unit 8 review
Global health aims to improve health and achieve equity worldwide. It tackles issues like infectious diseases, maternal health, and malnutrition, especially in low- and middle-income countries. The field recognizes social, economic, and environmental factors in shaping health outcomes.
Global health has evolved from early disease control efforts to a more comprehensive approach. Key milestones include the establishment of the World Health Organization, global vaccination campaigns, and the adoption of the Sustainable Development Goals. Today, it addresses challenges like COVID-19, non-communicable diseases, and health inequities.
Key Concepts in Global Health
- Global health focuses on improving health and achieving health equity for all people worldwide
- Encompasses various disciplines, including public health, medicine, economics, social sciences, and environmental studies
- Emphasizes prevention and treatment of diseases and conditions that disproportionately affect low- and middle-income countries (LMICs)
- Infectious diseases (malaria, HIV/AIDS, tuberculosis)
- Maternal and child health issues
- Malnutrition and micronutrient deficiencies
- Addresses health disparities and inequalities within and between countries
- Recognizes the importance of social, economic, and environmental factors in shaping health outcomes
- Promotes collaboration and partnerships among governments, organizations, and communities to address global health challenges
- Aims to strengthen health systems and improve access to essential health services and technologies
Historical Context of Global Health
- Global health has evolved over centuries, shaped by various factors such as colonialism, industrialization, and globalization
- Early international health efforts focused on controlling the spread of infectious diseases across borders
- Quarantine measures and sanitary conventions in the 19th century
- Establishment of the World Health Organization (WHO) in 1948
- Decolonization and the Cold War era saw a shift towards vertical disease control programs and the emergence of new global health actors
- Eradication of smallpox in 1980 through a global vaccination campaign
- The HIV/AIDS pandemic in the 1980s and 1990s highlighted the need for a more comprehensive and coordinated global health response
- The Millennium Development Goals (MDGs) in 2000 set targets for improving health and development in LMICs
- The Sustainable Development Goals (SDGs) in 2015 further emphasized the importance of addressing social, economic, and environmental determinants of health
Major Global Health Challenges
- Infectious diseases continue to pose significant threats to global health
- COVID-19 pandemic has highlighted the ongoing risk of emerging and re-emerging diseases
- Antimicrobial resistance is a growing concern, making it harder to treat common infections
- Non-communicable diseases (NCDs) are the leading cause of death worldwide
- Cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes
- Rising prevalence of NCDs in LMICs due to changing lifestyles and aging populations
- Maternal and child health remains a critical issue in many parts of the world
- High rates of maternal mortality and morbidity, particularly in sub-Saharan Africa and South Asia
- Preventable childhood diseases and malnutrition contribute to high child mortality rates
- Mental health disorders are increasingly recognized as a major global health challenge
- Depression, anxiety, and substance use disorders are among the leading causes of disability worldwide
- Environmental health threats, such as air pollution, water contamination, and climate change, have significant impacts on human health
- Health inequities persist within and between countries, with vulnerable populations often facing greater health risks and barriers to accessing care
Social Determinants of Health
- Social determinants of health (SDH) are the conditions in which people are born, grow, live, work, and age that shape their health outcomes
- Socioeconomic status (SES) is a key determinant of health
- Lower SES is associated with poorer health outcomes and higher mortality rates
- Factors such as income, education, and occupation influence access to resources and health-promoting opportunities
- Social and community networks provide support and influence health behaviors
- Strong social connections are associated with better mental and physical health outcomes
- Physical environment, including housing, neighborhood conditions, and access to green spaces, impacts health
- Exposure to environmental hazards (air pollution, lead) can lead to adverse health outcomes
- Health care system access and quality vary widely within and between countries
- Financial barriers, geographic distance, and cultural factors can limit access to care
- Discrimination and social exclusion based on factors such as race, ethnicity, gender, and sexual orientation can negatively impact health
- Early childhood experiences and development have long-lasting effects on health throughout the life course
- Adverse childhood experiences (ACEs) are linked to chronic health problems in adulthood
Health Systems and Policies Worldwide
- Health systems are responsible for delivering health services and improving population health
- Health system building blocks include service delivery, health workforce, information systems, medical products and technologies, financing, and leadership/governance
- Different types of health systems exist worldwide
- Beveridge model: Government-funded and operated (United Kingdom)
- Bismarck model: Funded by mandatory insurance with private providers (Germany)
- National health insurance: Government-funded with private providers (Canada)
- Out-of-pocket model: Limited government involvement, high private expenditure (many LMICs)
- Universal health coverage (UHC) is a goal to ensure all people have access to needed health services without financial hardship
- Achieving UHC requires strengthening health systems and increasing public health expenditure
- Health policies shape the organization, financing, and delivery of health services
- Policies can address issues such as health promotion, disease prevention, and health equity
- Health system performance varies widely across countries
- Factors such as health expenditure, health workforce density, and quality of care influence health outcomes
International Health Organizations
- World Health Organization (WHO) is the leading international agency for global health
- Sets global health priorities, provides technical assistance, and coordinates international health responses
- Plays a crucial role in monitoring health trends, setting norms and standards, and supporting health system strengthening
- United Nations agencies, such as UNICEF and UNAIDS, focus on specific health issues
- UNICEF works to improve the health and well-being of children worldwide
- UNAIDS leads the global effort to end the AIDS epidemic
- Global health initiatives and partnerships bring together multiple stakeholders to address specific health challenges
- Global Fund to Fight AIDS, Tuberculosis and Malaria mobilizes and invests resources to support countries in combating these diseases
- Gavi, the Vaccine Alliance, works to improve access to vaccines in LMICs
- Non-governmental organizations (NGOs) play a significant role in global health
- Médecins Sans Frontières (MSF) provides medical assistance in crisis situations and advocates for neglected populations
- Bill and Melinda Gates Foundation is a major funder of global health research and programs
- Academic institutions and research centers contribute to global health through research, education, and capacity building
- Collaborate with partners in LMICs to address local health priorities and strengthen health systems
Current Trends and Future Directions
- Increasing recognition of the importance of addressing social determinants of health and health inequities
- Efforts to promote health in all policies and intersectoral collaboration
- Growing emphasis on health system strengthening and resilience
- Investing in primary health care and community-based services
- Improving health information systems and data for decision-making
- Advances in technology and innovation are transforming global health
- Digital health tools (mobile health, telemedicine) are expanding access to health services
- New vaccines, diagnostics, and treatments are being developed for various diseases
- Climate change and environmental sustainability are increasingly recognized as critical global health issues
- Efforts to mitigate the health impacts of climate change and promote planetary health
- Shifting global health governance and financing landscape
- Increasing role of non-state actors and public-private partnerships
- Transition from development assistance to domestic financing in many LMICs
- Emphasis on health security and preparedness for emerging health threats
- Strengthening global surveillance, early warning systems, and outbreak response capacities
Ethical Considerations in Global Health
- Health equity and social justice are central ethical principles in global health
- Ensuring fair distribution of health resources and opportunities
- Addressing health disparities and inequalities within and between countries
- Respect for cultural diversity and local contexts is essential in global health practice
- Engaging communities and stakeholders in the design and implementation of health interventions
- Ensuring cultural sensitivity and appropriateness of health services
- Ethical challenges arise in the allocation of limited resources
- Balancing individual and population-level health needs
- Prioritizing interventions based on cost-effectiveness, equity, and urgency
- Research ethics in global health contexts require careful consideration
- Ensuring informed consent, minimizing risks, and maximizing benefits for participants
- Addressing power imbalances and ensuring local ownership and capacity building
- Ethical dimensions of global health governance and accountability
- Ensuring transparency, inclusivity, and accountability in decision-making processes
- Balancing national sovereignty with global health priorities and obligations
- Ethical implications of health-related trade and intellectual property policies
- Ensuring access to essential medicines and technologies in LMICs
- Balancing incentives for innovation with public health needs and affordability