Class notes
International Public Health (IPH) Summary (elective)
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This document contains the content of the lectures given summarized. It includes the most important terminology and examples given in class.
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Lecture 1: Introduction to the Course● health:
○ state of complete physical, mental and social well-being and not only the
absence of disease or infirmity
○ ability to adapt and self manae in the face of social, physical, and emotional
challenges
● Public Health:
○ focus on population
○ concern for individual
○ health promotion and disease prevention
● Medicine:
○ focus mainly on individual
○ emphasis on diagnosis and treatment, care for whole patient
○ depend on: health care system
● IPH:
○ public: preventing disease, prolonging life and physical health through
organized community efforts
○ international public health: apply principles of public health to health
problems and challenges that affect low-and middle-income countries
■ taking into account the array of global and local forces that influence
them
○ global: places a priority on improving health and achieving equity in health for
all people
■ worldwide
● History:
○ 400 BC: hippocrates present relation between environment and disease
○ 1990-date: priority given to health, equity and development, responses to
globalization, use of information, and communication technologies
● Income Groups:
○ low middle: 1,026-3,995
○ upper middle: 3,896-12,375
■ based on Gross national Income (GNI)
● Sustainable Development Goals (SDGs):
○ UNDP: united nations development program
,Lecture 2: Determinants of Health and Measurements
● Noncommunicable Diseases (NCDs)
○ chronic and mental diseases
○ highest disease burden in europe
○ highest burden worldwide (less % than europe)
● As mortality decreased, fertility decreased as well:
○ 4rth phase = mortality became higher and fertility lower
■ WHY?= Double Burden of Disease
● Hit of NCDs and communicable diseases
● Key determinants of health:
○ individual (sex, genes, age)
■ physical environment
● water, sanitation, air pollution
■ employment + work conditions
■ access to health services
■ healthy behaviors and coping skills
■ healthy child development
■ social environment
● economy, eduction, culture, gender norms
● Equality vs. Equity:
○ equality = all being treated the same
○ equity = give different support according to people’s needs
■ systematic barriers prevent this
○ Social determinants
■ ex: US life expectancy for white vs. black men (non-biological)
● Indicators of health:
○ Frequency of a disease
■ incidence rate: rate of new cases of disease
● ID = [(# of new cases D during t) / (total population at risk)] x 1000
○ total population at risk = people that can get the disease
■ Prevalence:
● P = [(# of existing cases of disease D during t or date) / total
population at risk)] x 1000
● Morbidity vs. Mortality:
○ morbidity = proportion of illnesses (tackles suffering)
■ disability a person suffers due to a disease
● No disability = 0
● Disability = 1
○ mortality indicators= incidence of death (how many are dying)
■ # of deaths / unit time
■ neonatal: under 28 days
■ infant: under 1
■ child: under 5
■ maternal: due to childbirth
,● Case Fatality Rate: (CFR)
○ CFR = [(# of deaths from disease D) / (# of people with disease D)] x 100
● Life Expectancy:
○ high child mortality = low life expectancy
● Burden of Disease: Measures
○ Health Adjusted Life Expectancy (HALE) = expected # of years to be lived in
good health
○ Disability Adjusted Life Years (DALY) = years lost due to disability
■ YLL + YLD
● Trends:
○ IDs reduced
○ antibiotic resistance
○ leading cause of death: from CDs to NCDs (80%)
○ leading risk factor: from wasting and low weight to high blood pressure
○ population growth
○ urbanization, globalization
, Lecture 3: Non-communicable Diseases
● Non-communicable diseases (NCDs):
○ chronic diseases, long duration
○ result of genetic, physiological, environmental and behaviors factor
○ Characteristics:
■ long latency
● shows symptoms later (like COVID)
■ high preventability
■ long period of treatment
■ comorbidity: existence of two diseases
● ex: high blood pressure and diabetes
● ex: (ETHIOPIA) HIV and TB
● Burden of NCDs:
○ ¾ of deaths is in middle income countries
○ 40% of premature death (before age of 70)
● Main NCDs:
○ Lung disease
○ cancer
■ most common: lung and breast cancer
○ mental disorders
○ type II diabetes
○ cardiovascular diseases
● Cardiovascular diseases:
○ blocked blood vessels = heart attack, chest pain, stroke
○ types:
■ cerebrovascular disease (stroke)
■ coronary heart disease (most common (men more than women))
○ Burden:
■ rirsk factor: sex, ethnicity, tobacco, high cholesteron, lack of physical
activity, alcohol
● Diabetes:
○ most common = type II = body cannot respond to insulin
○ type I = body fails to produce insulin (see in children)
○ gestational diabetes = happens in pregnancy
○ Burden:
■ 80% of diabetes death are in low and middle income countries
■ costly complications
■ risk factors (Type II): diet and obesity, family
● think about the countries (Ethiopia) and how life style there can
result in this disease
● Chronic Respiratory Disease:
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