Transcript File

Geog 1 - Health
BEREN MILES
Course Outline
• G5.1: Introduction to health issues
• G5.2: infections and disease
• G5.3: HIV/AIDS - Zambia and SSA
• G5.4: Diseases of affluence (CHD and
Obesity)
• G5.5: Famine - Somalia
• G5.6: Healthcare systems
- Emergent – HCS in LEDCs
- Pluralistic - US
- Insurance – France
- NHS – UK
- Socialised – Cuba
- Dual - Singapore
G5.7: Health and The DTM
G5.8: Transnational corporations (TNCs)
- Pharmaceutical: GSK
- Other: British American Tobacco
G5.9: Health variations in the UK
- New Forest and Southampton
Water
Waste
Alcohol
Medication – TNCS
Quality
Access to Healthcare
Medicine
/ Drugs
Sanitation
Health
LEDCS/
MEDC
Food
Preventable Disease
- HIV/AIDS
Obesity
Malnutrition
Healthy Eating
Introduction to Health Issues - Key Words
• Health – a state of complete physical, mental and social well being and
not merely the absence of diseases and infirmity (WHO 1946)
• Morbidity – Illness or any diseased state, disability, or conation of poor
health from any cause. Can be used to refer to the existence of disease,
or the extent that a health condition affects a patient.
• Mortality – Death, or susceptibility to death.
• Determining factors – things that could affect your health: Age, Sex,
lifestyle, community/social aspects, food, environment, living and
working conditions.
• Epidemiological transition model – tracks the types of illness throughout
the stages of development.
Millennium Development Goals
The eight Millennium Development Goals
(MDGs) – range from halving extreme
poverty to halting the spread of HIV/AIDS
and providing universal primary
education, all by the target date of 2015.
Source
Health differences from MEDC to LEDC
LEDC
Water-bourne
parasites
Bilharzia snail
Mosquito
Blackfly
Guinea worm
Malaria
Yellow fever
River Blindness
Poor Hygiene
Poor Diet
Typhoid
Lack of protein
Cholera
Dysentery
Trachoma
Hepatitis
Lack of
vitamins
Health differences from MEDC to LEDC
MEDC
Degenerative diseases
Diseases of affluences
Heart disease
Cancers
Mental disorders
Arthritis
Alzheimer's and dementia
Respiratory
Infectious Disease
• Infectious diseases are caused by pathogenic microorganism, such as bacteria, viruses, parasites, or
fungi. The diseases can be spread directly or indirectly from one person to another.
Area
Total Infections
Deaths
New Infections
SSA
24.7 million
2.1 million
2.8 million
South/ SE Asia
7.8 million
860000
590000
Latin America
1.7 million
65000
140000
E.Eurpe and Asia
750000
84000
270000
East Asia
750000
43000
100000
Europe
740000
12000
22000
North America
1.4 million
18000
43000
N. Africa + middle
East
460000
36000
68000
Carribean
250000
19000
27000
Oceania
81 000
4000
7100
AIDS- Zambia Case Study
- People don’t want to have
sex with “plastic” and so the
disease is spread.
- Men have many wives
- No sex Education
- Stigma - outcast
- 16 million die each year
- 26 Million living with AIDS
- 50% have underlying AIDS
- Fluid/ fluid contact spread disease
HEALTH NIGHT MARE
- 200,000 in a hospital but
only 273 beds
- Poor sanitation – often run
out of gloves
- Loss of Professionals – Teachers,
Doctors, Police
- Working age hit (20-30 y/o)
Diseases of affluence
In MEDCs and developing countries infectious disease has largely been
tackled and controlled. Instead there is a new type of disease to fight –
Disease of affluence – these tend to be due to people living to long or de
to people overindulging and having poor lifestyle choices.
Obesity - Case Study
• 30% UK is obese
• 50% USA
• Abnormal or excessive fat accumulation that may impair health
• BMI = Weight(kg) / Height (m2)
• Overweight BMI = 25+
• Obese = 30 +
• 2005: 1.6 billion adults were overweight
• 400 million were clinically obese
• 2015: 700 million (WHO)
• At least 2 million children under 5 were overweight
• 35% of children in the USA are overweight
Cardiovascular disease (CVD) – Case Study
• Responsible for 30% of global deaths
• 16 million deaths worldwide
• Highest areas : Russia, China, India
• It is expected that in 2030 23.6 million will die from CVDs
• 60% of CVD’s occur in developing countries
• Influenced by lifestyle
UK and CVD -CASE STUDY
- Nearly 75% of NHS time is
taken up by Diseases of
Affluence
- Treat affects rather than
prevent it
- 10 000 on impatient care
in 2006
- 2967 on impatient stroke
- Costs the NHS £238 pp
Types of CVD
• There are four main types of CVD. They are:
1. coronary heart disease
2. stroke
3. peripheral arterial disease
4. aortic disease
Famine
• What are the causes and impacts of famine and obesity?
• Malnutrition – Lack of nutrients – Can be due to famine (LEDC) or
eating the wrong things (obesity MEDC)
• Periodic famine – a time of so little food that people will starve to
death
• Links to MGD 1: end poverty and hunger
• There is enough food in the world for everyone to have 2700cal/day
Food distribution
• The areas affected by hunger and malnutrition are likely to be in
SSA and Asia.
• MEDC’s often have too much food and end up throwing it away
Famine
• Can occur due to natural events but also due to human
management
• Lack of resources often goes with lack of food and poverty
Sahel region of Africa - 1984
• 1/3 severely malnutrition
• ½ people don’t have food
• 40,000 no food, no transport
• People were living in the open with freezing temperatures
• “out of control”
• 7000 people packed in to sheds dying of malnutrition
• 37+ died each day at the camp
Somalia
• Britain withdrew from Somalia in 1960
• In 2011 a famine happened
• Up until this point causes of the famine had been things like,
unstable government, clan militias
• Somalia has been ranked as one of the worlds poorest most violent
countries
• Since 2006 the country faced an insurgence led by Al Shubab –
Extreme Islamism group
• The Shabab have blocked foreign aid
Health Care Approaches G5.6
2 types of Care:
• Primary Care – First line of care (paramedics, GP, A&E, dentists, opticians)
• Secondary Care – referred to from primary care (specialist in-patients)
• Some primary care can cost in the UK e.g. pharmacies, dentists,
opticians. Secondary care is usually free.
• Types of Health care
• Comparing health care approaches
Types of Healthcare approach
Type of Healthcare
Main Characteristic
Examples
Emergent
Healthcare is a personal consumption
Physicians are solo entrepreneurs
Direct payment from Patient to Physicians
No state role within healthcare
LEDC’s
Bangladesh/Brazil/India/ Kenya
Pluralistic
Consumer product
Private and public ownership
State role is minimal
USA
Insurance
Social Security
Healthcare is an insured product much like car insurance
Payment is indirect
State role is evident but indirect
France
Japan
Spain
National Health Service
(NHS)
State Supported
Facilities are publicly owned
State role is central and direct
UK
Canada
Socialised
State provided public service
Physicians are state employed
Professional associations are weak or non- existent
Facilities are completely public owned
Payments for services are entirely indirect
State role is total
China
Cuba
Dual
Funded by both private and public sectors
Singapore
Comparing H/C Systems
Comparison – Cuba Vs USA
USA
Cuba
• 18% (2012) of GDP on H/C –
highest in the world
• 8.6% of GDP (2012)
• Highest private sector
expenditure
• LE: 77
• IMR: 6.1/1000 (2014)
• LE: 77.4 years (2009)
• Pluralistic Approach
• IMR: 4.7 (2014)
• Dr to patient 1:159
• Socialised
• State provided service
• State employs 17651 Doctors
• All payments are indirect
• State has total control
CUBA Vs UK
UK
Cuba
• GDP/ Capita: USD: 40972 (2011)
• GDP/ Capita : USD:6051 (2011)
• 9.4% of GDP (2012)
• 8.6% of GDP (2012)
• IMR 4.4 (2014)
• IMR: 4.7 (2014)
• LE: 80.4
• LE: 78.2
• Doctors/1000: 2.8
• Dr to patient 1:159
• NHS
• Socialised
• State funded
• State provided service
• Tax funded
• State employs 17651 Doctors
• Some direct payments (dentist)
• All payments are indirect
• State has total control
France and UK
• France was ranked 1st in the
world for best health after a
report in 2000
• IMR: 3.3/1000
• Healthcare expenditure: 11.7%
• %65+: 18.3%
• Doctors/1000: 3.2
• Life Expectancy: 81.6
• Insurance/ Social Security system
• Health care is a product provided
by insurance companies
• UK was ranked 18th in the same
report
• GDP/ Capita: USD: 40972 (2011)
• 9.4% of GDP (2012)
• IMR 4.4 (2014)
• LE: 80.4
• Doctors/1000: 2.8
• NHS
• State funded – (free on the door)
• Tax funded
• Some direct payments (dentist)
Links between the DTM and Health
CHD
Famine
Stage 1
Stage 2
In stage 1 and 2 countries CHD is likely to be
undetected and therefore people may die
without even knowing they have it. Also CHD
comes from the lifestyle you lead, people in
these areas do not have the unhealthy lifestyle
associated with CHD
Stage 3
Stage 3 is often where the
change occur in these
developing countries the
lifestyle is often that of tobacco
use as well as high stress and
high blood pressure the
longevity of people is also
increasing in this area which is
another factor that affects CHD
Stage 4
Again people in stage 4 have
the lifestyle previously
associated with CHD. That of
inactivity from reliance on
cars and therefore people may
become diabetic and may be
stressed from work all these
attribute to higher risk of CHD.
CHD is the biggest killer in the
UK. However on the whole
CHD affects Stage 3 more than
stage 4 due to medical
facilities.
Stage 5
People in S5 countries
are encouraged to have
healthier lifestyle and to
have better treatment
due to better facilities
however the average ag
of this population is high
which could lead to
people being less likely
to survive CHD.
Stage 1 is likely to have less famine as tribes
and such like usually rely on subsistence
farming. Famine in stage 1 may only affected
one area unlike in stage 2 where a famine can
affect the whole country.
Famine tends to be more common in LEDC’s
and unlike CHD has natural causes as well as
human causes. Poorer countries have less of a
system to cope with famine and often this
Famine is less likely in the other Stage 4 and 5 are unlikely to experience famine except i
stages of the DTM and is caused extreme circumstances.
due to either unfair poverty
within a country – e.g china or
due to extreme weather
During this task I found that
conditions.
often stage 3 is the bridge
between stage 4 and 5 and
stage 1 and 2. Stage 1 and 2
tend to be similar just as 4 and
TNC’s and their impact on Health – G5.8
How do they impact world health ?
• How they treat employees
• How they market their products
• How they sell their products
• What products they choose to research and development
• Who has the access to the global health market
• A TNC is a company that operates in at least 2 countries. Usually the HQ
and R+D departments are in the country of origin and manufacturing is
in plants overseas.
Glaxo Smith Kline (GSK) – Big Pharma TNC
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Biggest UK – Based Pharma TNC
Supply ¼ of World Vaccines
Employs 100,000+ people in 117 countries
15,000 Work in research
Mission: To improve the quality of human life
2006 – donated 155 million Albendazone tablets.
3 priority diseases
AIDS/HIV
Spends £500 million/ year on research
Disease of affluence get more money invested due to higher demand
Designer drugs
Smoking and British America Tobacco
• Smoking is a greater cause of death and disability than any single disease (WHO)
• Smoking can cause 25 diseases!
• Men who smoke are 22 times more likely to get lung cancer!
BAT:
• Have cigarette factories in 44 Countries
• Revenue: £33921 Million (2008)
• Main Brands: Kent, Dunhill, Vogue
• Between 2000-2007 the sale of cigarettes increased from 85billion to 161 billion
(nearly double in 7 years)
• Each year BAT purchases about 460000 tonnes of tobacco
• 80% from developing countries
• 250000 farmer from emerging economies
• The company has a CSR in tobacco production
• This programme covers improving agriculture, soil and water conversation and
health and safety
G5.9 – Health variations in the UK
The health of people in New Forest is generally better than the
England average. Deprivation is lower than average, however
about 3,800 children live in poverty.
Life expectancy for both men and women is higher than the
England average. Life expectancy is 5.3 years lower for men in
the most deprived areas of New Forest than in the least deprived
areas. Over the last 10 years, all cause mortality rates have fallen.
Early death rates from cancer and from heart disease and stroke
have fallen and are better than the England average. In Year 6,
13.1% of children are classified as obese, better than the average
for England. The level of alcohol-specific hospital stays among
those under 18 is worse than average. Teenage pregnancy and
breast feeding are better than the England average.
The estimated level of adult physical activity is better than the
England average.
The rate of road injuries and deaths is worse than the England
average. Rates of hip fractures, sexually transmitted infections,
smoking related deaths and hospital stays for alcohol related
harm are better than the England average. The rates of malignant
melanoma and hospital stays for self-harm are worse than
average. Priorities in New Forest include older people, alcohol
misuse and long term conditions.
NEW FOREST VS SOUTHAMPTON
Southampton
• Population 240,000
• The health of people in Southampton is mixed compared with the England average.
• Deprivation is higher than average and about 11,200 children live in poverty.
• Life expectancy for both men and women is similar to the England average. Life
expectancy is 8.0 years lower for men and 3.4 years lower for women in the most
deprived areas of Southampton than in the least deprived areas.
• Over the last 10 years, all cause mortality rates have fallen. Early death rates from
cancer and from heart disease and stroke have fallen.
• About 19.8% of Year 6 children are classified as obese. Levels of teenage pregnancy,
GCSE attainment, alcohol-specific hospital stays (-18) and smoking in pregnancy are
worse than the England average.
• The estimated level of adult 'healthy eating' is worse than the England average. The
estimated level of adult obesity is better than the England average.
• Rates of sexually transmitted infections and smoking related deaths are worse than
the England average. Rates of hip fractures and hospital stays for alcohol related harm
are better than the England average.
• Priorities in Southampton include violent crime, drug and alcohol misuse and obesity.