GPH Exam 1

Huber eat al, 2011. Definition of health

the ability to adapt and to self-manage.

Emotional

coping effectively with life and creating satisfying relationships

Finanical

Satisfaction with current and future financial situations

Social

Developing a sense of connection, belonging, and a well-developed support system

spiritual

expanding our sense of purpose and meaning in life

Occupational

personal satisfaction and enrichment derived from one's work

Physical

recognizing the need for physical activity, diet, sleep, and nutrition

Intellectual

Recognizing creative abilities and finding ways to expand knowledge and skills

environmental

Good health by occupying pleasant, stimulating environments that support well-being

Public Health (CDC)

Public health is the science of protecting and improving the health of people and their communities.

Public health is the science of

population-based prevention

Examples of public health activities

promotion of hand washing, promotion of helmets, education of HIV/ AIDS, Large scale screening for diabetes/ hypertension, large scale screening of eyesight in schoolchildren, mass dosing of children against worms, operation of a supplementary feeding program for poorly nourished young children

Public Health perspective

Focus: population

Ethical basis: public service

Emphasis: disease prevention and health promotion for communities

Interventions: Broad spectrum that may target the environment, human behavior, lifestyle, and medical care

Medicine perspective

Focus: individual

Ethical basis: personal service

Emphasis: disease diagnosis, treatment, and care for individuals

Interventions: emphasis on medical care

Benjamin Franklin quote

an ounce of prevention is worth a pound of cure

Global Health

an area for study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide

Global health issues

- emerging and reemerging infectious disease

- antimicrobial resistance

- eradication of polio

- TB

- Malaria

- HIV

- The increasing cases of diabetes and heart disease globally

Determinants of Health (WHO)

- Income and social status

- Education

- Physical environment

- Social support networks

- Genetics

- Health services

- Gender/sex

Key issues in Global Health

- environmental health

- nutrition

- women's health

- child health

- communicable diseases

- non-communicable diseases

- injuries

The United Nations

An international organization formed after WWII to promote international peace, security, and cooperation. The UN was created to safeguard global peace and ensure the horrors of the Holocaust would never occur again.

The United Nations Children's Fund (UNICEF)

procures vaccines that reach 45% of the world's children, saving the lives of 2.5 MILLION children

The Office for the Coordination of Humanitarian Affairs (OCHA)

Helped half a million people protect their homes before waters rose during a 2024 flood alert in Bangladesh

UN Refugee Agency (UNHCR)

Protects and safeguards the rights of refugees worldwide and helps facilitate resettlement or return home.

UNHCR delivers lifesaving aid and promotes access to education, healthcare, and economic opportunity.

UNHCR is helping tens of millions of people displaced by famine, armed conflict and persecution.

World Health Organization (WHO)

A group within the United Nations responsible for human health, including combating the spread of infectious diseases and health issues related to natural disasters.

- 194 COUNTRIES

* For every dollar the US gave WHO, it receives 0.46 back to the economy.

World Food Programme (WFP)

Branch of the UN that assists people facing hunger worldwide and works with communities to improve nutrition.

- WFP provides food and cash assistance to more than 150 million people in 120 countries.

- American farmers and food producers worth more than 2.6 billion in the last five years.

UNAIDS (Joint United Nations Programme on HIV/AIDS)

Leading global effort to end AIDS as a public health threat

- it places people living with HIV and people affected by the virus at the decision-making table and at the center of designing, delivering and monitoring the AIDS response.

Gavi

Global Alliance for Vaccines and Immunization

- has helped vaccinate more than 1.1 billion children in 78 lower-income countries, preventing 18.8 million future deaths.

Global Fund for AIDS, TB, Malaria

a worldwide partnership to defeat AIDS, tuberculosis (TB) and malaria and ensure a healthier, safer and more equitable future for all

The Gates Foundation

founded by bill gates donated money to develop schools in Africa to improve the overall level and quality of education

The Clinton Health Assess Initiative (CHAI)

A nonprofit global health organization committed to building a world in which everyone is able to live a health and fulfilling life.

- Getting medication prices lower and into the right hands

PEPFAR

President's Emergency Plan for AIDS Relief

- The largest commitment by any nation to address a single disease in history (saving 26 million lives)

The Global Health Center (CDC)

CDC aspires to create a world where people in the United States and around the globe live healthier, safer, and longer live

- Global health security is a "best buy" for America

Doctors Without Borders

Doctors volunteer all over the world to help people with emergency medical aid from war, conflict, epidemics, disasters, and poverty.

"we work to ensure that our teams can reach people in need without restriction and provide aid directly"

Peace Corps

(1961 by President Kennedy)

Volunteer oversees, typically just over two years.

-travel to developing countries all over the world to assist with many ongoing efforts including AIDS, education, business training, and information infrastructure development.

Nipah Virus

- First discovered in 1999 following an outbreak of disease in pigs and people in Malaysia and Singapore. (recent epidemic in India)

-zoonotic virus, it initially spreads between animals and people.

- Animal host reservoir for NiV is the fruit bat

-acute respiratory infection and fatal encephalitis.

- The case-fatality rates in outbreaks across Bangladesh, India, Malaysia, and Singapore typically range from 40% to 100%

Nipah Virus prevention

- date palm juice should be boiled.

- fruits should be washed and peeled before consumption

- fruits with signs of bat bites should be discarded

Monkeypox (Mpox)

Pandemic #1 (2022-2023)

- Mpox hit the US in 2022, globally there were 99,518 cases of including 32,063 in the US (54 US Deaths)

DALYs (disability-adjusted life years)

In low-income countries they accounted for about 40% of all deaths and 40% of all DALYS

What is the Burden of Disease Caused by Communicable Diseases?

Communicable disease may be caused by a wide variety of organisms, such as bacteria, viruses, or parasites

Smallpox (ex of cd)

- estimated to have killed up to 300 million people in the 20th century

- estimated to have killed around 500 million in the last 100 years of its existence

-caused by a virus

1918 Influenza (ex of cd)

killed 50 million people (worldwide pop of 2 billion)

- caused by a virus

Tuberculosis (ex of cd)

caused by a bacteria

# of people living with TB

11 million

# of new TB cases

9 million

# of TB deaths

1.5 million

Proportion of new cases with multidrug-resistant TB

3.5%

Malaria (ex of cd)

caused by a parasite

The Burden of Malaria

- leading cause of DALYs in sub-saharan africa among all age groups

- the necessary risk factor for malaria is being bitten by mosquitoes that carry the malaria parasite

- pregnant women who contract malaria are at heightened risk of maternal death and giving birth to low birthweight children

Key interventions of addressing the burden of Malaria

- prompt treatment of those infected, based on confirmed diagnosis

- intermittent preventive therapy for pregnant women and infants

- seasonal malaria chemoprevention for children under 5 in selected areas

- Long-lasting insecticide-treated bednets for people living in malarial zones

- indoor residual spraying in malarial zones

What Public Health Tools are Available to Address the Burden of Communicable Diseases?

-Barrier protections: isolation, quarantine

-Immunizations

-Screening and case finding

-treatment and contact treatment

-efforts to maximize effectiveness of treatments and prevent resistance to treatment

How Can Barriers Against Disease be Used to Address the Burden?

-Insecticide-impregnated bed nets decrease the rate of malaria

transmission

-Condoms prevent sexually transmitted diseases

-Masks reduce the spread of disease in healthcare institutions

-Isolation and quarantine are used to separate individuals with

disease from the healthy population to prevent exposure

Screening controls the spread of many infections (examples)

HIV, STDs, tuberculosis, syphilis

Screening for communicable disease has been linked with case finding

-Confidential interviewing of those diagnosed with the

disease and asking for their recent close physical or sexual

contacts

- Key to the control of syphilis and TB both before and

after the availability of effective treatment

Foodborne (transmission paths for communicable diseases)

salmonella, E.coli

Waterborne (transmission paths for communicable diseases)

Cholera, rotavirus

Sexual or bloodborne (transmission paths for communicable diseases)

Hepatitis, HIV

Vector-borne (transmission paths for communicable diseases)

malaria

Inhalation (transmission paths for communicable diseases)

- tuberculosis, influenza, covid-19

Non-traumatic contact (transmission paths for communicable diseases)

Anthrax

Traumatic Contact (transmission paths for communicable diseases)

rabies

Chain of infection (CDC)

Transmission occurs when the agent leaves its reservoir or host through a portal of exit, is conveyed by some mode of transmission, and enters through an appropriate portal of entry to infect a susceptible host.

Reservoir

The habitat in which the agent normally lives, grows, and multiplies.

(include humans, animals, and the environment)

Portal of exit

a pathogen leaves its host.

-corresponds to the site where the pathogen is localized

direct transmission

involves physical contact between humans, or close contact

- also refers to contact with soil or vegetation harboring infectious organisms.

-kissing disease + gonorrhea are spread person-to-person

Skin-to-skin contact (direct transmission)

kissing or sexual intercourse

droplet transmission (direct transmission)

-spray with relatively large, short-range aerosols produced by sneezing, coughing, or even talking.

(pertussis and meningococcal infection)

Indirect transmission

the transfer of an infectious agent from a reservoir to a host by suspended air particles, inanimate objects (vehicles), or animate intermediaries (vectors)

Airborne Transmission (indirect transmission)

Infectious agents are carried by dust or droplet nuclei suspended in air

ex: measles

Vehicle Transmission (Indirect Transmission)

may indirectly transmit an infectious agent include food, water, biologic products (blood), and fomites.

- May passively carry a pathogen- as food or water may carry hepatitis (a virus)

Fomites

Inanimate objects, such as countertops and computer keyboards, (or handkerchiefs, bedding, or surgical scalpels) that can harbor material containing infectious agents

Vectors (indirect transmission)

mosquitoes, fleas, and ticks may carry an infectious agent through purely mechanical means or may support growth or changes in the agent.