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This 7 page Class Notes was uploaded by Maya Blair on Wednesday February 3, 2016. The Class Notes belongs to Psyc 3128 at George Washington University taught by Thomas Nassif in Winter 2016. Since its upload, it has received 28 views. For similar materials see Health Psychology in Psychlogy at George Washington University.
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Date Created: 02/03/16
CH 3: GLOBAL COMMUNICABLE AND CHRONIC DISEASE First documented communicable disease occurred in 430 BCE in Greece Lowincome countries are those which the annual gross national income (GNI) per capita (per person) is less than $1,025 per year Middleincome countries are those in which the GNI per capita is between $1,026 $12,475 per year Highincome countries report a GNI greater than $12,476 per year Developing refers to low or middleincome countries Developed refers to highincome countries SECTION I: GLOBAL HEALTH PROBLEMS Communicable Diseases: HumantoHuman Transmission Epidemics and Pandemics Athenian Plague first communicable disease in 430 BCE in Greece Epidemic when a disease affects large numbers of a population within a geographic area ( epi “upon” and demos “people) Pandemics when a disease spreads through large geographic regions of the world or occur worldwide (pan “alldemos “people) Animaltohuman transmission (ex. Avian Bird Flu) Humantohuman transmission (ex. A/H1N1 flu or TB) Ex. Haemorrhagic Plague (lack Death ) Decreased 4060% of Europe’s and 30% of China’s population Tuberculosis (TB) Highly contagious, communicable disease Can be transmitted directly (person to person) or indirectly through environment agents (air) US has one of the lowest TB rates worldwide ➢ This is because the bacterium cannot survive in the environment. It thrives in the crowded conditions of prisons, refugee camps, and slums Higher rates of TB from 20002005 may be due to... ➢ Drugresistant strains of the disease ➢ HIV/AIDS (weakens the immune system) ➢ Increase in the number of refugees due to wars, famines, and natural disasters Active case of TB (untreated or ineffectively treated) can be transmitted to others ➢ Can infect 1 person per month or about 1015 people per year Latent cases of TB cannot be transmitted to others ➢ Carrier will test positive but no signs of illness Childhood Viral Diseases All preventable illnesses Are infrequent occurrences in developed (high income) countries Are more prevalent in developing (low and middle income countries) Primary childhood viral diseases Measles, Chickenpox ,Polio 1 Measles Presents as fever with rash on face/neck that spreads to the body Illness itself is not dangerous but can lead to complications that can result in death Ex. Pneumonia, severe diarrhea, encephalitis (inflammation of brain) High contagion and fatality rate for children < 5 years old In emergency settings (ex. refugee camps) 25% of all child deaths attributed to measles Chickenpox Caused by the varicella zoster virus Presents as blistering pox over body, head, and extremities that secretes small amount of pus Rarely a serious illness if contracted during childhood Over 90% of children successfully overcome virus Usually immune for a life once contracted Can result in respiratory illness and eventually death when contracted as an adult Poliomyelitis (olio) Highly contagious viral disease Flulike symptoms for over 90% of people However in 2% of people it can cause severe damage Damages cells in the spinal cord Specifically attacks the muscle controlling nerves Can result in partial or total paralysis of arms or legs Waves of polio epidemics in the US in first half of 1900s Vaccines Should be vaccinated by age 6 Effective in preventing spread of diseases, especially childhood viral diseases Medicines that contain a small amount of the virus (dead or alive) from the disease in question Prompts body’s immune system to build antibodies that will destroy foreign viruses and bacteria when entering body Goal: to immunize (protect) people from contracting diseases or contracting severe strains of illness Reasons for not vaccinating Cultural or religious beliefs (individual, family, cultural factors) Fear of the consequences of vaccines (individual factors) Cost of vaccines (affordability, a demographic factor) Access to health care (health systems factor) Vaccine programs (a health policy factor) Recurring Diseases Type of communicable diseases that are largely preventable Transmitted to humans from insects or bacteria that breed in unsanitary environmental conditions Environmental conditions are a predisposing factor Common recurring diseases Cholera, Malaria, Parasites 2 Cholera Intestinal infection caused by vibrio cholerae bacteria Bacteria is found in contaminated food, water, or human feces Closely linked to poor environmental management and unsafe water conditions Can cause severe dehydration, kidney failure, death in 1020% of cases Prevention and eradication of cholera linked to health policy Malaria Caused by the parasite plasmodium Virus transmitted from person to person through the female anopheles mosquito Over 90% of deaths occur in subSaharan Africa Children disproportionately are the victims Malaria is most prevalent when environmental conditions are hot and humid (tropical climates) as this is the preferred breeding grounds for carrier mosquito Parasites A form of animaltohuman transmission Parasites ingested when eating contaminated, raw, or undercooked meats Three common types ➢ Cestodiasis (tapeworm) : lives in the intestines of animals such as cattle or pigs ➢ Taenia Saginata : a parasite found in contaminated beef ➢ Taenia Solium : a parasite found in contaminated pork Causes diarrhea, abdominal pain, weight loss Can cause brain damage if left untreated Guinea Worm...goes into the bottom of the foot, can be very long have to pull it out (painful) Chronic Diseases (doesn’t go into them) Defined as longterm (>3 months) complex illnesses that can be treated but not cured Are the leading causes of death worldwide In 2000, 60% of all deaths worldwide due to chronic illnesses 80% of deaths due to chronic illnesses occur in developing countries Common examples: arthritis,asthma ,cancer , diabetes , and heart disease MORE DEATHS DUE TO CHRONIC ILLNESSES WORLDWIDE THAN TO INFECTIOUS DISEASES Causes of Chronic Diseases Three principle causes due to lifestyle behaviors 1. Unhealthy diets (evolutionarily makes sense b/c we use to survive on sweet and fatty foods) 2. Physical inactivity 3. Tobacco use Confounding factors : variables that do not cause but may exacerbate the problem 1. Socioeconomic class (specifically income) 2. Race/ethnicity Diabetes Mellitus (DM) Defined: chronic disease that occurs when the pancreas does not produce enough insulin, or when the body cannot use the insulin it produces Insulin = hormone that controls the blood sugar levels in the body Can be prevented in 8595% of instances 3 Contributors Genetic predisposition (5% 15% of occurrences) Unhealthy diets Sedentary lifestyles Type I Diabetes Genetic origin Body fails to produce insulin Affects 515% of diabetics in the US Type II Diabetes Insulin resistance or the inability of the body to use insulin properly Most common form in the US and worldwide 20 million in the US Over 90% of all incidences are classified as type II Obese children are more likely to develop DM as teens or adults, if left unchecked Diagnosing Diabetes Difficult due to nonspecific symptoms (could be associated w/ other illnesses), easily overlooked symptoms, or lack of awareness Nonspecific : weight loss, increased fatigue, irritability Overlooked : frequent urination, extreme thirst Diagnosis confirmed with a blood test Chronic Respiratory Diseases Defined: class of chronic illnesses that affect the airways and damage lung function Ex: asthma, Chronic Obstructive Pulmonary Disease (COPD), respiratory allergies, occupational lung disease (Mesothelioma) Can be biological or environmental Asthma Partial obstruction of the airway that can cause wheezing or impair breathing Triggers: Genetic predisposition Environmental triggers (ex. cigarette smoke, animal fur, dust) Chronic Obstructive Pulmonary Disease (COPD) Damage to airways caused by irritants (ex. tobacco smoke, pollution, chemical fumes) Causes coughing, mucus, sneezing, shortness of breath, chest tightness Commonly underdiagnosed disease Difficulty to diagnose Lack of access to care reduces timely diagnosis Cost (time/money) of repeated medical visits reduces incentive to seek care Developing countries, less than 45% of people suspected of having COPD are tested Socioeconomic Class, Race/Ethnicity, and Chronic Diseases Two confounding factors 4 Socioeconomic class Findings by Adler and colleagues, (1994( Kelly and colleagues (2005) and Institute of Medicine (2001) Individual’s health outcomes affected by country’s economic status, individual’s own economic class, and race/ethnicity Adler and colleagues (1994) The lower one’s socioeconomic class, the higher the likelihood of contracting a chronic illness Ethnicity Study by Whittle, Conigliaro, Good and Lofgen (1993) Examined rates of four types of cardiovascular procedures on African American and white patients in a Veterans Affairs Hospital Result African American and white patients received dissimilar treatment African American patients were 1.382.2 times less likely to receive the more invasive surgical procedures to address their cardiovascular illness than whites Study by Sonel and colleagues (2005) 43,000 patients African American and white African Americans 20%40% less likely to be given newer, more resource intensive treatment for heart illness than whites (as if whites would benefit more) (Nothing below was covered in class) Measure of Life Expectancy, Quality of Life, and Chronic Illnesses Disability Adjusted Life Expectancy (DALE) measure of population’s health status that adjusts for quality of life Estimates effects of chronic illness on overall wellbeing Quality of life: the number of years of good, fully functioning ability Estimates # of years of healthy, unimpaired functioning, NOT life expectancy Helps predict a country’s likely economic health based on its most valuable resource: the health of its workforce SECTION II: GLOBAL HEALTH ORGANIZATIONS Purpose: to bridge the gap between needed and available health resources in countries/regions where resources are unavailable or insufficient to meet need Three examples of Global Health Organizations 1. World Health Organization (WHO) 2. The Federation of Red Cross and Red Crescent Societies 3. Medecins Sans Frontieres (Doctors without Borders) World Health Organization (WHO) A United Nations specialized agency created in 1948 to help attain the highest standards of health for all people Promotes its health goals using a threestep process 1. Assesses the health needs of a population 5 2. Develops policy initiatives to control/eliminate specific health problems 3. Implements the policies in targeted regions of the world (to a limited extent) Examines and reports on the macroeconomic impact of ill health Individual’s health affects more than just the individual, their family, or immediate community Has the potential to affect also the economic health of a country A country’s productivity suffers when large segments of society suffer from the same or related contagious or chronic illnesses Millennium Development Goals for 20002005 Improve management/detection of emergency health threats Reduce tobacco use Increase healthy eating habits to prevent chronic illnesses The Federation of Red Cross and Red Crescent Societies Original goal Serve as a neutral entity in war to provide relief to all wounded soldiers regardless of side of conflict Current mission Assist individuals regardless of nationality, race, religious beliefs, class or political opinion Improve the lives of people by mobilizing the power of humanity Focus on four key areas Promoting humanitarian principles and values Disaster response Disaster preparedness Health care in communities Contributed to relief work in the aftermath of Hurricane Sandy (2012) Haiti Earthquake (2010) Hurricane Katrina (2005) 2004 Indian Ocean earthquake and tsunami (2004) Medecins Sans Frontieres Purpose: provide emergency medical care to persons in need An international humanitarian organization founded in 1971 Mission provide medical care to people affected by... Armed conflicts (war) Epidemics Natural or manmade disasters Persons with no access to healthcare Document plight of people served by organization SECTION III: HEALTH POLICY National Policy: Global Implications Advantages Benefits families and communities Reduce national and/or international health crisis 6 Disadvantages Prioritizes health of community over rights of individual Ex. Isolation & containment for TB and HIV/AIDS Isolation and Containment for TB and HIV/AIDS Implemented in US in late 19th and 20th centuries Goal: prevent spread of highly contagious illness to communities Infected individuals placed in sanatoriumsloge like facilities to isolate and treat TB patients Purpose: 1. Prevent individuals from interacting with noninfected persons 2. Treat TB patients before returning them to communities Could be forced to remain in sanatoriums Isolation policy invoked in 2007 for Andrew Speaker (TB guy) Cuba Aggressive containment policy instituted in 1986 in Cuba when first HIV cases detected Purpose treat HIV infected individuals and their partners Result reduced Cuba’s HIV infection rate to .1% by 2001, far less than global rate of 1.0% SECTION IV: THE ECONOMIC CONSEQUENCES OF POOR HEALTH Individual Health Effects on Family Wellbeing Individual ill health affects ability to function normally, including earning income Inability to work adversely affects family economic health and can lead to poverty May also negatively affect access to healthcare Individual’s ill health can impact family’s emotional, mental, and physical welbeing Lesoto, Africa A small country in Southern Africa Current HIV/AIDS prevalence rate of 40% (4 out of 10 adults are infected) Entire generation of adults from 2040 years of age are becoming ill and dying at an alarming rate Adults are unable to work or volunteer in community Businesses fail or relocate to other countries 7
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