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GLBL 210 Notes 4/4/16-4/6/16 4/4/16: Marissa Hall Guest Lecture - WHO defines health as complete physical, mental, and social well-being o Not just absence of disease o Social and mental health correlated with physical health - Health is human right o Outlined in Universal Declaration of Human Rights - 4 of UN Millennium Development Goals deal directly with health o Health as prerequisite for many other goals - Measurements of health: o Life expectancy (doesn’t take into account living with disease) o Disability-adjusted life years (DALYs)  Morbidity (living with disease) and mortality  Years life lost plus years living with disease/disability - Top 10 causes of death worldwide: o Heart disease o Stroke o COPD o Lower respiratory disease o Lung cancer o HIV/AIDs o Diarrheal disease o Diabetes o Road injury - Different causes of death in high vs. low income countries - Risk transitions: disease causes shift with development/progress, traditional risks  modern risks (ex. malaria  road injury) o Medical improvements o Population ageing o Public health interventions - Non-communicable disease (NCD’s): not infectious, not transmissible between people, chronic disease o General world transition to NCD’s (modern risks) o More deaths due to NCD’s in low and middle-income countries - Socio-ecological model: how to approach health problem o Different levels of risk factors:  Individual knowledge, attitudes, skill  Interpersonal: social networks  Organizational: environment, surroundings  Community: cultural values  Public policy: paws, regulations o Expand thinking about why people have diseases o Ex. diabetes:  Individual: self-efficacy to exercise  Interpersonal: family attitudes toward exercise  Organizational: availability of recreational facilities  Community: social norms around exercise  Public policy: workplace policy compensating gym membership fees o Class activity example: malaria  Individual: lack of education of causes  Interpersonal: few health professional to teach/treat  Organizational: lack of mosquito nets  Community: belief in other treatments, religion/sorcery  Public policy: no requirements for prevention (household/business/structural requirements for nets)  Possible solutions: access to nets, medication, and healthcare facilities - Health impact pyramid: 5 tier pyramid from reading o Socioeconomic factors o Changing context to make default decisions healthier o Long-lasting protective interventions (ex. vaccines) o Clinical interventions o Counseling/education o Lower levels have more impact  Reach more people, doesn’t require as much individual effort o Examples of changing context to make default decisions healthier: cleaner water, fluoridating water, putting health foods near check-out counter, warning labels on cigarette packets - Most effective combative strategy: o Cost-effective o Population-level o Address multiple risk factors - Honduras research application: contraception use o More difficult for rural/poor women to meet contraceptive needs o US levels of unplanned pregnancy similar to Honduras o Honduran Health Alliance (HHA) clinic to provide access to care, prevention, screenings o Interviewed and conducted focus groups with rural women o Focused on social determinants of health  Conditions in which people live (especially health system)  Shaped by power/economic distribution o Many women use multiple methods o Women had positive attitudes toward family planning  Believed life is easier for smaller families  Difficult to allocate resources among larger families because la situación economica o Barriers to contraceptive use:  Individual/interpersonal barriers: ideas about side effects, men’s attitudes toward contraceptive use  Positive attitudes toward own partners, negative attitudes toward other men in community  Organization/public policy barriers: longer-lasting methods unavailable in rural areas, frequently out of stock, difficult to travel to places to access other methods (time-consuming, dangerous, expensive) 4/6/16: Guest Lecturer Dale Evarts - Evidence for climate change: o Thousands of peer-reviewed studies o Continuous process of inquiry and discovery o State of climate science reports: summaries of recent research on climate change  Done by Intergovernmental Panel on Climate Change o 10 indicators of warming world:  Sea ice decreasing  Rising sea levels  Increased water vapor  The rest are on PowerPoint uploaded to Sakai o Human activities effects:  Natural carbon cycle: balance between addition and removal of CO2  Humans increase CO2 concentration and decrease areas able to sequester carbon - Global greenhouse gas emission trends: o Electricity, agriculture, transportation are main economic sectors of emissions o China has highest emissions - Impacts of climate change: o Rising temps o Increased precipitation  Can cause flooding and increased water levels o Habitat loss o Extreme weather o Species changes and distribution o Impacts vary by region  Ex. Alaska has less snow, increased forest fires in Midwest - Conventional pollutants: o Particulate matter  Black carbon: what is seen coming out of diesel trucks, not long-lasting  Ozone: also short-lived o Methane: in the middle of short and long-lived o Long-lived pollutants: CO2, nitrous oxide o Possible solution: increase carbon sinks  Ex. planting trees, increasing algae in oceans o Many different sources of short-;lived pollutants  Have ability to control them  Able to help air quality and climate control - International efforts to address climate change: o UN Framework Convention on Climate Change  1992- countries try to limit average global temps  Kyoto Protocol: legally binds members to emissions restrictions (only binds developed countries) o Building Post-2020 Global Agreement:  Agreed to limit global warming to 2 degrees C (3.6 F)  Must reduce emissions by 80% by 2050 o Questions addressed in Paris Agreement:  Is 2 degrees C sufficient to avoid catastrophic events  What would developing countries commit vs. developed countries  Common goal, but differentiated responsibilities  How to hold countries accountable for commitments  What funding would developed countries contribute  How to update targets with new technology and ambition - Negotiating global agreement: o Must be consensus in all aspects  Every country must agree, so one nation can alter outcomes - US and China joint-agreement to reduce carbon pollution: o China agreed to peak emissions by 2030 - US Clean Power Plan: o Proposed regulations to reduce CO2 emissions and particulate pollution o Climate and health benefits will outweigh costs - Sample policies o Promote renewable energy o Promote energy efficiency o Urban planning to reduce energy demand o Electric transportation instead of fossil fuels - Paris Agreement to be signed April 22 o Also ratify to ensure country can actually follow through