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Jay Zanzibar 08

Global Health : Attention to the health outcomes of the most socially and economically vulnerable populations Global Impact Orientation 2011 Jay Mclean-Riggs MPH. Jay Zanzibar 08.

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Jay Zanzibar 08

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  1. Global Health : Attention to the health outcomes of the most socially and economically vulnerable populations Global Impact Orientation 2011 Jay Mclean-Riggs MPH Jay Zanzibar 08

  2. Let us be thankful for the fools. But for them the rest of us could not succeed. (Mark Twain [Samuel Langhorne Clemens] (1835-1910), U.S. author. Following the Equator, ch. 28, "Pudd'nhead Wilson's New Calendar," (1897).)

  3. Social Determinants of Heath Social determinants of health are the economic and social conditions under which people live which determine their health.

  4. Social Determinants of Health • Genetic • Socio-economic • Access to adequate clean water, quality and quantity of food, sanitation, adequate housing • Access to education • Psychosocial • Gender equality • Emotional support and nurture, safety • Cultural acceptance • Environmental - presence and absence of factors • National and regional infrastructure in electrification, communications, IT, sewage disposal, employment, transportation • Health services access, quality, affordability of treatments, preventions and screening • Health Promotion

  5. Virtually all major diseases are primarily determined by a network of interacting exposures that increase or decrease the risk for the disease.

  6. Example : Measles Measles is a viral disease that has killed 190 000 children in 2011 so far. No children in any part of the Americas, North, Central or South have died of measles in 2011.

  7. If a child gets measles they have not been vaccinated (a failure of public health, nationally and globally) • If a child who is well nourished, has no other diseases and has access to clean water, sanitation and care child gets measles it is a mild inconvenience • If an extremely poor child, malnourished without access to care, food, shelter, good hygiene and sufficient clean water gets measles there is a 40% chance they will die. Their immune systems cannot cope with measles.

  8. Global Health Strives to improve the health of vulnerable populations and those who need help most

  9. Poverty impacts Health more powerfully than anything else. Alleviation of dire poverty is the cornerstone of Global Health. Social justice is the cornerstone of poverty alleviation. Awareness and empathy is the key to social justice activism.

  10. International: between or among nations Global implies not only among nations but within nations (intra-national) and includes indigenous peoples, internally displaced peoples, transnational immigrants and refugees

  11. Life Expectancy, Mortality and Morbidity • Life Expectancy: the average time a person lives subjected to the mortality risks in the environment they live in. • Mortality: the number of people who die of a particular cause/population • Morbidity: the suffering, loss of productive work days and capacity, disability from a particular cause

  12. Life expectancy … is the average lifespan a newborn can expect … is short when child deaths are common

  13. 100 Sweden Life expectancy(years) 81 years 80 60 Burundi 50 years 40 Population (millions) 1 100 20 1000 0 200 $ 2000 $ 20 000 $ Income per person (comparable dollars per year)

  14. 100 Burundi Life expectancy(years) 80 60 Burundi 50 years 40 Population (millions) 1 100 20 1000 Can you get old in Burundi? 0 200 $ 2000 $ 20 000 $ Income per person (comparable dollars per year)

  15. 100 Burundi Burundi 2007 2007 Life expectancy(years) 80 Age (years) 60 Burundi 50 years 40 Population (millions) 1 100 20 1000 0 200 $ 2000 $ 20 000 $ Income per person (comparable dollars per year)

  16. 100 Burundi Look at the expected life of five newborn Burundians… 2007 2007 Life expectancy(years) 80 Age (years) 60 Burundi 50 years 40 Population (millions) 1 100 20 1000 0 200 $ 2000 $ 20 000 $ Income per person (comparable dollars per year)

  17. 100 Burundi 2007 How longwillthey live… 80 Age (years) 60 …ifconditionsremain as in Burundi in 2007 duringtheirwholelifetime? 40 20 0 Pierre Liz Jean Ann Sarah

  18. 100 Burundi 84 2007 80 72 57 Age (years) 60 36 40 20 1 0 Pierre Liz Jean Ann Sarah

  19. 100 old Burundi 84 2007 80 72 adult 57 Age (years) 60 36 40 child So yes, 2 of 5 get old in Burundi 20 1 0 Pierre Liz Jean Ann Sarah

  20. 100 Burundi Calculate the mean… 84 2007 This is the Life Expectancy 80 72 = 50 57 Age (years) 60 50 years 36 40 20 1+36+57+72+84 5 1 0 Pierre Liz Jean Ann Sarah

  21. 100 Burundi 84 2007 Sweden Life expectancy(years) 81 years 80 72 31 years 57 60 Burundi 50 years 36 40 Population (millions) 1 100 20 1000 1 0 200 $ 2000 $ 20 000 $ Income per person (comparable dollars per year)

  22. Sweden 100 Sweden Life expectancy(years) 81 years 80 60 40 Population (millions) 1 100 20 1000 Do all Swedes live 31 years longer than the Burundians? 0 200 $ 2000 $ 20 000 $ Income per person (comparable dollars per year)

  23. 100 Sweden 2007 Sweden 2007 Life expectancy(years) 81 years 80 Age (years) 60 40 Look at the expected life of five newborn Swedes… Population (millions) 1 100 20 1000 0 200 $ 2000 $ 20 000 $ Income per person (comparable dollars per year)

  24. 100 Sweden How longwillthey live… 2007 80 Age (years) 60 …ifconditionsremain as in Sweden in 2007 duringtheirwholelifetime? 40 20 0 Per Lisa Jan Anton Sara

  25. 93 100 88 Sweden 84 2007 77 80 63 Age (years) 60 40 4 old 20 1 adult 0 Per Lisa Jan Anton Sara

  26. 93 100 88 Sweden 84 2007 77 81 years 80 63 Age (years) 60 40 Calculate the mean… 20 =81 63+77+84+88+93 5 0 Per Lisa Jan Anton Sara

  27. 100 Sweden 2007 Sweden Life expectancy(years) 81 years 80 60 40 Population (millions) 1 100 20 1000 0 200 $ 2000 $ 20 000 $ Income per person (comparable dollars per year)

  28. Let’s compare Sweden Burundi

  29. 100 Sweden Life expectancy(years) 81 years 80 60 Burundi 50 years 40 Population (millions) 1 100 20 1000 0 200 $ 2000 $ 20 000 $ Income per person (comparable dollars per year)

  30. 100 2007 81 80 Age (years) 60 50 40 20 0

  31. 100 “To live long” in Sweden is almost the same as “to live long” in Burundi 2007 80 Age (years) 60 40 20 But “dying young” in Sweden is very different from “dying young” in Burundi So, no, all Burundians donot live 31 years shorterthan Swedes 0

  32. Life expectancy … is an average -Most Burundians get older than 50 -Some die in childhood … is low when child- deaths are common -It is low in Burundi not because all die a bit earlier -But because some die much younger

  33. Life Expectancy and Wealth • At a certain GDP per capita (estimated at about $23,000) a rise in GDP and income per capita does not generate significantly better life expectancy • The richest countries do have health and well-being related to GNI but to equity of resource distribution

  34. Gender Inequality: burdens on women Nutrition Genetic Inheritance POVERTY Infectious Diseases (malaria, HIV, TB and others) INEQUALITY Weak water Infrastructure & transportation Chronic Diseases (Diabetes, Heart (IHD), Strokes (CVD), Blood Pressure (HTN), Obesity Environment: Physical & Psychosocial

  35. Inequities between nations and within nations: • Levels of Poverty • Gender Inequality • Access to education • Water and sanitation infrastructure • Patterns of Diseases: AIDS, Malaria, TB, Parasitic Worms, Diarrhea, Pneumonias

  36. What are the Millennium Development Goals? The Millennium Development Goals (MDGs) are the most broadly supported, comprehensive and specific development goals the world has ever agreed upon. Eight time-bound goals provide concrete, numerical benchmarks for tackling extreme poverty in its many dimensions. Goals and targets on income poverty, hunger, maternal and child mortality, disease, inadequate shelter, gender inequality, environmental degradation and the Global Partnership for Development.The eight MDGs break down into 21 quantifiable targets that are measured by 60 indicators.

  37. Global Impact Supports the MDGs Pangani Beach, Tanzania Jay08

  38. In Tanzania: Sustainable Agriculture, Orphan Care, Special Education For better immunity, poverty alleviation, and environmental sustainability and conservation And global partnership Supporting MDGs 1, 3, 4, 5, 7, and 8

  39. In Vietnam: Building Infrastructure, providing access to clean water, preventative dental services, access to care, and Global Partnership Supporting MDGs 2, 4, 7 and 8

  40. In Peru: Preventing respiratory diseases, reducing fuel consumption by installing stoves, Increasing access to clean water with water filters, access to care and preventative health services, and Global Partnership Supporting MDGs 1, 3, 4, 5, 7, and 8

  41. In India: Environmentally sound infrastructure projects, reducing fecal-oral disease with sanitation and medical and dental outreach work Supporting MDGs 1,3,4,5,7,and 8

  42. Health is vigor, vitality, strength, fitness, well being, stamina, soundness of body and mind, and the capacity to live a full and productive life. Global Health is for everyone.

  43. Education is the most powerful weapon which you can use to change the world. Nelson MandelaGlobal Impact 2011

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