International Public Health
summary
1
,Lecture 1 | Introduction to IPH 3
Lecture 2 | Health determinants, measurements & trends 4
Lecture 3 | Non-communicable diseases 8
Lecture 4 | Infectious diseases 11
Lecture 5 | Sexual and reproductive health 16
Lecture 6 | Mental health 20
Lecture 7 | Environmental health 24
Lecture 8 | Nutrition and global health 25
Lecture 9 | Natural disasters and complex humanitarian emergencies 31
Lecture 10 | Science, technology and global health 33
Lecture 11 | Child and youth health 37
2
, Lecture 1 | Introduction to IPH
- De nition of health:
- WHO, 1948: a state of complete physical+mental+social well-being and not merely the
absence of disease/in rmity
- Still considered what aspects of physical/mental/social well-being concern
health
- Huber et al., 2011: the ability to adapt and self manage in the face of
social+physical+emotional challenges
- Some unique features of public health:
- Use of prevention as prime intervention strategy
- Can be direct prevention of illness, deaths, and hospital admission; or more
related to quality of life by preventing/reducing days lost from work/school/
consumption of human+ nancial resources associated with ill-health
- Grounded in a broad array of sciences
- Basis in social justice philosophy
- Everyone should have access to basic health needs
- Equity in health care
- Link with government and public services
- Public health vs medicine:
- Public health:
- Primary focus on population
- Public service ethic, with concern for the individual
- Emphasis on health promotion and disease prevention
- Works within multiple systems
- Medicine:
- Primary focus on the individual
- Emphasis on diagnosis and treatment; care for the whole patient
- Dependent on the health care system
- International Public Health:
- Public Health: the science+art of preventing disease, prolonging life and promoting
physical health and e ciency through organized community e orts
- International Public Health: application of the principles of public health to health
problems and challenges that a ect low-and-middle-income countries and the complex
array of global+local forces that in uence them
- Global Health: an area for study+research+practice that places a priority on improving
health and achieving equity in health for all people worldwide
- One Health: the integrative e ort of multiple disciplines working
locally+nationally+globally to attain optimal health for
people+animals+environment
- Focus on interconnectedness of animal, human, and environmental health
- Planetary Health: the health of human civilization and the state of the natural
systems on which it depends; the achievement of the highest attainable
standard of health+wellbeing+equity worldwide through judicious attention to
human systems
- Focus on the health of the environment and the connections between that
and human and animal well-being
- History of international public health:
- 400 BC — Hippocrates presents causal relation between environment and disease
- 1st century AD — Romans introduce public sanitation and organized water supply
system
- 14 century — Black Death leads to quarantine and cordon sanitaire
- Middle Ages — Colonial expansion spreads infectious diseases around the world
- Particularly in Northern US
- 1750-1850 — Industrial revolution results in extensive health+social improvements in
cities in Europe and US
- 1850-1910 — Great expansion of knowledge about the causes+transmission of
communicable diseases
3
fi ffifi fi ff ff fl ff
, - 1910-1945 — Reductions in child mortality; establishment of schools of public health
and international foundations and environmental agencies interested in public health
- 1945-1990 — Creation of the World Bank and other UN agencies, WHO eradicates
smallpox; HIV/AIDS pandemic begins, Alma Ata Conference gives emphasis to primary
health care; UNICEF leads e orts for universal childhood immunization; greater attention
to chronic diseases
- 1990-date — Priority given to health sector reform, equity, health and development,
impact of and responses to globalization, cost-e ectiveness, public-private partnerships
in health, and use of information+communications technologies
- Critical global health concepts:
- Determinants of health
- Key risk factors for di erent health conditions
- Global burden of disease
- Measurement of health status
- Importance of culture to health
- Demographic+epidemiological transitions
- Organization+function of health systems
- Links among health, education, poverty, and equity
- WHO regions:
- World divided into: Africa Region, European Region, Region of the Americas, Eastern
Mediterranean Region, South-East Asia Region, and Western Paci c Region
- World Bank country income groups:
- Low-income: < $1,026
- Lower middle-income: $1,026 - $3,995
- Upper middle-income: $3,896 - $12,375
- High-income: > $12,375
- Based on Gross National Income (GNI) per capita (current US$); classi cation is
updated each year on July 1st
- Millennium Developing Goals (MDGs):
- In 2000, leaders from 189 countries agreed on a vision for the new millennium: end
extreme poverty in all of its forms
- List of 8 goals: MDGs
- Wanted to achieve these goals in 15 years (by 2015)
- United Nations Development Program (UNDP) was 1 of leading organizations
- Sustainable Developing Goals (SDGs):
- New set of 17 goals to help nish the work of MDGs
- Want to achieve these goals in 15 years (by 2030)
- Including: no poverty, zero hunger, good health+well-being, quality education, and clean
water+sanitation
Lecture 2 | Health determinants, measurements & trends
- Every year, 40 million people die from NCDs (=chronic diseases)
- CVDs cause most death worldwide
- Highest burden in Europe is caused by NCDs (incl. chronic diseases and mental health; 84%),
then injuries (intentional+unintentional; 11%), then
communicable+maternal+neonatal+nutritional diseases (5%)
- Highest burden worldwide is caused by NCDs (64%), then
communicable+maternal+neonatal+nutritional diseases (26%), then injuries (10%)
- Epidemiological and demographic transition in industrialized countries:
- 1st phase — fertility slightly is higher than mortality; both stable
- Fertility: average number of births; average number of children that a woman
has
- 2nd phase (Industrial Revolution) — population grows: fertility decreases slightly, while
mortality decreases signi cantly
- 3rd phase (medical advances etc.) — fertility decreases more, while mortality starts to
stabilize
4
ff fi fiff ff fi fi
summary
1
,Lecture 1 | Introduction to IPH 3
Lecture 2 | Health determinants, measurements & trends 4
Lecture 3 | Non-communicable diseases 8
Lecture 4 | Infectious diseases 11
Lecture 5 | Sexual and reproductive health 16
Lecture 6 | Mental health 20
Lecture 7 | Environmental health 24
Lecture 8 | Nutrition and global health 25
Lecture 9 | Natural disasters and complex humanitarian emergencies 31
Lecture 10 | Science, technology and global health 33
Lecture 11 | Child and youth health 37
2
, Lecture 1 | Introduction to IPH
- De nition of health:
- WHO, 1948: a state of complete physical+mental+social well-being and not merely the
absence of disease/in rmity
- Still considered what aspects of physical/mental/social well-being concern
health
- Huber et al., 2011: the ability to adapt and self manage in the face of
social+physical+emotional challenges
- Some unique features of public health:
- Use of prevention as prime intervention strategy
- Can be direct prevention of illness, deaths, and hospital admission; or more
related to quality of life by preventing/reducing days lost from work/school/
consumption of human+ nancial resources associated with ill-health
- Grounded in a broad array of sciences
- Basis in social justice philosophy
- Everyone should have access to basic health needs
- Equity in health care
- Link with government and public services
- Public health vs medicine:
- Public health:
- Primary focus on population
- Public service ethic, with concern for the individual
- Emphasis on health promotion and disease prevention
- Works within multiple systems
- Medicine:
- Primary focus on the individual
- Emphasis on diagnosis and treatment; care for the whole patient
- Dependent on the health care system
- International Public Health:
- Public Health: the science+art of preventing disease, prolonging life and promoting
physical health and e ciency through organized community e orts
- International Public Health: application of the principles of public health to health
problems and challenges that a ect low-and-middle-income countries and the complex
array of global+local forces that in uence them
- Global Health: an area for study+research+practice that places a priority on improving
health and achieving equity in health for all people worldwide
- One Health: the integrative e ort of multiple disciplines working
locally+nationally+globally to attain optimal health for
people+animals+environment
- Focus on interconnectedness of animal, human, and environmental health
- Planetary Health: the health of human civilization and the state of the natural
systems on which it depends; the achievement of the highest attainable
standard of health+wellbeing+equity worldwide through judicious attention to
human systems
- Focus on the health of the environment and the connections between that
and human and animal well-being
- History of international public health:
- 400 BC — Hippocrates presents causal relation between environment and disease
- 1st century AD — Romans introduce public sanitation and organized water supply
system
- 14 century — Black Death leads to quarantine and cordon sanitaire
- Middle Ages — Colonial expansion spreads infectious diseases around the world
- Particularly in Northern US
- 1750-1850 — Industrial revolution results in extensive health+social improvements in
cities in Europe and US
- 1850-1910 — Great expansion of knowledge about the causes+transmission of
communicable diseases
3
fi ffifi fi ff ff fl ff
, - 1910-1945 — Reductions in child mortality; establishment of schools of public health
and international foundations and environmental agencies interested in public health
- 1945-1990 — Creation of the World Bank and other UN agencies, WHO eradicates
smallpox; HIV/AIDS pandemic begins, Alma Ata Conference gives emphasis to primary
health care; UNICEF leads e orts for universal childhood immunization; greater attention
to chronic diseases
- 1990-date — Priority given to health sector reform, equity, health and development,
impact of and responses to globalization, cost-e ectiveness, public-private partnerships
in health, and use of information+communications technologies
- Critical global health concepts:
- Determinants of health
- Key risk factors for di erent health conditions
- Global burden of disease
- Measurement of health status
- Importance of culture to health
- Demographic+epidemiological transitions
- Organization+function of health systems
- Links among health, education, poverty, and equity
- WHO regions:
- World divided into: Africa Region, European Region, Region of the Americas, Eastern
Mediterranean Region, South-East Asia Region, and Western Paci c Region
- World Bank country income groups:
- Low-income: < $1,026
- Lower middle-income: $1,026 - $3,995
- Upper middle-income: $3,896 - $12,375
- High-income: > $12,375
- Based on Gross National Income (GNI) per capita (current US$); classi cation is
updated each year on July 1st
- Millennium Developing Goals (MDGs):
- In 2000, leaders from 189 countries agreed on a vision for the new millennium: end
extreme poverty in all of its forms
- List of 8 goals: MDGs
- Wanted to achieve these goals in 15 years (by 2015)
- United Nations Development Program (UNDP) was 1 of leading organizations
- Sustainable Developing Goals (SDGs):
- New set of 17 goals to help nish the work of MDGs
- Want to achieve these goals in 15 years (by 2030)
- Including: no poverty, zero hunger, good health+well-being, quality education, and clean
water+sanitation
Lecture 2 | Health determinants, measurements & trends
- Every year, 40 million people die from NCDs (=chronic diseases)
- CVDs cause most death worldwide
- Highest burden in Europe is caused by NCDs (incl. chronic diseases and mental health; 84%),
then injuries (intentional+unintentional; 11%), then
communicable+maternal+neonatal+nutritional diseases (5%)
- Highest burden worldwide is caused by NCDs (64%), then
communicable+maternal+neonatal+nutritional diseases (26%), then injuries (10%)
- Epidemiological and demographic transition in industrialized countries:
- 1st phase — fertility slightly is higher than mortality; both stable
- Fertility: average number of births; average number of children that a woman
has
- 2nd phase (Industrial Revolution) — population grows: fertility decreases slightly, while
mortality decreases signi cantly
- 3rd phase (medical advances etc.) — fertility decreases more, while mortality starts to
stabilize
4
ff fi fiff ff fi fi
