Intro GH Midterm

World Health Organization (WHO)

Specialized agency of the United Nations responsible for international public health. It works to promote health, keep the world safe, and serve vulnerable populations.

Health

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

Health intervention

actions/ collection of actions in response to a specific health problem designed to improve health outcomes and address public health issues.

Global health

Collaborative actions taken to identify and address transnational concerns about the exposures and diseases that adversly affect human populations

International health

Health issues that are specific to different countries, often emphasizing the health systems and policies of individual nations/regions

Etiology

The study of the social/behavioral, environmental, biological, and other causes of disease

Social ecological model

Looks at the individual within the context of their environment:

Individual, interpersonal, organizational, community, society

Health trajectory

Graphical representation of one’s life showing their health throughout and their relative time of death

Intervention

A strategic action intended to improve individual and population health status

Interventions at larger level (societal vs. individual) are more effective

Prevention science

Study of which preventative health interventions are effective in various populations, how successful the interventions are, and how well they can be scaled for widespread implementation

More cost effective than treatment

Primary prevention

Total prevention; seatbelts

Secondary prevention

Early detection that allows for prompt treatment; screenings

Tertiary

Treatment before something gets worse

Health promotion

Being extra healthy; eating vitamins

Step 1: Surveillance

What is the problem

Step 2: Risk factor identification

What is the cause?

Step 3: Intervention evaluation

What works?

Step 4: Implemention

How do you do it?

Incidence

New cases

Equation: # of new cases of the disease occurring / total # of people at risk

(within given time period)

Prevalance

Existing cases (newly diagnosed or long established)

Equation: (# total existing cases + duration) / total population

Global vs. public health

Global:

Requires global cooperation

All encompassing

Transcends national boundaries

Public:

Focuses on particular community or country

Globalization

Process of countries becoming more integrated and interdependent across economic, political, cultural, and other domains

Health transitions

Shift in the health status of a population; usually occurs in conjunction with socioeconomic development

Human Development Index (HDI)

Estimate of national development based on composite data on longevity, knowledge, and income

High HDI = better health status + great levels of happiness

Gini Index

Measure of the inequality in the distribution of income within a country on scale of 0-1

0: complete inequality

1: complete equality

Millennium development goals (MDG)

8-goal UN framework focused primarily on poverty and social issues in developing nations from 2000 to 2015

Sustainable Development Goals (SDG)

17 goals addressing economic, social, and environmental challenges for all countries established by the member countries of the UN at the end of 2015 to be accomplished by 2030

One health

integrative effort of multiple disciplines working locally, nationally, and globally to attain optimal health for people, animals, and the environment

Endemic

A disease that is always present in a human population

Outbreak

At least several people becoming ill with something that is not usually present in that population

Epidemic

Disease occurring more often than usual in a human population (larger than outbreak and relatively local)

Pandemic

Worldwide epidemic

Mortality

Death rate, annual # of deaths per 1000 people

Birth Rate

Annual # of births per 1000 people

Morbidity

Presence of illness or disease

Vital Statistics

Population level metric about births, deaths, and other life events. Includes birth rate, death rate, and morbitity

Health Difference

Any gap in health between groups; some are expected

Health inequity

A gap that is avoidable, unfair, unjust

Health Disparity

Preventable systematic gaps borne by socially disadvantaged populations

Social Determinants of Health

the conditions in places people live, learn, work, play, worship, and age that affect health risks/outcomes

Structural Determinants

The root cause of health inequalities: they decide whether resources are distributed fairly or unjustly by race, gender, class, and geography

Extreme Poverty

Under the international line of poverty ($1-2/day)

Relative Poverty

Under one’s national poverty line

Health literacy

Ability to understand CDC guidelines, what is good for you

Literacy

Reading, writing, and applying those skilss

Direct costs of healthcare

Insurance, copays, providers, hospital stays, medication

Indirect costs of healthcare

Transport, child care, lost wages, lodging, meals

The exposure pathway

Source - Transport - Exposure - Dose - Effect

Between each is a point of intervention

Dose response

the connection between the amount or concentration of a substance a person is exposed to and the resulting biological or medical effect

Threshold (dose response)

Classic toxicant, safe until threshold

No threshold (dose response)

Never safe

Non monotonic (threshold)

Your body adapts to the substance and it will effect you less the more you use it; occurs for endocrine disruptors

Quality (water access)

Free of pathogens and chemicals

Reliability (water access)

Always available

Quantity (water access)

Enough to drink, cook, wash with

Proximity (water access)

Under 30 minutes round trip

Cost (water access)

Affordable for the poorest

Sanitation

The safe disposal of human waste

Hygiene

The practice of maintaining cleanliness to prevent disease

Open defecation free

When all members of a community are using designated toilet facilities

Energy

Necessary for at least four important purposes: cooking, boiling water, heat, source of light

Household airpollution

Smoke from biomass, coal cooking, heating fuels

Concentrated in low income homes

Women and children most affected

Ambient air pollution

Vehicles, industry, power plants, fires

Household air pollution fix

Clean stoves, electricity, ventiliation

Ambient air pollution fix

Clean Air Act, cleaner fuels/transit, increased green spaces

Occupational health controls (best to worst)

Elimination (removal of hazard) - Substitution (replace hazard with something safer - Engineering controls (isolate people from it) - Administrative controls (Change how people work) - PPE (personal protective equipment)

Toxicology

Study of poisons

Carcinogen

Something that causes cancer

Endocrine disruptor

Something that messes with your hormones

Teratogen

Something that causes birth defects

Neurotoxicant

Damages the nervous system

Child labour

Illegal when workload, conditions, or intensity harm physical, mental, or moral development

Costs compound: injury + lost schooling = lost lifetime health & income

Ecological footprint

The amount of energy consumed and waste produced per person

Carrying capacity

Maximum population an environment can sustain

Affects of climate on health (direct)

Heat waves, floods, storms, wildfire smoke, droughts

Affects of climate on health (ecosystem mediated)

Mosquitoes, ticks, water/food borne illness, crop failure

Affects of climate on health (socially directed)

displacement, conflict, disrupted health systems

Biodiversity

The variety of all living things on earth

Antimicrobial resistance

When bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines like antibiotics or antifungals

Planetary health

The relation between human health and the earth and the damage we cuase to both by damaging the earth

Strategies for improvement

Regulate, monitor, build (access to clean water, site cleanup), design (implementation of trees/green spaces), households (indoor air filters), involve people