Summary Internationale Volksgezondheid (200)

Table of contents
Lecture 1: Introduction to International Public Health..........................................................................2
Lecture 2: Health Determinants, Measurements and Trends................................................................5
Lecture 3: Health, Education, Poverty and the Economy.....................................................................15
Lecture 4: Universal Health Coverage and SDGs..................................................................................20
Lecture 5: Health Systems...................................................................................................................26
Lecture 6: Culture, Health and Well-being...........................................................................................31
Lecture 7: Gender and Health..............................................................................................................35
Lecture 8: Ethics, Human Rights and the Law in International Public Health.......................................41
Lecture 9: Health Policy and Governance............................................................................................46
Lecture 10: Equity in Healthcare..........................................................................................................51
Lecture 11: International Cooperation in Global Health......................................................................54




1

,Lecture 1: Introduction to International Public Health
Short recap of IPH 1:

What is health?
- Health is a state of complete physical, mental and social wellbeing and not
merely the absence of disease or infirmity.
- Health is the ability to adapt and self-manage in the face of social,
physical and emotional challenges.

Public health is important for:
 Preventing disease.
 Prolonging life.
 Promoting health through the organized efforts of society.

International public health is interdisciplinary, issues transcending borders and
emphasizes on regions with high burdens of disease and weak health systems.
These regions are mostly low middle income countries (developing countries).

Timeline of public health
Pre modern states: Before 19th century:
 Hippocrates links environment and disease.
 Epidemics: quarantaine was introduced for deadly infectious diseases.
 Hospitals were run as religious charities.
 Colonial expansion brought infectious diseases, such as small pox.

Modern states: Beginning 18th-19th century:
1790s:
 French revolution brought the ‘right to health’.
 Diseases have links to poverty and living conditions.
19th century:
 Industrial revolution brought wealth.
 Emerge of the welfare state: state is responsible for population health
measures and health care services.

Modern states: 19th century and later:
 First international public health meetings.
 Control of cholera, plague, yellow fever.
 Scientific developments on communicable diseases.
 Sanitation and hygiene became more important: better control of
epidemics.
 Vaccinations and antibiotics saved lives.
 Biomedical paradigm (medicine) dominated the health field.
 Health and health care became important.

20th century:
1910-1945:
 Reductions in child mortality.
 Schools of public health are established.




2

, 1945-1990:
 UN agencies and World Bank were created.
 Eradication of small pox.
 Universal childhood immunization.
 HIV/AIDS pandemic.
1980-2000s
 Health promotion.
 Unlike biomedical paradigm (preventative interventions).
 Health is not only a product of health services, the role of non-health
sectors on health also started to play a role.
 Though, health is still largely considered to be a product of health and
healthcare. Therefore, there lays emphasis on the biological factors of
disease and there is exclusion of other determinants of health.

Infectious diseases
 Caused by pathogenic micro-organisms.
 Can spread from person to person.
 Spread through a carrier.
 Influenced by hygienic conditions and environment.

Social impact of infectious diseases:
 Disruption of family and social networks.
o Quarantaine, isolation, staying at home, child headed households,
social exclusion.
 Widespread stigma and discrimination.
o Being afraid of certain ethnicities, discriminating people of other
ethnicities.
o Discrimination in employment, schools, migration policies.
 People that already have a low SES are being fired as a result
of a long-lasting infectious disease pandemic (downward
spiral).
 Interventions such as quarantaine measures may aggravate social
disruption.
 In discrimination, not only the current factors play a role, but also the pre-
existing factors.
o Black people with symptoms are being sent home more often
during the COVID-19 pandemic, but they already had less access to
good health care than white people before this pandemic.

Economic impact of infectious diseases:
Macro level:
 Reduction in revenue for the country (e.g. tourism).
 Drop in international travel to affected countries by 50-70%.
 Malaria causes an average loss of 1.3% of the annual GDP in countries
with high transmission.
 Infectious disease outbreaks cost the economies of countries much
money, e.g. through travel restictions and embargoes (restricted trade).
Household level:
 Poorer households are disproportionally affected.
 Substantial loss in productivity and income for the person who is sick and
for the caregiver.
 Very high costs for treating the illness.

Non-communicable diseases


3