Classroom discussion

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Health Medical

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Classroom chats provide an opportunity to respond to the videos, readings and presentations in the module. This is also a good place for you to share your personal experience as it relates to the course content. You should write at least a paragraph. While we will not be grading on grammar, spelling, APA etc. in this board, you are expected to write well and in your own words. Copy and pasted material will not be accepted. You will be expected to have a total of 2 classroom chat posts during a module. One of them should be initiated by you and one should be a response. We encourage you to question your classmates and push them to think of issues in depth and with complexity. We will be doing this too. With that said, make sure you post in a way that is respectful of others.

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#$%&'$!()'$*+!,!(-.!//"0! -$12)!.3)4)5*'*1%5!('52%6* -$12)!"! The best student-centered learning experience in America -$12)!/! Photo: Global health indicators and trends Community assessment chart in Kakelo, Kenya. This lecture will describe terms and measures typically used in public and global health. These measures are important to assess the state of health in a country or region, and is also critical for measuring trends and impact of interventions. The photo here is a chart that a community in western Kenya was using to plan and coordinate a community health intervention. While it might not use the same terms used in academic settings, it serves the same purpose. We need to remember that when we go into communities to assist, it is important to not bypass what they are already doing. What they are already doing may be quite effective. ! !! By measuring health we can: Measures of health allow • Estimate the relative importance of diseases. This allows us to decide what to prioritize. • Monitoring trends is important so that we can see what is working and what is not working, as well as what we need to watch to identify outbreaks. • Measuring allows us to make etiological connections. Unless you carefully measure potential risk factors and disease, you cannot make connections. • Estimates of relative importance of disease within a population • Monitoring of trends & identification of epidemics • Connection between determinants and health ! ! "! This picture comes from my own research in Kenya, during which we measured the impact of caring for orphans on the health of elders. Before we started measuring, the assumption was that caregiving had great negative impacts. What we found, however, was that overall caregiving had mostly positive effects on the health of grandmothers.!! -$12)!7! Health is complex and is determined by a combination of factors. While we tend to focus on one or two of these factors, depending on our disciplines, in fact all are important. Remember these factors as we discuss interventions throughout the course.!! Determinants of health: context • Health must be addressed within its context. • Factors include: • • • • • • • Behavior Nutrition Environment (physical and social) Access to healthcare Cultural Socioeconomic status others INMED, 2009 -$12)!8! ! This figure from your textbook provides a little more detail about the determinants of health. As discussed throughout the course, interventions must account for these multiple factors. Figure 2.1: Key determinants of health ! ! ! /! -$12)!9! This is another model of the determinant which layers individual innate factors, lifestyle factors, social and community networks with broader socio-economic, cultural and environmental conditions. So, when we think about a basic health problem—for example malaria—we can look at the disease from all of these perspectives. Another model of health determinants http://www.dohc.ie/publications/fulltext/quality_and_fairness/part1.html ! Innate factors: Pregnant women and children are more likely to get bitten by mosquitoes that carry malaria; people with sickle cell trait are equally likely to be infected, but are less affected by malaria Lifestyle factors: Certain occupations are more likely to put people in areas with high risk of mosquito exposure: fisherman, rice farmers. If people have standing water around their house or screens, their risk changes. Social and community networks: Those with stronger networks can rely on others to help care for them when they are sick. General factors: People who live in rice-farming regions or near lakes are at higher risks. Education is associated with higher rates of use of preventive measures. People may or may not be tested if they do not have access to healthcare facilities. All of these layers interact with each other.!! ! 7! -$12)!:! You will see many indicators throughout the book and they are defined here in the table from your textbook. Table 2.1: Key Health Status Indicators Source: Data from the Public Health Agency of Canada. What Determines Health. Available at: http://www.phacaspc.gc.ca/phsp/determinants/ indexeng.php#determinants. Accessed November 19, 2010. • Life expectancy is most effected by infant and child mortality. ! • Child mortality rates (particularly under 5) is often used as a general indicator of a nation's health.!! -$12)!;! This table presents life expectancy in broad geographic areas. Notice that there has been an increase across all regions but it is greater in some areas. Also note that subSaharan Africa has always and continues to lag behind the other regions.!! Life expectancy by region ! -$12)!
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