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Notes lectures International Public Health (AB_470088)
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Elaborated on learning goals of the International Public Health course. I passed the exam with a 9.2 with these notes.
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International Public HealthLecture 1
- Explain what the scope is of international public health as a field of study and practice
o Issues transcending borders
o Scientific enquiry based on data
o Focus on equality/ social justice
o Focus on dignity
o Focus on cosmopolitanism
o Emphasis on regions with high burden of disease and weak health systems
o Analysis of phenomena like globalization/urbanization/migrations
o Highly interdisciplinary
- Explain the historical evolution of international public health and discuss the importance of
international public health
o Public health science and art of preventing disease, prolonging life and promoting
health through the organized efforts of society
o History of (international) public health
Before 19th century
Hippocrates link environment and disease
Quarantine for deadly infectious diseases
Hospitals religious charity
Colonial expansion spreading diseases
Beginning 18th/19th century
French Revolution right to health
Industrial revolution wealth
o State responsible for population health measures and health
care services
After 19th century
1851 First international public health meeting
Control of some infectious diseases cholera/plague/yellow fever
Scientific developments on communicable diseases
Better hygiene/sanitation control of epidemics
Vaccination and antibiotics
o Biomedical paradigm dominates
o Focus on health care> health
th
20 century
1910-1945
o Reduction child mortality
o Schools of public health established
1945-1990
o UN agencies/World Bank created
o Eradication of smallpox
o Universal childhood immunization
o HIV/AIDS
1980s-2000
o Health promotion (unlike biomedical paradigm)
o Health > product of health services
Prerequisites for health recognized (education etc)
o Importance of international public health
Gain better understanding of the progress that is made so far
Better understand the challenges that remain and learn how to address them
rapidly/effectively/efficiently/fairly
1
, - Explain in general foundational concepts and notions of international public health such as the
WHO definition of health, the difference between communicable and non-communicable
diseases, the concept of global burden of disease, social determinants of health, Millennium
Development Goals and Sustainable Development Goals
o WHO definition of health
“Health is a state of complete physical, mental and social well-being and not
merely the absence of disease or infirmity
o Communicable diseases transmittable
Social/Economic impact
o NCDs long latency degenerative/complex/lifestyle diseases
4 main NCDs Cardiovascular/diabetes/chronic respiratory/cancer
+ mental health
o Global burden of disease describe combination of morbidity/disability/mortality
measures in DALYs
o Social determinants of health conditions in which people are born/grow/live/work/age
o Millennium Development Goals & Sustainable Development Goals
Lecture 2
- List the different determinants of health and explaining their interconnectedness and their
impact on the health of individuals and populations
o Individual genetic make-up/sex/age
o Physical environment water/sanitation/air
pollution
o Employment/working conditions
o Access to health services
o Healthy behavior and coping
o Healthy child development
o Social environment
o Social determinants of health increased
attention (rainbow model)
Conditions in which people are born,
grow, live and age and the wider set
of forces and systems shaping the conditions of daily life
Include economic policies and systems, development agendas, social
norms, social policies and political systems
Causes avoidable/remediable differences within and between countries
1. Personal & inborn factors
a. Genetic make-up inheric genetic markers et
b. Sex physical differences
c. Age at different ages vulnerable to different diseases
2. Individual lifestyle factors people’s own practices/behaviors
3. Social network social support/community/culture
4. Living & working conditions housing/access to safe water/nutrition/health services
5. Socioeconomic factors
a. Culture
i. shapes how one feels about illness/health
ii. Gender roles
b. Education
i. Brings knowledge of good health practices
ii. Provides opportunities for gaining skills etc enhancing social
status
c. SES
d. Environment (indoors/outdoors)
i. Safety of the environment
2
, - Explain and apply main health status indicators such as incidence, prevalence, mortality, case-
fatality ratio, morbidity and life expectancy
o Incidence (per 1000 or 100,000)
New cases of the disease
o Prevalence (per 1000 or 100,000)
Existing cases of the disease
o Mortality (per 1000 or 100,000)
Number of deaths
Different mortality rates neonatal/infant/child/maternal mortality ratio
o Case-fatality ratio (percentage)
Proportion of those with a disease who die because of it
Number of deaths from disease D/total population with D x 100
o Morbidity
Disability that a person suffers as a consequence of the disease
Who/how long/how severe
o Life expectancy
Average from birth to death
- Explain various tools of analysis and measurement relating to global burden of disease and in
particular on HALE and DALYs
o HALE health adjusted life expectancy
Years that will be lived in good health
o DALY disability adjusted life year
Years lost due to premature death and years lived with disability
Also modified by discounting and age weighting
- Discuss general trends impacting the health of individuals and populations such as population
growth, aging, urbanization
o Mortality/life expectancy
Increased
Child mortality decreased
o Causes of death
Infectious diseases decreased
Reduction in NCDs has stalled/reversed
o Disability
Increased
Mostly NCDs
o Health life expectancy and early death and disability
Disparities by sex and level of development
o Risk factors
More lifestyle related high blood pressure/smoking/high blood sugar
o Urbanization
o Population growth
Lecture 3
- Discuss the dynamic of poverty and explain the various definitions of the phenomenon and the
different parameters to measure it
o UNDP definition of poverty
Deprived of income and other resources needed to obtain the conditions of life,
that enable them to play the roles, meet the obligations and participate in the
relationships and customs of their society
o Hard to measure contextual
o Levels of poverty
Absolute
3
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