Intro to global health
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University of Nottingham UK
China | Malaysia
Public Health Theme: Global Health
Instructor: Dr. Ilze Bogdanovica
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Public Health Theme Overview:
Understanding health inequalities and determinants of population health
Developing public health policy and programs to improve health
Assessing health status and needs of populations
Efficient use of scarce resources for health
Applications of Public Health Toolkit:
Introduction to Public Health
Screening
Environment, occupation, and health
Global Health
Communicable disease control
Epidemiology
Supporting high-quality health systems
Lifestyle risks
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Learning Outcomes:
Describe global health challenges and strategies
Explain health impacts of globalization
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Global Health Trends (University of Nottingham UK | China | Malaysia)
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What is Global Health?
Improving health and achieving equity for all worldwide
Focus on unfair health outcome differences between countries
Health issues that transcend individual nations
Recognition of shared problems and solutions (e.g. Ebola, Climate change)
Interdisciplinary Approach: Involvement of health care professionals, economists, engineers, etc.
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Global Trends in Causes of Death (1990-2017):
41% decrease in communicable diseases and neonatal disorders
40% increase in non-communicable diseases
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Epidemiological Transition (Omran 1971):
Societal development leads to:
Decline of infectious diseases and malnutrition
Rise of non-communicable chronic diseases
Age Patterns of Mortality:
Shift from younger to older age groups
Age of Pestilence and Famine: Life expectancy 20-40 years
Age of Receding Pandemics
Age of Degenerative and Man-Made Diseases: Life expectancy 70+ years
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Healthy Life Expectancy (2019):
Measured as average years a person can live in full health
Average: 63.7 years in 2019
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Global Burden of Disease - Nottingham
Leading Causes of Early Death and Disability (2017):
Low SDI countries:
Neonatal disorders
Lower respiratory infections
Diarrheal diseases
Malaria
Congenital defects
High SDI countries:
Ischemic heart disease
Low back pain
Stroke
Lung cancer
COPD
SDI: Captures income, education, and fertility.
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Global Health Determinants:
Factors influencing health outcomes at a global level
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Determinants of Health:
Living and working conditions: Employment, community, sanitation, etc.
Age, sex, and constitutional factors
Applies universally, irrespective of geography
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Global Health Determinants Include:
Urbanization
Migration
Anti-microbial resistance
Conflict
Emerging/re-emerging infections
Climate change
Weak health systems
Poverty/lack of development
Globalization
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What is Globalization?
Increasingly connected cultures and economies
Enhanced interaction and formal collaborations among countries
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Globalization Impact on Health:
Positive: Dissemination of knowledge and economic growth
Negative: Spread of communicable diseases and unhealthy lifestyle promotion
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COVID-19 Global Impact:
Cumulative Cases: 617,597,680
Total Deaths: 6,532,705
Vaccine Doses Administered: 12,723,216,322
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Global Solutions for COVID-19:
Oxford AstraZeneca vaccine optimization for developing countries
Recognition of flawed global response to vaccination challenges
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Importance of Vaccine Equity:
36% vaccinated with at least one dose
Ensures allocation regardless of economic status
Consequences: socio-economic recovery impact, preventable deaths, growing inequalities, prolonged pandemic
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Determinants of Global Health - Conflict:
Consequences of armed conflict: injuries, food supply disruptions, mental health effects, healthcare access issues
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Global Consequences of War:
Economic growth impact: inflation, extreme poverty, food insecurity, environmental impact
Affects migration patterns
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Reasons for Migration:
Social and Political Factors: Persecution from ethnicity, religion, or politics
Demographic and Economic Factors: Poor labor standards, high unemployment
Environmental Factors: Natural disasters, extreme weather
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Determinants of Global Health - Migration:
281 million international migrants as of 2020
Contribution of migrants to health services in high-income countries
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Health Impacts of Migration:
Risks: death in transit, interrupted care for chronic diseases, overcrowding in refugee camps
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Poverty and Health:
Connection to poor sanitation, overcrowding, and inability to access health care
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Weak Health Systems:
Factors include leadership, health financing, workforce challenges, service delivery
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Weak Health Systems - Challenges:
Resource management, transparency, and infection control issues
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Ebola Outbreak (2014-16) - Determinants:
Weak health systems shaped the outbreak: poor surveillance, insufficient workforce, and infrastructure issues
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Ebola Impact:
Severe health worker losses (7% of Sierra Leone's workforce) and increased mortality from other diseases
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Ebola Virus Management:
Specific handling requirements for deceased Ebola patients by World Health Organization
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Global Health Goals (University of Nottingham)
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Sustainable Development Goals (2015):
Framework addressing interconnected challenges across poverty, health, and growth areas
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Goal 3 - Good Health & Well-being:
Targets to reduce mortality, end epidemics, achieve universal health coverage, among others
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Global Health Architecture:
Involvement of UN agencies, government bodies, philanthropic organizations, and civil society in health initiatives
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Vertical vs. Horizontal Approaches:
Vertical: Focused, immediate health interventions
Horizontal: Comprehensive health system strengthening leading to long-term impact
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Vertical Approach Examples:
Preventative and treatment interventions targeted to reduce under-5 mortality
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Horizontal Approach: Strengthening Systems:
Emphasis on community engagement, training, and decentralization for improved health outcomes
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Global Health Progress Measurement:
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Progress in Reducing Under-5 Mortality:
Results from increased healthcare access, vaccinations, and nutrition
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Maternal Mortality Trends:
Downward trend influenced by skilled birth attendance access
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Childhood Obesity Trends:
Dramatic increase with projected future trends needing urgent action to meet targets
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Consequences of Increased Healthcare Access:
Rising mortality linked to antibiotic resistance, especially for drug-resistant TB
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Global Health Challenges:
Priority setting, data sufficiency, program funding, sociopolitical context challenges
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Conclusion:
Globalization's double-edged impact on health
Persistent inequalities in health outcomes globally
Influence of poverty, urbanization, conflict, and health system weaknesses
UN Sustainable Development Goals as vital frameworks for addressing challenges.