: total number of cases in a population per 100,000 people
  • Incidence: number of new cases per 100,000 people
  • Life expectancy: average length of life
  • Mortality: death rate, often expressed as deaths per 100,000 people
  • Disability-adjusted life years (DALYs): lost healthy years of life
  • DALYs include years lived with disability, and years of life lost due to illness, injury, or death

Functions and Key Global Health Indicators

  • Functions in global health include evaluating effectiveness, guiding policies, creating health metrics and responding to global challenges
  • Key Global Health Indicators include prevalence, incidence, life expectancy, mortality, and disability-adjusted life years (DALYs).

Epidemiology's Bathtub

  • Prevalence is the total number of cases in a given population
  • Incidence is the number of new cases in a given time
  • Recovery reduces prevalence
  • Deaths increase mortality

GBD By Disease Category

  • Globally, non-communicable diseases (NCDs) are the leading cause of DALYs.
  • Infectious diseases are a significant cause of DALYs in low-income countries.

Avert DALYs; Prevention and Cost-Effectiveness

  • Preventing diseases is the most cost-effective strategy
  • Cost-effectiveness of interventions is determined by its cost compared to other prevention or treatment methods
  • Primary, secondary and tertiary prevention strategies for managing disease -Examples include primary preventative measures like vaccines, secondary prevention checks for early disease detection, and tertiary prevention managing symptoms already established.

Determinants of Health: Top 10

  • Global risk factors include diet, blood pressure, smoking, and other behavioral and environmental factors
  • Global North and Global South face different prevalent risks

Global Health System Actors

  • Intergovernmental actors include UN agencies and multilateral development banks
  • Many non-governmental organizations (NGOs), for example contribute, work with, and/or support these programs
  • The private sector sometimes plays a critical role in global health programs
  • National, systems, and programs form part of global health

Building Blocks of Health Systems

  • Delivery systems, health workforce, information, and medical supplies are all key building blocks, as well as financing systems, leadership, and governance
  • Improving health equity and social risk protection are crucial goals in health systems

Countries as Actors

  • The United States participates in global health, often through bilateral and multilateral agencies.
  • Funding, building blocks, and goals within health systems.
  • These goals focus on improving health levels and equity and include responsiveness and the protection of social and financial risks

Preparedness and Risk Management

  • Global health systems frequently face threats ranging from pandemics to natural disasters.
  • Global health preparedness is a critical component to protect against these threats, which frequently include disaster-related responses.

Disease Burden, Violence, & Disasters

  • Some specific areas of concern in global health include infectious disease burdens, injury burdens, natural disasters, and man-made disasters.
  • Injury and Violence and Disaster responses are in themselves large topics in the global health scene.

Refugees and IDPS

  • Protecting refugees and internally displaced people (IDPs) is a key issue in global health

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