Class notes

Comprehensive Notes on Global Health: Disparities, Ethics, Historical Contexts, and Modern Challenges

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Course
HSS4331 (HSS4331)

Institution
University Of Ottawa (U Of O )

This document is an extensive and well-organized compilation of notes and analyses on key topics related to global health. It provides a nuanced exploration of historical, social, economic, and ethical factors that influence health outcomes across populations. By integrating detailed discussions, c...

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Uploaded on January 15, 2025
Number of pages 27
Written in 2024/2025
Type Class notes
Professor(s) Dr. alejandra dubois
Contains All classes

uottawa
international
health
international health
university of ottawa
health science
health sciences
science
mdgs
sdgs
globalization
health disparities
colonialism
diabetes epidemic
epigenetics
thrif

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WEEK 1

Chapter 1:
- Human civilization is more global, with nations adopting shared political and
economic goals. This interconnectedness influences global health, creating both
challenges and opportunities
- Global trade, travel, and migration connect health across borders. Events like the 2008
financial crisis and COVID-19 show how crises in one region can impact global
health and economies
- Health risks include faster spread of diseases through travel and imported goods, and
environmental degradation from resource exploitation in developing countries
- Global health involves politics, economics, technology, the environment, and more
- Simplistic views of global health as aid from rich to poor nations miss the broader,
complex factors at play, such as poverty, human rights, conflict, and migration
- Issues like war, natural disasters, and migration are interrelated, often creating health
challenges
- Globalization can lead to economic shifts and reduced labor protections, influencing
access to healthcare
- “Global health” focuses on transnational health issues requiring collective action,
while “international health” historically emphasized differences between nations.
- Today, the distinction is less relevant due to globalization
- Global health is influenced by political perspectives. Acknowledging and analyzing
biases is key to addressing global health disparities effectively
- Millennium Development Goals (MDGs) and Sustainable Development Goals
(SDGs):
- MDGs (2000) aimed at eradicating poverty, improving education, health, and
sustainability by 2015
- The SDGs replaced the MDGs, setting broader global development targets for
2030
- Discussion Questions:
- Defining International vs. Global Health: Previously, “international health”
might have meant country-to-country aid, while “global health” encompassed
broader global issues. The distinction now seems unnecessary
- Motivation for Studying Global Health: Motivations could include addressing health
disparities and achieving health equity worldwide
- Is All Health Now International?: Yes, the interconnected nature of the world makes
most health issues global in scope
- Non-Medical Global Health Issues: Includes economics, politics, environment, human
rights, and technology, all affecting health outcomes

, WEEK 2

Chapter 2:
- Development studies focus on the disparity between wealthy and less wealthy
populations, particularly in international/global health
- Wealth and health disparities are closely related, as wealthier societies often exhibit
better health indicators like life expectancy, though wealth can also introduce
unhealthy behaviours
- Historical events, particularly colonialism, play a key role in shaping modern
disparities
- Wealthy nations (Western Europe and their colonies) were historically dominant, but
the economic landscape is shifting (e.g., rise of China and India, Sub-Saharan Africa’s
potential growth)
- The term “Third World” originally referred to non-aligned nations during the Cold
War, not low-income countries
- Understanding the root causes of wealth and health disparities is crucial to addressing
and targeting these issues
- Arguments for why some nations became wealthier:
- Some argue racist ideologies or that superior social institutions in Western
nations led to wealth
- Military historians like Hanson suggest factors like capitalism, individualism,
and open debate gave Western nations advantages
- Niall Ferguson highlights “6 killer apps” (competition, science, property
rights, medicine, consumer society, and the Protestant work ethic) that led to
Western dominance
- Jared Diamond’s environmental and geographical factors, such as the
discovery of calorie-rich crops, access to large domesticated animals, and
immune system benefits, helped Eurasian societies thrive
- Colonialism created long-term disparities through:
- Economic exploitation (e.g., Britain’s policies in India and the “Drain of
Wealth Theory”)
- Brain Drain: Professionals migrating to former colonizers for better
opportunities
- Corruption: Authoritarian institutions fostered cultures of oppression and
extortion
- Decapitation: Removal of functional local leadership during colonial uprisings
weakened post-colonial societies
- Environmental Degradation: Colonial resource extraction led to long-term
damage
- Redrawn Borders: Arbitrary borders, especially in Africa (e.g., Conference of
Berlin), created ethnic conflicts that persist today

, - Remaking of Economies: Colonial economies were restructured to serve the
colonizers, focusing on cash crops or resources for European industries (e.g.,
tobacco, cotton, coffee)
- Some argue that colonialism brought development (e.g., India’s unity), but others
view its legacy as overwhelmingly negative, especially in regions where colonizers
failed to invest in public health infrastructure
- Colonialism’s legacy still affects former colonies in terms of inequality, poor health
outcomes, and economic challenges

Discussion Questions:
- What is our role in addressing disparities between poor and rich nations?
- Recognize historical injustices and support equitable global policies. Advocate
for fair trade, development aid, and healthcare access
- Should change be effected locally or nationally?
- Solutions should be both local and national, addressing specific community
needs while aligning with broader national policies
- What policy initiatives would you have suggested or expected in the past, now, or in
the future?
- In the past: Abolition of exploitative colonial economic practices.
- Now: Support for sustainable development, healthcare infrastructure,
education, and anti-corruption policies
- Future: Policies that promote equity, technological advancement, and
self-sufficiency in formerly colonized nations
- Can you identify other ways colonialism manifests as inequity, insecurity, or poor
population health today?
- Legacy of resource extraction leads to economic dependence and
environmental issues
- Ongoing brain drain from developing countries
- Enduring geopolitical conflicts and corruption rooted in colonial
administration structures

Chapter 3:
- International health likely began with human migration, as early interactions exposed
populations to new health challenges. Significant crises include cross-cultural
contacts, like those between Europeans and Indigenous populations in the Americas
during the 15th and 16th centuries, leading to the destruction of local societies.
- Modern international health structures, including the WHO and NATO, emerged
post-WWII.
- Truman’s 1949 address highlights how health became intertwined with military and
political objectives.
- The WHO’s malaria eradication program used a militaristic approach, relying on
chloroquine and DDT, but faced local resistance.
- Vertical programs are top-down and narrowly focused, while horizontal programs
integrate care across broader populations. Vertical programs like malaria eradication

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