Global Health concepts, insights, and disparities

Insights on global health and best strategies out there.

1. Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of Elsevier Inc.
Chapter 5
Global Health

2. Lecture Objectives
At the end of this lecture the student will be able to:
Access key international health resources
Identify
 the major forces that influence the health of individuals and populations around the world
Articulate an
 understanding of the complexity of global health issues, especially in low-resource
settings
Identify the risk factors that affect disease burden.
Articulate the role of CPH nurses as advocates for improving the health of patients and populations
in their communities and around the world.
Discuss the epidemiological transition
Identify the Top Ten Best Buys of Public Health
Identify key International, Intergovernmental and Non-governmental Agencies engaged in global
health efforts
Discuss the eight Millennium Development goals
 
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
2

3. What Is the Concept of Global Health?
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
3
Considering health, illness, & disease with a global
perspective
More than 2 million people cross national
boundaries daily
Travelers can expose many people to disease

4. Health Disparities among Countries
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
4
Developed countries:
Richer & more economically
stable
Include U.S., United
Kingdom, Australia
Middle-income countries:
Progressing along the
development spectrum
Include Brazil, China,
Mexico, Turkey
Developing countries:
Poorer & economically
unstable
Include Ethiopia,
Honduras, & Viet Nam

5. Health Disparities in Developing Countries
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
5
Unequal levels of health
Poorer countries: Higher rates of death, disease, &
disability
Life expectancy is shorter
Children suffer from malnutrition & premature
death

6. Alma-Ata Conference
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
6
Joint WHO/UNICEF International conference on
Primary Health Care
1978 USSR now (Almaty, Kazakhstan)
Health for All
Commitment to social justice of eliminating health
disparities
Primary Health Care should encompass:

7. Primary Health Care Should Include:
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
7
Education
Improved food supplies &
nutrition
Safe water & sanitation
Maternal & child health
care
Immunizations
Prevention & control of
diseases
Treatment of diseases
& injuries
Adequate drug supplies
(WHO, 1978)

8. UN Millennium Declaration
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
8
September 2000 NYC largest gathering of world
leaders in history representing 189 nations
Adopted the UN Millennium Declaration
Overarching goal of eliminating worldwide poverty
by 2015

9. United Nations Millennium Development Goals
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
9
Maternal health
HIV/AIDS & malaria
Environmental
sustainability
Development
partnerships
Eradicate poverty &
hunger
Universal primary
education
Gender equality
Reduce child mortality
(WHO, 2004)

10. Top Ten Buys of Public Health
Box 5-1
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
10
Vaccinate…
Monitor children’s health…
Levy taxes on tobacco products…
Mount coordinated attack on HIV, 100% condom use…
Provide children and pregnant women with essential nutrients…
Provide insecticide treated-bed nets
Traffic regulations/speed bumps…
Dots for TB…
Teach mothers and birth attendants to keep babies warm
Promote use of aspirin and other inexpensive drugs to treat and
prevent heart attack and stroke…

11. International Health Organizations:
Intergovernmental
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
11
World Health Organization (WHO)
Associated with the United Nations (UN)
Technical support & health care programs
Standards for vaccines & medications
Pan American Health Organization (PAHO)
WHO and UN
Immunizations

12. International Health Organizations: Intergovernmental (con
t.’d)
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
12
UNICEF (UN Children’s
Fund):
Maternal/Child Health
CDC (Centers for Disease
Control and Prevention):
Disease prevention & control
World Bank & USAID
(U.S. Agency for
International
Development):
Economic

13. International Health Organizations: Voluntary
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
13
Voluntary (Nongovernment organizations):
Religious groups: Services
Global Health Council (GHC): Health & development

14. Epidemiological Transition
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
14
Disparity in health status
Higher death rates from communicable diseases in
developing countries
Sanitation & immunization
Relationship with health & poverty: HIV and infant
mortality
Global burden 0f disease due to infectious disease
being replaced by chronic diseases and lifestyle
diseases : heart disease, depression, tobacco use,
injury, violence

15. Major Global Health Problems
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
15
Conditions easily
preventable & treatable,
such as infectious
diseases
Chronic Diseases:
More complicated to
treat and require
more economic
resources

16. Extent of Global Health Burden
4/5 of world’s people live in developing countries.
Our public health approaches will need to adapt to the
ever increasing need for prevention and treatment of
non-communicable diseases
Chronic disease
Diseases related to lifestyle
Injury (intentional and unintentional) and violence
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
16

17. Problems Common to Developing Countries
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
17
Unsafe water
Malnutrition & obesity
Diarrheal diseases
HIV/AIDS & malaria
Tuberculosis
Vaccine-preventable diseases and Integrated
Management of Childhood Illness (IMCI)

18. Other Serious Health Concerns in Developing
Countries
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
18
Maternal mortality
Reproductive health
Refugees from famine and war
Viral hepatitis B
Human trafficking

19. Receding Health Problems in Developing
Countries
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
19
Smallpox
Polio
Guinea worm disease
River blindness

20. Health Delivery Systems
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
20
Entrepreneurial: Free-market approach
Minimal government involvement (U.S.) Prior to Affordable
Care Act
Bismarck Model: Welfare oriented
Government regulation; taxes & personal money (Germany)
Beveridge Model: Comprehensive
Taxes & total government control; comprehensive (United
Kingdom)

21. Old & New Emerging Health Issues
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
21
E. coli 0104.H4 outbreak in Europe
Dengue fever
Severe Acute Respiratory Syndrome (SARS)
Cholera
HIV/AIDS
Hantavirus
Influenza & avian flu
EBOLA

22. Environment
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
22
Global pollution
Depletion of ozone layer
Greenhouse gases
Biodiversity of plants & animals
Chemical pollution

23. Tobacco-Related Illnesses
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
23
Markets shifting from developed to developing
countries
Tobacco-free initiative to ban advertising and
promote smoking cessation
Using graphic pictures on cigarette packaging

24. Nursing & International Health
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
24
Members of professional organizations
International Council of Nurses (ICN): Federation of national
nursing organizations
Sigma Theta Tau International Honor Society of Nursing
(STTI): Leadership & research
International health organizations
Political activists, employees, or volunteers

25. Summary
Copyright © 2013, 2009, 2005, 2000, 1995 by Saunders, an imprint of
Elsevier Inc.
25
Health as a global priority
Health disparities exist among countries
Intergovernmental organizations provide leadership,
financing, & support
Many voluntary agencies work in world health
Public health measures: Sanitation, safe water, &
vaccination