N309 Global Health Test Review Guide Fall 2024 PDF

**N309 Global Health Test Review Guide** **NOTE: Chapters are from the textbook by Skolnik** **Each test guide identifies areas of general emphasis in studying for the test, but the test is not necessarily limited to only these areas. Be familiar with both the textbook chapters and class materials...

**N309 Global Health Test Review Guide** **NOTE: Chapters are from the textbook by Skolnik** **Each test guide identifies areas of general emphasis in studying for the test, but the test is not necessarily limited to only these areas. Be familiar with both the textbook chapters and class materials.** **Test 1** **Chapter 1. Introduction to Global Health** - Define health (WHO, 1948), public health, global health. - **HEALTH is: a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity (WHO, 1948)** - Health care is vital to all of us some of the time, but public health is vital to all of us all of the time -- C. Everett Koop - **PUBLIC HEALTH \[n\]. The science and practice of protecting and improving the health of a community, as by preventative medicine, health education, control of communicable diseases, application of sanitary measures, and monitoring of environmental hazards. (The American Heritage Dictionary)** - What is Public Health? - Control communicable diseases - Educate the public about health - Provide population interventions (e.g., Vitamin A & immunizations) - Maintain safety net for vulnerable populations - **GLOBAL** **HEALTH** = \"Health problems, issues, and concerns that transcend national boundaries and may best be addressed by cooperative actions\" (I0M, 1998) - \"The application of the principles of public health to health problems and challenges that transcend national boundaries and to the complex array of global and local forces that affect them\" (Mercen, Black, & Mills, 2001) - What is the difference between public health and medicine? - **PUBLIC HEALTH:** - Population focus - Greatest good for greatest number -- public service - Emphasis on preventing disease and promoting health of communities - Interventions target environment, behavioral lifestyles, and medical care -- broad spectrum - **MEDICNE:** - Individual focus - Needs of individual more important than needs of group -- personal service - Emphasis on diagnosing and treating diseases - Interventions are medical -- emphasis on medical care - Why should we study global health? - -Diseases cross borders - Understand the progress made and remaining global health problems - Many health problems require global solutions and international cooperation - Global health is broader than the perspective of any individual country - Global health recognizes that countries must work together to solve health concerns - \"Some issues (e.g., climate change) affect the whole world - How many Sustainable Development Goals (SDGs) were developed by the United Nations? - 17 SDGs were developed: 169 targets and 230 indicators - They were established by the member countries of the United Nations at the end of 2015 - Aim by 2030 to end poverty, protect the planet, and promote prosperity and peace. **Chapters 2, 3 & 4. Health Determinants, Measurements, and the Status of Global Health & Global Burden of Disease & Health, Education, Equity, and the Economy** - Give examples of determinants of health. - Physical environment - Employment and working conditions - Access to health services - Individual characteristics - Health behaviors - Health prenatal and child development - Social and economic environment - Governance, policies, and interventions - Define health status indicators: life expectancy at birth, maternal mortality rate, infant mortality rate, neonatal mortality rate, and under-5 mortality rare. - **LIFE** **EXPECTANCY** **AT** **BIRTH** = the average number of years a newborn baby could expect to live if current mortality trends persist for the rest of the newborn's life - Ex. For infants born in Japan in 2020, life expectancy at birth = 85 years - **MATERNAL** **MORTALITY** **RATE** = the number of women who die as a result of pregnancy and childbirth complications per 100,000 live births in a given year - (number of maternal deaths / number of live births) \* 100,000 live births (during a year) - **INFANT MORTALITY RATE** = number of infant deaths (from 0-364 days) divided by the number of live births during the year times 1000 - = death per 1000 live births in a year - **NEONATAL MORTALITY RATE** = number of neonate deaths (0 to \< 28 days) divided by the number of live births during the year times 1000 - = neonatal death per 1000 live birth in a year - Sensitive to conditions present at birth or birth-related practices - **UNDER 5 MORTALITY RATE** = the probability that a newborn baby will die before reaching age 5 - Expressed as a number per 1000 live births - Highest income countries = 3-5 per 1000 live births is good - Poorest countries = 150 per 1000 live births not good - How are incidence and prevalence calculated and how are they different? - **INCIDENCE** = number of **new cases** divided by the total population at risk (minus the "old" cases) times a multiplier like 100 during a period of time - **PREVALENCE** = number of **all people** with a disease divided by the average population or total in the group (during a time period) - What are DALYs and what "losses in health" are considered in DALYs versus mortality rates? - DALYs are **disability-adjusted life years** (a disease burden indicator that is most used) - HEALTH LOST due to particular illness and disability in a particular year in a particular population compared with the healthiest population possible - Higher the DALY = a society with more premature death, so a **LOWER DALY IS BETTER** - **CONSIDERS BOTH MORTALITY (YEARS OF LIFE LOST) AND MORBIDITY (YEARS LIVED WITH DISABILITY) SO ITS MORE BROAD THAN JUST MORTALITY RATES** - What are the three levels of prevention in public health**? (upstream approach)** - **Primary prevention:** Prevents disease from occurring (e.g., vaccination). - **Secondary prevention:** Detects disease early (e.g., screening programs). - **Tertiary prevention:** Reduces the impact of disease (e.g., rehabilitation). - What are the demographic and the epidemiologic transitions? - **Demographic Transition:** The shift from high birth and death rates to low birth and death rates as a country develops. - **Epidemiologic Transition:** The shift in the primary causes of death from infectious, communicable diseases to chronic, non-communicable diseases as societies progress. - What are the 3 broad groups of causes of death used by WHO? - **Group I:** Communicable diseases, maternal and perinatal conditions, and nutritional disorders. - Common among poorer populations, cause death in younger ages, account for 18% of deaths worldwide - **Group II:** Non-communicable diseases (e.g., heart disease, cancer). - Cause death at older ages, more common among wealthier populations, account for 74.4% of deaths worldwide - **Group III:** Injuries (intentional and unintentional). - What made smallpox eradication successful? - No animal vector - Easily diagnosable - Vaccine available - no refrigeration needed - Available technology - Bifurcated needle allowed easy application, small amount of vaccine - Lifetime immunity - How do education, income, and health affect each other? - Education leads to better health behaviors and access to healthcare, which can result in higher income. - Income affects access to health resources and living conditions. - Health enables individuals to participate fully in educational and economic activities. - What do equity and health disparities mean? - **Equity** refers to fairness in health; reducing avoidable health inequalities. - **Health disparities** are differences in health outcomes among different population groups, often due to social, economic, or environmental disadvantages. - What is the measure of the income level of a country? What is the measure of the income inequality of a country? How do they relate to health? - Measure of income level of a country = **GDP (gross domestic product)** - **GINI = income inequality index** - **a higher Gini coefficient means greater inequality, often leading to poorer population health outcomes.** - - **Public Expenditure:** Government spending on health. - **Private Expenditure:** Private sector and personal spending like insurance or charity - **Out-of-pocket Expenditure:** Direct payments made by individuals for healthcare services that are not covered or reimbursed by an insurance program/public source - What is cost effectiveness and how can it be helpful in deciding how to spend money to promote health of a population? - Cost effectiveness is considering **how much health do we buy for the cost?** - **It helps prioritize interventions that provide the most significant health benefit per dollar spent.** - What are the Guinea worm disease (dracunculiasis)? What are solutions to eradicate this disease? - A parasitic infection transmitted through contaminated water. Eradication efforts include providing clean water, education, and community health programs. **Chapter 6. Health Care Systems and Access to Care** - What are six building blocks of health systems? What does each do to ensure quality? - **Service delivery = safe, effective care given** - **health workforce = trained capable staff** - **health information systems = reliable and accurate** - **medical products and technologies = essential medicine available, equipment in working order** - **financing = public financing may be very low in LMIC** - **leadership** and **governance = accountable management and spending** - What is universal health care/coverage? - UHC ensures all people receive essential health services without suffering financial hardship. - What are 3 "prototypes" of health systems and what is a country with each type? - **National Health Service (NHS):** Government-funded and operated, e.g., the UK. - **National Health Insurance (NHI):** Insurance-based, e.g., Canada. - **Pluralistic:** Private, public, and individual financing, e.g., the USA. - What are the 3 levels of healthcare in the hierarchy of health systems and what is the focus of each? - **Primary:** Preventive care and basic health services. - **Secondary:** Specialized outpatient care and hospital services. - **Tertiary:** Advanced, specialized medical care. **Chapter 8. The Environment and Health** - What are key environmental factors (main focuses) that impact the global burden of disease? - Indoor/outdoor air pollution, unsafe water, poor sanitation, chemical exposures, and climate change. - How are toxin, toxicant, biohazard, and environmental health defined? - **Toxin:** naturally occurring substances harmful to health. - **Toxicant:** Synthetic or man-made toxic substances. - **Biohazard:** Biological agents that pose risks to human health (bacteria, medical waste, viruses, etc) - **Environmental Health:** Study of how environmental factors affect human health by reducing exposure to adverse environment conditions and promoting behavior change; focuses on direct and indirect causes of disease and injuries and taps resources in and outside the healthcare system to help improve health outcomes - What are the causes of indoor air pollution? What are solutions? - **Causes:** Use of solid fuels (wood, charcoal) in poorly ventilated spaces. - **Solutions:** Clean affordable cooking technologies, improved ventilation, alternative fuels, public education - What are the 4 types of water-related infections? - Waterborne (e.g., cholera) where germ in water is ingested - water-washed (e.g., trachoma) or water scarce where lack of water for hygiene - water-based (e.g., schistosomiasis) where transmission occurs aquatic intermediate hosts like a snail - water-related insect vector (e.g., malaria) like insects that breed in water like mosquitos - Which populations are at greater risk for health problems caused by poor environments? To which environmental factors (indoor air pollution; outdoor air pollution; unsafe water, sanitation, hygiene) are each of these most at risk: women, children, poor people, and older people most at risk? - **Women:** Indoor air pollution. - **Children:** Unsafe water and sanitation. - **Poor people:** All factors (indoor/outdoor air pollution, sanitation, hygiene). - **Older people:** Outdoor air pollution. **Chapter 17: Working Together to Improve Global Health** - What are the key UN agencies that focus on health or health-related problems? - **WHO (World Health Organization)** and **UNICEF (United Nations Children\'s Fund)**. - What are two global agencies/organizations that focus on child health? - **UNICEF** and **Gavi, the Vaccine Alliance.** - What is the largest international NGO (non-governmental aid groups)? What does it focus on? - **BRAC** (Bangladesh Rural Advancement Committee), focuses on poverty reduction and improving health through education and empowerment.