Global Health 101
Chapter 1 The Principles and Goals of Global Health
The reason for studying global health is to gain a better understanding of
the progress made so far in addressing global health problems and to
understand the most important global health challenges that remain and
learn how to address them rapidly, effectively, efficiently and fairly with
the help of different actors.
Progress in global health: increased life expectancy, decrease in child
mortality, progress against vaccine preventable diseases, fewer maternal
deaths, decrease in tobacco consumption.
Health = a state of complete physical, mental and social well-being and
not merely the absence of disease or infirmity.
Public health = the science and art of preventing disease, prolonging life,
promoting physical health and mental health and efficiency through
organized community efforts toward a sanitary environment; control of
community infections; education of the individual in principles of personal
hygiene; organization of medical and nursing service for the early
diagnosis and treatment of disease; the development of the social
machinery to ensure to every individual in the community a standard of
living adequate for the maintenance of health.
Winslow: Also promoting people to drive with seatbelts, regulating
industrial pollution or maintenance of disease surveillance systems.
Principles of public health; prevention of disease, respect for the rights of
individuals and a commitment to developing public health in conjunction
with communities. They highlight the need to pay particular attention to
disenfranchised people and communities and the importance of evidence
based.
Difference public health and medicine
Differentiating Public health Medicine
factors
Focus Population Individual
Ethical basis Public service Personal service
Emphasis Disease prevention and Disease diagnosis,
health promotion for treatment, and care
communities for individuals
Interventions Broad spectrum that may Emphasis on medical
target the environment, care
human behaviour, lifestyle
and medical care
Global health implies a global perspective on public health problems. It
suggests issues that people face in common such as the impact of a
growing and aging worldwide population on health or the potential risks of
climate change to health. It also relates to problems that require
cooperative action.
,Significant global health issues include how countries can organize and
manage their health systems to enable the healthiest population possible
given the resources available.
One health = the integrative effort of multiple disciplines working locally,
nationally, and globally to attain optimal health for people, animals and
the environment.
Planetary Health = the achievement of the highest attainable standard of
health, wellbeing, and equity worldwide through judicious attention to the
human systems – political, economic and social – that shape the future of
humanity and the Earth’s natural systems that define the safe
environmental limits within which humanity can flourish.
Difference; one health focusses on interconnectedness of animal, human,
and environmental health whereas planetary health has a greater focus on
the health of the environment and the connections between and human
and animal well-being.
The WorldBank classifies countries into four income groups, based on
estimates of their gross national income (GNI) per capita:
- Lower-income economies: GNI per capita of 995 dollars (Ethiopia)
- Lower-middle-income economies: GNI per capita between 995-3895
dollars (India)
- Upper-middle-income economies: GNI per capita between 3895-
12055 dollars (Turkey)
- High-income economies: GNI per capita of 12056 or more dollars
(Netherlands)
Sustainable Development Goals: build on the Millennium Development
Goals (MDGs) which were formulated in 2000 at the United Nations
Millennium Summit. All the goals have an important, even if indirect,
relationship with the achievement of good health and wellbeing.
,Chapter 2 Health Determinants, Measurements, and the Status of
Health Globally
Determinants of health = range of personal, social, economic and
environmental factors which determine the health status of individuals or
populations.
Social determinants of health = conditions in which people are born, grow,
live, work and age.
Group of factors that helps to determine health:
- Personal and inborn features of the individual: genetic makeup, sex
and age
- Individual lifestyle factors: eating pattern, drive safely, alcohol etc.
- Social networks: the extent to which people receive social support
from family, friends, community. The stronger the networks and the
stronger the support, the healthier people will be.
- Living and working conditions: housing, access to safe water,
nutrition etc.
- Social economic factors. It refers to a person’s economic, social and
work status.
o Education: brings with it knowledge of good health practices, it
provides opportunities for gaining skills, getting better
employment, raisings one’s income and enhancing one’s social
status.
o Culture: shapes how one feels about health and illness, how
one uses health services and the health practices in which one
engages.
o Environment: the safety of the environment in which people
work (pollution in air, lack of safe drinking water and
sanitation).
Key Health indicators (to make comparisons across people);
, - Infant mortality rate = the number of deaths of infants under the
age 1 per 1000 live births in a given year.
- Life expectancy at birth = the average number of additional years a
newborn baby can be expected to live if current mortality trends
were to continue for the rest of that person’s life. The higher the life
expectancy at birth, the better the health status of a country.
- Maternal mortality ratio = the number of women who die as a result
of pregnancy and childbirth complication per 100,000 live births in a
given year.
- Neonatal mortality rate = the number of deaths of infants under 28
days of age in a given year per 1000 live births.
- Under-5 mortality rate (child mortality rate) = the probability that a
newborn baby will die before reaching age 5, expressed as a number
per 1000 live births.
They all vary with level of income; the more the income the lower the
rates. Sub-Saharan Africa has the worst health indicators, South Asia the
second worst.
Morbidity = sickness or any departure, subjective or objective, from a
psychological or physiological state of wellbeing.
Mortality = death
Death rate = number of deaths per 1000 population in a given year.
Disability = temporary or long-term reduction in a person’s capacity to
function.
Prevalence = the number of people suffering from a certain health
condition over a specific time period. It measures the chances of having a
disease.
Point prevalence = the proportion of the population that is diseased at a
single point in time.
Incidence rate = how many people get a disease, for a specified number of
people at risk, for a given period of time. The denominator for the rate
usually depends on how commonly the disease occurs in a year and is
often per 1000 or per 100,000 people.
Prevalence is pool of people with the disease and incidence as the flow of
new cases of people with that disease into that pool.
Primary prevention = intervening before health effects occur, through
measures such as vaccinations, altering risky behaviours, and banning
substances known to be associated with a disease or health condition.
Secondary prevention = screening to identify diseases in the earliest
stages, before the onset of signs and symptoms, through measures such
as mammography and regular blood pressure testing.
Tertiary prevention = managing disease post diagnosis to slow or stop
disease progression through measures such as chemotherapy,
rehabilitation and screening for complications.
Communicable diseases (group I) = infectious diseases, illnesses that are
caused by a particular infectious agent and that spread directly or
indirectly from people to people, animals to people, or people to animals.
