Global Health Midterm

What is global health?

The study and practice of improving health and achieving health equity for people worldwide through collaborative, cross-border action.

How is health defined broadly?

As physical, mental, and social well-being, not simply the absence of disease.

What is population health?

The health outcomes of a group and the distribution of those outcomes within the group.

What is health equity?

A situation in which everyone has a fair opportunity to reach their best possible health.

How does global health differ from international health?

Global health emphasizes shared cross-border challenges and collaboration, while international health traditionally focuses on health issues between countries, especially assistance to lower-income countries.

How does public health differ from clinical medicine?

Public health focuses mainly on preventing disease and improving health in populations; clinical medicine focuses mainly on diagnosing and treating individuals.

What is prevention science?

The study of ways to prevent disease, injury, disability, and premature death before or during their development.

What is primary prevention?

Action taken before a disease or injury occurs, such as vaccination or improving sanitation.

What is secondary prevention?

Early detection and treatment intended to stop or slow a health problem, such as screening.

What is tertiary prevention?

Action that reduces complications or disability after a disease or injury has developed.

What is a risk factor?

A characteristic, behavior, exposure, or condition associated with a greater chance of a negative health outcome.

What is a protective factor?

A characteristic or condition associated with a lower chance of a negative health outcome.

What are modifiable risk factors?

Risks that can potentially be changed, such as tobacco use, diet, or environmental exposure.

What are nonmodifiable risk factors?

Risks that cannot be changed, such as age, inherited traits, or some biological characteristics.

What is a health transition?

A population-level shift in health status that usually occurs alongside socioeconomic development.

What is the demographic transition?

A shift from high birth and death rates to low birth and death rates, changing population growth and age structure.

What is the epidemiologic transition?

A shift from infectious diseases being the main burden to chronic, noncommunicable diseases becoming more prominent.

What is the nutrition transition?

A shift from undernutrition as the main concern toward diets and lifestyles linked with overweight and chronic disease.

Why can health transitions create a double burden of disease?

Infectious diseases may remain common while chronic diseases and injuries are also increasing.

What major forces improved population health historically?

Sanitation, safe water, improved nutrition, vaccination, safer workplaces, infection control, and advances in medical care.

Name several major global health achievements.

Vaccination, safer water, malaria prevention, HIV/AIDS control, tuberculosis control, tobacco control, and reductions in child mortality.

What is globalization?

The growing movement and connection of people, goods, money, information, and ideas across borders.

How can globalization harm health?

It can speed the spread of disease, unhealthy products, pollution, economic instability, and unequal working conditions.

What is global health security?

The prevention, detection, and response to health threats that can cross borders and affect populations internationally.

What are the International Health Regulations?

A legal framework that guides countries in detecting, reporting, and responding to public-health threats of international concern.

What is a health priority?

A health issue selected for focused attention and resources because of its burden, urgency, preventability, or social importance.

What were the Millennium Development Goals (MDGs)?

Eight international development goals pursued from 2000 through 2015, several of which focused directly on health and poverty.

What are the Sustainable Development Goals (SDGs)?

Seventeen interconnected goals adopted for 2016-2030 to promote health, equity, development, and environmental sustainability.

Which SDG focuses directly on health?

SDG 3: Ensure healthy lives and promote well-being for all at all ages.

Why are all SDGs relevant to health?

Health is shaped by poverty, food, education, gender, water, work, inequality, cities, climate, peace, and partnerships.

What is mortality?

Death within a population.

What is life expectancy at birth?

The average number of years a newborn is expected to live if current mortality patterns continue.

What is infant mortality rate?

The number of deaths before age one per 1,000 live births in a given period.

What is under-five mortality rate?

The probability or rate of dying before age five, commonly expressed per 1,000 live births.

What is maternal mortality ratio?

The number of maternal deaths per 100,000 live births.

What is morbidity?

Illness, injury, disability, or other poor health within a population.

What is incidence?

The number of new cases that develop in a population during a specified period.

What is prevalence?

The total number or proportion of people with a condition at a particular time or during a period.

What is a disability-adjusted life year (DALY)?

One lost year of healthy life due to premature death or time lived with disability.

What is the difference between communicable and noncommunicable diseases?

Communicable diseases can be transmitted through infectious agents; noncommunicable diseases are not transmitted person to person in that way.

How does disease burden often differ by country income?

Lower-income settings tend to have more infectious, maternal, neonatal, and nutritional disease, while chronic diseases dominate many higher-income settings.

What are social determinants of health?

The conditions in which people are born, grow, learn, work, live, and age, plus the systems shaping those conditions.

What does the PROGRESS-Plus framework help researchers examine?

Health differences by place, race or ethnicity, occupation, gender or sex, religion, education, socioeconomic status, social capital, and other characteristics.

What is socioeconomic status?

A person’s or group’s social and economic position, often assessed using income, wealth, education, and occupation.

What is the difference between income and wealth?

Income is money received over time; wealth is the accumulated value of assets minus debts.

What is absolute or extreme poverty?

Lacking the resources required to meet basic needs such as food, shelter, safe water, and essential care.

How can poverty affect health directly?

It can limit food, safe housing, sanitation, health care, medication, transportation, and protection from hazards.

What is the social gradient in health?

Health generally improves at each step up the socioeconomic ladder, not only above a poverty cutoff.

What is health literacy?

The ability to find, understand, evaluate, and use health information and services to make decisions.

How does education influence health?

It can improve employment, income, health knowledge, decision-making, social power, and the ability to navigate services.

Why is educating girls associated with better population health?

It is linked with later marriage, greater autonomy, improved family health, and lower maternal and child mortality.

What are three health-related components of employment?

Whether a person has work, the conditions and security of that work, and the income or benefits the work provides.

What is culture?

Shared and learned beliefs, values, behaviors, practices, and ways of understanding the world.

How can culture influence health?

It can shape diet, communication, care-seeking, family roles, beliefs about illness, and acceptance of health services.

How does discrimination affect health?

It can restrict access to resources and opportunities while causing chronic stress and harmful treatment within institutions.

What is structural discrimination?

Policies and institutional practices that systematically disadvantage certain groups, even without obvious individual prejudice.

How can migration affect health?

Health may be shaped by conditions before migration, risks during movement, and access or discrimination at the destination.

What is the healthy migrant effect?

The pattern in which some migrant groups initially have better health than the average population in their destination country.

What is governance?

The processes and institutions through which decisions are made, implemented, and held accountable.

How does governance influence health?

It shapes laws, budgets, public services, accountability, rights, infrastructure, and the distribution of resources.

What is interprofessionalism?

Professionals from different fields communicate, coordinate, collaborate, and make decisions together. Multidisciplinary teams involve several fields; transdisciplinary teams go beyond traditional disciplinary boundaries.

What interpersonal skills are important in global health teams?

Communication, teamwork, listening, adaptability, conflict management, empathy, and respect.

What does cultural humility involve?

Ongoing self-reflection, recognition of power differences, and willingness to learn from people and communities.

What is experiential learning?

Learning through direct experience followed by reflection and application.

Why must communities be treated as partners?

Community members hold essential knowledge, experience the effects of decisions, and help ensure that solutions are relevant and sustainable.

What does the PACES model stand for?

Population, Action, Cooperation, Equity, Security: five lenses for understanding and prioritizing global health problems.

Why can names matter in global health?

Names can reflect a person's history, identity, culture, and experiences, which are important to recognize when working across cultures.

What does the One Tragedy, Many Professions example demonstrate?

A single health tragedy can involve health-system capacity, infrastructure and patient safety, emergency preparedness, workforce, governance, maternal and newborn health, and equity, so multiple professions are needed.

What is the main lesson of How Not to Be Ignorant About the World?

People, including highly educated people, can hold systematic misconceptions about global health and development, so decisions should be based on data rather than intuition alone.

What is a health disparity?

A difference in health that is closely linked with social or economic disadvantage.

How can healthcare-provider bias contribute to health inequities?

Bias, prejudice, and stereotyping can contribute to differences in how patients are evaluated, listened to, treated, and given access to care.

What is institutional racism?

Racism embedded in the policies, practices, structures, or organizational culture of institutions that control or distribute resources and opportunities.

What is residential segregation?

The separation of racial or ethnic groups into different residential areas, often produced and maintained by policies, institutions, economic inequality, and discriminatory practices.

What is redlining?

A discriminatory housing and lending practice that denied or restricted mortgages and investment in neighborhoods, especially communities with Black residents.

How did discriminatory housing policies contribute to the racial wealth gap?

They helped many White families buy appreciating homes while excluding many Black families from the same opportunities, limiting home equity and intergenerational wealth.

How can residential segregation affect health directly or indirectly?

Directly: pollution, unsafe housing, fewer healthcare providers, food deserts, and limited safe recreation. Indirectly: fewer wealth-building opportunities, underfunded schools, employment barriers, and chronic stress.

What did When the Bough Breaks show about socioeconomic status and Black infant mortality?

Higher education and socioeconomic status improve health overall, but they do not fully eliminate the racial gap in adverse birth outcomes.

How can chronic stress from racism affect pregnancy?

Repeated discrimination and structural inequity create chronic physiological stress that can contribute to inflammation, premature labor, low birth weight, and infant mortality.

What is the life-course perspective on birth outcomes?

Birth outcomes reflect experiences and exposures across a woman's entire life, not only what happens during the nine months of pregnancy.

What is the difference between biological sex and gender?

Sex refers to biological factors such as genetics, hormones, reproductive anatomy, and physiology; gender refers to socially created roles, expectations, power, and access to resources.

Why is gender considered a determinant of health?

Gender roles and expectations can affect treatment, education, employment, resources, workload, decision-making power, healthcare access, and exposure to health risks.

What is the intergenerational cycle of malnutrition?

Undernourished girls may become undernourished mothers, increasing risks of low birth weight, child malnutrition, and poor health in the next generation; poverty, gender inequality, and early pregnancy can perpetuate the cycle.

What major women's health risks were emphasized in the course?

Violence and sexual abuse, sexually transmitted infections, unsafe abortion, and maternal morbidity and mortality.

Why can women's anatomy increase susceptibility to some STIs?

The vaginal lining is thinner and more delicate than penile skin, and the vagina provides a moist environment in which microorganisms can grow.

What serious reproductive complications can untreated STIs cause in women?

Pelvic inflammatory disease, infertility, and ectopic pregnancy.

What is the relationship between HPV and women's health?

HPV is a common sexually transmitted infection and is the main cause of cervical cancer.

Why is the postpartum period important in maternal mortality prevention?

Many maternal deaths occur after birth; postpartum follow-up, warning-sign recognition, continuity of care, and access to treatment are essential.

What was the overall U.S. maternal mortality ratio presented for 2024?

17.9 maternal deaths per 100,000 live births.

What 2024 maternal mortality ratio was presented for Black women in the United States?

44.8 maternal deaths per 100,000 live births.

What factors contribute to high maternal mortality in the United States?

Medical conditions interact with unequal access to quality prenatal and postpartum care, insurance and transportation barriers, bias, chronic stress, and social determinants. Prevention requires individual, community, health-system, and policy actions.

What does the story of Mrs. X demonstrate about maternal mortality?

Maternal death can result from interacting medical, healthcare-access, quality-of-care, social, cultural, and structural factors rather than one isolated cause.

What is nutrition?

The consumption of food that allows the body to survive, grow, heal, and remain healthy, together with the processing of nutrients within the body.

What is malnutrition?

Suboptimal nutritional status caused by deficiencies, excesses, or imbalances in the intake and processing of energy and nutrients.

What is child stunting?

Low height for age.

What is child wasting?

Low weight for height.

What is the triple burden of malnutrition in the UNICEF framework?

Undernutrition, micronutrient deficiencies, and overweight/obesity.

What is protein-energy malnutrition (PEM)?

Malnutrition involving inadequate energy and protein, often interacting with infection.

What effects of PEM were shown in Fistful of Rice?

Stunting, slowed development, reduced activity, greater susceptibility to infection and disease, impaired mental development, and increased risk of death.

How do infection and malnutrition reinforce each other?

Malnutrition weakens resistance to infection, while infections such as diarrhea, pneumonia, and measles can worsen nutritional status, creating a vicious cycle.

How did migration to Kathmandu increase vulnerability to malnutrition in Fistful of Rice?

Migrant families faced loss of community support, overcrowding, pollution, water shortages, unstable income, and the need to purchase necessities such as food.