BBH 305 Midterm

Chp 1, 2, 3, 6, 7, 17

What are important reasons regarding the importance of studying health care system early on? (3)

• health systems are vehicles of health services delivery 

• countries spend substantial amt of money on health system

• population aging place pressure on health system 

What does universal health care mean?

ensure that all ppl get health services they need while ensuring that use of these services is free of financial hardships

health system

sum total of all the organizations, institutions, and resources whose primary purpose is to improve health

What makes up a health system?

• agencies that plan, fund, and regulate health care

• money that financces health care

• clinical service providers

• preventative health service providers

• rehab providers

• specialized health providers

brain drain

migration of health personnel in searchof better standard of living and quality of life 

task shifting

• rational redistribution of tasks among health workforce teams

• essentially move tasks from highly qualified workers to short-trained workers

• ensure efficient use of available Human Resources

What is accessibility?

people can get the health services they need without facing barriers related to cost, geography, culture, or other obstacles

What are out of pocket expenditures?

money spent on private health paid on your own 

What are the 6 building blocks of health systems?

• service delivery

• health workforce

• information

• medical productions, vaccines, technologies

• financing

• leadership/governance

Which countries presented in class are pluralistic?

• India

• Nigeria

• United States

What programs in the US covered the disabled?

Medicare

What programs in the US system cover the elderly?

Medicare

What programs in the US system cover the poor?

Medicaid

Which country has universal health care, but also pluralistic?

Switzerland

How do people in Canada pay for health insurance?

providinces are billed, not individual

In which countries are doctors, health care workers, and even hospitals part of the government?

England (United Kingdom) and Cuba

What is the United Kingdom’s health care system explicity called?

national health service 

What is meant by human capital?

people’s ability to be production and to accumulate knowledge and skills to be productive

How does poor health affect generations?

• sick children miss school, limiting future job opportunities

• children w unhealthy mothers more likely to be premature, malnourished

How does malnutrition and illness affect productivity?

• impair brain development → lower educational attainment

• reduce attendance in school 

• reduce school perfomance 

What is a positive connection between health and education?

healthy children more likely to …

• Attend school regularly

• Stay in school longer

• Concentrate

individuals that are educated…

• Make healthier lifestyle choices

• Use health services

• Better hygiene

What is the CDC definition of health disparities?

a type of difference in health that is closely linked with social or economic disadvantage

Which groups or populations will most likely be affected by health inequities, inequalities, and disparities?

• People living in poverty

• Women

• Rural populations

• Minorities

• People w disabilities

• Elders

Why is being born female more dangerous to your health?

• Maternal mortality

• Lower social status

• Less education

• STIs, mental health issues

What is female infanticide?

Deliberate killing of newborn female children, due to cultural or societal preference for male children

Why does females infanticide happen in some countries?

baby girl is not wanted or family feels unable to take care of her

What are out-of-pocket expenditures?

money that individuals spend on their health, but it is not covered or reimbursed by an insurance program

What are some examples of private expenditure?

• nongovernmental organizations

• self employed women’s association in India

How does good health promote economic development in societies?

• ppl sick (Ex. malaria), govt must use money to allocate resources to stop spread of disease

• longer life expectancy → work longer → boost labor production

What does considering the cost-effectiveness of different models for tuberculosis reveal, e.g., even though one method was cheaper than the other, what was important to note?

• the supervised method was more expensive than the unsupervised

• PRO supervised method led to a higher rate of people taking all their medicine and being cured

• more cost-effective

What are examples of the links between education and health as they relate to mother-child health?

More education mother has…

• more likely to immunize child, protect from diseases

• more likely to eat well during pregnancy 

• more likely delay births after further education/more income 

Skolnik offers 3 links between health, productivity and earnings, what are they?

• health and education of parents affect health and education of children

• malnutrition and disease affect cognitive development and academic performance of children

• education enables ppl to better prevent and manage illness

What are some concerns about disabilities and health expenditures or productivity?

• cannot afford healthcare → worst health outcomes

• financial barriers

• economic loss due to reduced labor production

When we consider access to and coverage of health care/services, what are some of the dimensions of access we should look at besides just being covered or not?

• health status

• access to health servcies 

• coverage of health services

• protection from financial risks because of health costs 

• distribution of health benefits 

What are some factors that should be considered when using a health disparity lens when analyzing a population or group?

• disabilities

• SES

• ethincity

• gender

• religion

• occupation

• location

• sexual orientation

What are 3 reasons to study global health?

1. better understand progress made in solving global health issues

2. better understand current global health challenges and how to address them

3. link between health and development

What are example of diseases moving across borders? (3)

• avian flu

• West Nile virus

• zika virus

What are examples of “link between health and development”?

• poor health of mothers is linked to poor health of babies

• poor health of childre is linked to economic instability

WHO stands for …

world health organization

What are some examples of public health activities? (4)

• promotion of handwashing

• promotion of bicycle/motorcycle helmets

• promotion of HIV/AIDs

• regulation of food labeling

What’s the difference between public health and medicine in terms of focus?

• public health - focuses on population, public service, disease prevention/health promotion

• medicine - focuses on individual, personal service, diagnosis, treatment

What is the gross national income (GNI) for low-income countries?

$1,135 or less (Ex. Nepal, Haiti)

What is the gross national income (GNI) for high-income countries?

$14,005 or above (Ex. Singapore, Argentina)

What are the determinants of health? (8)

1. agriculture and food production

2. education

3. work environment

4. living/working conditions

5. unemployment

6. water and sanitation

7. healthcare

8. housing

How does WHO define health?

state of complete physical, mental, and social well-being and not merely the absense of disease or infirmity

epidemiology

study that focuses on patterns and causes of disease in specific populations and applying global health info to control health issues

What is an example of how genetic makeup as a determinant of health?

inherit a genetic marker for Huntingin’s disease

What is an example of sex as a determinant of health?

females face risk involved with childbearing whereas men can have prostate cancer

What is an example of age as a determinant of health?

young people in low income die of diarrheal disease whereas older people die of heart disease

What is an example of an indivdual behavior as a determinant of health?

smoking, alcohol, sedentary lifestyle

What are 4 examples of living/working conditions as a determinant of health?

• housing

• access to healthy foods

• access to safe water and sanitation

• access to health services

What happen if there is no access to safe water?

risk factor for diarrheal diseases increases leading to deaths of young children

What are 3 ways education is a determinant of health?

• knowledge of good health practices

• provides opportunities for gaining skills, employement, raising income

• better educated → less likely to smoke, drink, be obese

What is meant by “indoor pollution”?

in low-income countries, women cook with poor ventilation and smoke harms health (respiratory illness and asthma)

Government policies can have a big affect on health. What is an example of this in terms of education: For example, countries that promote education will have better health status, why?

Why do we need data for health indicators? (3)

• know what health conditions people suffer from

• know extent to which conditions cause people to be sick, disabled, or die

• disease surveillance

What are the 5 key health indicators?

1. infant mortality rate

2. life expectancy at birth

3. maternal mortality ratio

4. neonatal mortality ratio

5. under-5 mortality rate (child)

What are 2 factors why sub-Saharan Africa and South ASia have low health statuses?

• low levels of education

• lack of safe water and sanitation

What is the difference between leading causes of death in high income vs low income countries?

• high income - ischemic heart disease, dementia, stroke → chronic disease, old age

• low income - low respiratory infections, diarrheal diseases, neonatal diseases → contagious, lack of healthcare/sanitation

England is the ONLY high-income country to NOT have universal health care

True

Teachers, mentors, and others in medical school, PA programs, nursing, and other allied-health areas are considered part of health care systems.

True

Both the USA and Canda have health care system components and programs called “Medicare”

True

Unlike other high-income countries, the USA offers the elderly little government assistant for healthcare.

False 

Tobacco consumption, a major risk for non-communicable disease is on the rise in many countries

False

Globally, mortality death rates have decreased for all age groups except for children under 5 years old.

False, children deaths regardless of age 

Years of life lost because of premature deaths are in part increasing because…

rates of diabetes, increase in cancers, wars and conflicts (ALL)

The number of deaths of infant deaths are under the age of 28 days in a given years per 1,000 live births is called neonatal mortality rate.

True

What is global health?

health problems, issues, and concerns that transcend national boundaries and may be best addressed by cooperative actions

What are the 7 regions that the World Bank breaks the world up into?

1. east asia and pacific

2. latin america and caribbean

3. n. america

4. sub-saharan africa

5. europe and central asia

6. middle east and n. africa 

7. south asia 

Which goals in addition to Goal 3 does Skolnik note have important links to good health?  

• no poverty

• zero hunger

• quality education 

• clean water sanitation 

What was the intervention of smallpox?

• Edward Jenner created smallpox vaccine

• Smallpox eradication unit established by WHO

What were the lessons learned from smallpox?

• vaccination systems are important

• community participation

What has caused an improvement in health status?

• better public hygiene

• better water supply

• better education

• increased nutritional status

What has caused a decline in health status in sub-Saharan Africa and Soviet Union?

HIV/AIDs

Do countries need to be in a high-income country for good health status?

no, china, Costa Rica, cuba, kerala all low-income with good health status

Why is culture an important health determinant?

determines people’s perceptions of illness, usage of health services, related to health behaviors

society

a group of people who occupy a specific locality and share the same cultural traditions

ethnocentrism

judging a society through the view of one’s own society 

cultural relativism 

Since cultures are unique, they can be evaluated according to their own standards and values (Ex. females aren’t allowed to drive in some countries)

cultural competence

the ability to interact effectively with people of different cultures

cultural humility

• lifelong process of self-reflection and self-critique 

• individual not only learns about another’s culture, but starts by identifying their own

• understand own assumtpions, biases, and values

health literacy 

degree to which individuals have the capacity to obtain, process, and undestand basic health information

traditional medicine

the sum total of knowledge, skill, and practices based on theories, beliefs, and experiences indigenous to diff cultures

western biomedicine

medical doctors treat symptoms and disease

aka allopathic medicine, biomedicine, conventional medicine, mainstream medicine, orthodox medicine

What’s the difference between illness and disease?

• illness - your reactions to symptoms you are having, subjective

• disease - malfunctioning or maladaptation of biological and psychophysiologic processes

What’s the difference between individualist vs collectivist societies?

individualist -

collectivist -

watch video on canvas

the number of death of infant under age 1 per 1,000 live births in a given year 

infant mortality rate 

average number of years a newborn baby could expect to live if current mortality trend were to continue for the rest of the newborn’s life

life expectancy at birth

the number of women who die as a result of pregnancy and childbirth complications per 100,000 live births in a given year

maternal mortality rate

number of deaths of infants under 28 days of age in a given year per 1,000 live births in that year 

neonatal mortality rate 

probability that a newborn baby will die before reaching age 5, expressed as a number per 1,000 live births 

under-5 mortality rate (child mortality rate)

illness or disease

morbidity

death

mortality

number of deaths per 1,000 population in a given year 

death rate 

temporary or long-term reduction in a person’s capacity to function

disability

proportion of the population that has a condition at a given time 

point prevalence 

number of people suffering from certain health conditions over a specific time period

prevalence

intervening before health effect occur through measures such as vaccination, altering risky behaviors, and banning substances 

primary prevention 

screening to identify diseases in the earliest stages

secondary prevention

managing the disease post-diagnosis to slow/stop progression 

tertiary prevention