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International Public Health (AB_1145): Complete Summary (VU Amsterdam)

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  • December 22, 2022
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Lecture 1 – Introduction
Chapter 1

What is global health?

 health problems and issues that transcend national boundaries and may be best addressed
by cooperative actions
 focused on improving the health of the entire population
 issues that extend beyond national borders
 specific attention to social justice
 much attention to low- and middle-income countries where morbidity and mortality are
high and health system functions are fragile
 focused on delivering health services that are: accessible, affordable, appropriate,
acceptable and with good quality
 considers the social, political, and economic forces that increases the risk of poor health
outcomes (structural violence)
 acknowledges the cultural differences that lead to varying health outcomes
 an interdisciplinary approach to understanding health outcomes
 considers the role of international NGOs, private philanthropists, and community-based
organizations




History of Public/Global Health

, 1750 – 1850:
 Industrial Revolution - bad working conditions and environmental pollution
 urbanization - unhygienic living conditions in cities
 epidemics - cholera, smallpox, TB, and other infectious diseases that resulted in high
infant mortality
 improvement of water supply, sanitation & sewerage
 start of formal public health policy
 1850 – 1900:
 first international meeting on public health problems in 1851 - start international
cooperation
 substantial increase in knowledge about infectious diseases, including cause and
transmission
 insight into possible intervention strategies
 start targeted intervention programs
 1900 – 1945:
 substantial decrease in (child) mortality
 antibiotics and medications
 start of academic training in health sciences
 first international organization: Health Organization of the League of Nations in
Geneva,1920
 creation of charity organizations, such as Rockefeller Foundation
 1945 – 1980:
 establishment of UN, with WHO and UNICEF as public mandate
 intervention strategies targeting:
 family planning
 infectious diseases – EPI (Expanded Program on Immunization)
initiated in 1974 & Smallpox eradicated (1966-1980)
 PHC (Primary Health Care) strategy - Alma Ata Conference 1978
 research programs on emerging diseases
 1980 – 1990:
 UN organizations The World Bank and IMF become important
 economic crisis leads to health reforms
 increasing role of NGOs in providing health services
 focus on non-communicable diseases
 UNICEF's campaign for child survival (GOBI FFF):
 included interventions for: Growth monitoring, Oral rehydration,
Breastfeeding, Immunization
 then added: sexual health (female) education, Family spacing, Food
supplements
 HIV/AIDS and establishment UNAIDS
 1990 – now:
 focus on cost effectiveness
 PPP (public-private partnership)

,  attention to CBPR (Community-Based Participatory Research)
 more attention to other health issues: chronic diseases, gun violence, injuries,
neglected tropical diseases and more


Sustainable development goals

 Sustainable Development Goals were developed and supported by governments and the
international community
 the goals apply equally to all countries
 the goal is to reduce health inequalities through processes, policies, and programmes




Critical global health

 determinants of health
 global burden of disease
 measurement of health status
 importance of culture
 demographic and epidemiologic transitions
 organization and function of health systems
 health equity and social justice


Lecture 2 – Global Burden of Disease
Chapter 3

,  burden of disease – a concept that describes death and loss of health due to diseases,
injuries, and risk factors
 it measures the impact of living with illness and injury and dying prematurely with
e.g., mortality and morbidity (indicators)
 estimated/calculated in terms of disability- adjusted life years (DALYs) which
quantify the number of years of life lost (YLL) due to disease & premature death and
the number of years of life a person lives with disability caused by the disease (YLD)
 DALY = YLL (mortality) + YLD (morbidity)
 YLL – years of life lost to (early) death
 YLD – years of life with disability
 1 DALY = the loss of one year of healthy life due to disability or premature death




The global burden of disease study

 a systematic scientific effort to quantify the comparative magnitude of health loss due to
diseases, injuries and risk factors by age, sex, and geographies for specific time points
 WHO – main causes of death:
 Group 1 – communicable, maternal, perinatal, and nutritional conditions (CDs)
 Group 2 – non-communicable conditions (NCDs)
 Group 3 – injuries, including motor vehicle accidents and homicide; mental health
problems and suicide


Communicable diseases (CDs)

 a communicable disease is one that can be spread from one person to another through a
variety of ways, including:

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