Exam 1 Nutri Sci 203 UW Madison Fall 2024

International Health

the study of health issues that affect people living in the developing world or outside one's own country

Domestic Public Health

issues that affect people living in the US or within a country

Environmental Health

the theory and practice of assessing, correcting, controlling, and preventing environmental factors that can adversely affect the health of present and future generations

Public Health Code of Ethics

-Prevention of disease

-Respect for the rights of individuals

-Commitment to developing public health efforts in conjunction with communities

-Attention to disenfranchised people and communities

-Appreciate values, beliefs, and cultures of diverse groups

-Enhance the physical and social environment

Health

health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity

Public Health vs Medicine

Public health: focus on population and public service, emphasizes disease PREVENTION and health promotion for communities, interventions have a broad spectrum and may target the environment, human behavior, lifestyle and medical care

Medicine: focus is on the individual and personal service, emphasis on disease diagnosis, treatment, and care for individuals, interventions are for medical care

Sustainable Development Goals

Seventeen goals adopted by the U.N. in 2015 to reduce disparities between developed and developing countries by 2030.

SDG 1

No poverty. End poverty in all its forms everywhere. Extreme poverty means less than $1.25 a day. Halve the number of ppl living in poverty by 2030

SDG 2

End hunger, achieve food security and improved nutrition and promote sustainable agriculture

Food Security

Access by all people at all times to enough food for an active, healthy life

At a minimum: 1) the ready availability of nutritionally adequate and safe foods, and 2) an assured ability to acquire acceptable foods in socially acceptable ways (no stealing)

Food Insecurity

Limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways

Hunger

The uneasy or painful sensation caused by a lack of food. The recurrent and involuntary access to food.

SDG 3

Ensure healthy lives and promote well-being for all at all ages

SDG 4

Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all

Kerala state in India

quality education, widespread healthcare access, strong nutrition programs

SDG 5

Achieve gender equality and empower all women and girls

SDG 6

Ensure availability and sustainable management of water and sanitation for all

SDG 7

Ensure access to affordable, reliable, sustainable, and modern energy for all

SDG 8

Promote sustained, inclusive, and sustainable economic growth, full and productive employment and decent work for all

SDG 9

Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation

SDG 10

Reduce inequality within and among countries

SDG 11

Make cities and human settlements inclusive, safe, resilient, and sustainable

SDG 12

Ensure sustainable consumption and production patterns

SDG 13

Take urgent action to combat climate change and its impacts

SDG 14

Conserve and sustainably use the oceans, seas, and marine resources for sustainable development

SDG 15

Protect, restore, and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss

SDG 16

Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels

SDG 17

Strengthen the means of implementation and revitalize the global partnership for sustainable development

Determinants of Health

Physical environment, health behaviors, social environment, access to health services, individual

Infant mortality rate

Number of deaths of infants under age 1 per 1000 live births in a given year.

Deaths/live births (1000)

Life expectancy at birth

The average number of years an infant can expect to live if current mortality trends were to continue for the rest of the newborns life

Maternal mortality rate

Number of women who die as a result of pregnancy and childbirth complications per 100000 live births in a given year

Neonatal mortality rate

the number of deaths to infants under 28 days of age in a given year per 1000 live births in that year

neonatal deaths/live births (1000)

Under five mortality rate

the probability that a newborn baby will die before reaching age five, expressed as a number per 1000 live births

HALE

Health Adjusted Life Expectancy: number of years to be lived in the equivalent of good health

DALY

Disability Adjusted Life Year: measure of premature deaths and losses due to illness and disabilities in a population

Kerala Case Study

Health indicators are the best in India, despite slow economic growth and a low per capita income. Success due to educating women and free education since the early 20th century. Targeted the most vulnerable groups and applied community-based solutions.

NGO

non-governmental organizations that are non-profit

private foundations

founded by for profit companies (bill and melinda gates foundation)

How does wealth/poverty affect nutrition?

Wealth improves nutrition and poverty breeds undernutrition

How does wealth affect life expectancy?

Higher GDPs generally lead to longer life expectancies

How does wealth affect infant mortality?

Wealth decreases infant mortality.

How does education affect life expectancy?

More education = longer life expectancy

What does height tell us about someones health?

Height is an indicator of investments in human capital made during childhood. Can have poor health status.

Poor nutritional intake impacts

poor health status, diseases and infections, low functional health status

how does health status affect labor productivity?

Lower health status = lower labor productivity

What is the effect of access to healthcare? (Indonesia case study)

In Indonesia, some public health clinics raised user fees and others kept their fees constant. Utilization of clinics declined where the fees increased. Labor force participation also declined in the areas where fees increased.

Affordable Care Act

An expansion of medicaid, most of employers must provide health insurance, have insurance or face surtax, prevents rejection based on pre-existing condition, coverage until 26 on parents plan. Also referred to as "Obamacare", signed into law in 2010.

What effect does a mother's education have on childhood stunting?

as more women are educated, less children are stunted.

Demographic transition

change in a population from high birth and death rates to low birth and death rates

Momentum

tendency for population to grow even after fertility falls to replacement level

Total Fertility Rate

total number of children a woman would have in her reproductive years

Why choose many children?

labor, care in old age, replace dying children, culture, religion, gov exhortation and rewards

Why choose fewer children?

- Labor no longer need on farm

- U-5 mortality declines (no longer need worry about replacing dying children)

- Women want to study and/or work

- Women want more control of their lives

- Ability to give kids a better life

- Other sources of old age security - savings, gov

- Gov policies

- Decrease risk of maternal mortality

Relationship between fertility and wealth?

more wealth == lower fertility

Impacts of climate change on food security

reduced yields of plants, reduced nutritional content, increased disease transmission rates, loss of water stored in snow pack and glaciers

Green Revolution

Rapid diffusion of new agricultural technology, especially new high-yield seeds and fertilizers.

Yield gap

the gap between a certain crop's average yield and its maximum potential yield

Defensive technologies (protect the potential yield)

Drought tolerant varieties, fertilizer, fungicides or pesticides

Yield-enhancing technologies

new varieties, fertilizer, irrigation, tractor

CIMMYT Mission

maize and wheat science for improved livelihoods

CoCA

Cost of Calorie Adequcy: minimum cost to meet energy requirements using the least cost available starchy staple food in each country

CoNA

Cost of Nutrient Adequacy: minimum cost to meet energy and nutrient requirements

CoRD

Cost of Recommended Diet: minimum cost to meet food based dietary guidelines, based on food group classifications

How many people can't afford the CoNA?

3 billion

defensive technologies

protects yield

How do we feed 9.8 billion people?

Close yield gap, increase yield potential, reduce waste, and change diets

wasting

being underweight for their height

Female farmers in nepal

provided safe storage for their seeds so they could sell more and have an asset to make more money

Horticultural crops

vegetables, fruits, nuts, ornamental crops

high value small scale

not staples

sold fresh

Agronomic crops

oilseeds, grains and feeds, cotton tobacco and sugar, alfalfa and hay

phytonutrients

nutrients and promoters of health found in some plants

why the shortfall nutrient intake from vegetables and fruits?

horticultural crops are underconsumed in the US

SDGs that apply to animal source foods

no poverty, zero hunger, good health and wellbeing, decent work and economic growth, responsible consumption and production, life below water, life on land

Food System

the people, places, and activities that bring us food

systems approach for health outcomes

build and connect systems to more parts of themselves

linkages among animal source foods, nutrition and health

ASFs can contain higher concentrations or more bioavailable forms of nutrients (protein, omega 3s, iron, zinc, calcium...)

Bioavailability

the proportion of ingested nutrient that is absorbed

anemia

low red blood cells, limiting the ability for the body to carry oxygen to tissues

stunting

low height for age, impacts cognitive and physical development

Linkages among ASF on nutrition and health

inverse association between child stunting and meat consumption at country level

dietary energy from cereals roots and tubers associated w hidden hunger index

excess consumption of certain ASF can lead to

health problems (cardiovascular diseases) (saturated fat and cholesterol)

impacts of asf production on environment

land use, GHG emissions, pollution, biodiversity changes

impacts of animal source food production on livelihoods

important for livelihoods in many societies, w livestock playing important roles in farming systems

-livestock production supports 1 billion low income smallholders in low-middle income countries

FoodTank double pyramid

fruits and veggies have the least env impact, and its recommended we eat the most of them

red meat and dairy have the most env impact, and its recommended we eat less of them.

ecosphere

the dynamic mantle of life made possible by the interactions of air, water, minerals, and living beings

Ecosphere is the limited living globe that is our home

SDGS most relevant to ecosphere health

no poverty, zero hunger, good health, clean water and sanitation, affordable and clean energy, climate action, life below water, life on land, peace and justice

Greenhouse Effect

Natural situation in which heat is retained in Earth's atmosphere by carbon dioxide, methane, water vapor, and other gases

Reductionist approach

analysis, pieces, parts, mechanisms, structure

Holist approach

synthesis, whole, meanings, functioning

eutrophication

A process by which nutrients, particularly phosphorus and nitrogen, become highly concentrated in a body of water, leading to increased growth of organisms such as algae or cyanobacteria.

dead zone (hypoxia)

In a body of water, an area with extremely low oxygen concentration and very little life

industrial agriculture

intensive farming practices involving mechanization and mass production (high yielding bred seeds, chemical fertilizers, etc)

Agroecology

nature model, local adapted species and cultivars, biological pest and disease control

perennials

flowering plants that live for more than two years

SDGs most relevant to global health systems

ending poverty and partnerships for the goals

key actors in global health

UN agencies (UNICEF children's fund, UNAIDS)

Multilateral development banks (The World Bank)

Bilateral agencies (work directly with developing countries) (USAID, Canadian IDA)

The World Bank

Gives loans for low-income countries and NGOs

Want to end extreme poverty (less than 1.90 a day)

Promote shared prosperity by fostering income growth of the bottom 40% for every country

Key actors in global health

foundations (bill and melinda gates foundation and NGOS (save the children, doctors without borders)

Setting the global health agenda

world health assembly, 1993 world development report, investments of bill and melinda gates foundation, population action by NGOs, international orgs