Morbidity - Refers to ill health. It includes any diseased state, disablility or condition of poor health - due to any cause.
Mortality - Refers to deaths. It is the condition of being mortal, or suseptible to death.
Endemic/ epidemic - The constant presence of disease or infectious agent in a crtain geographic are or population group.
Pandemic - A world wide epidemic: an epidemic occuring over a wide geographical area and affecting a very large number of people.
Infant mortality rate - the number of dealths of children under the age of 1 year expressed per 1,000 live births per year. It is a useful barometer of social and environmental conditions and is sensitive to changes in either.
Attack rate - the number of cases of disease diagnosed in an area, divided by the total population, over a period of an epidemic.
Health in World Affairs - Cholera
Cholera - Haiti, 2010:
After the earthquake in 2010, UN sent help from Nepal. The Nepali workers brought cholera.
Water pollution, poor sanitation, feaces in drinking water and poor drainage system.
8,300 dead, sickness and diarroeha, social and economic concequences, long term cholera in Haiti.
Hydration and sanitation.
Health in World Affairs - Ebola
Ebola - Western Africa:
Ebola was an epidemic, but it was also a potential pandemic disease.
Example of country - Sierra Leone
Eating infected bush meat, spread by bodily fluid exchange, very easily spread.
11,000 + dead - death by belleding out of all oraphis, land borders closed, economy decreased in West Africa, social impacts - cant bury dead, quarantine to UK, weakness in global respoces.
Quarantine, ebola control, education, develop vaccine.
Study of one infectious disease - HIV/AIDs
AIDS, communicable disease - Botswana:
Impact on health - weaknes immmune system by invaiding white blood cells, life expectancy decreases, increased mortality and morbidity - e.g. Life expectancy in Botswana was 60 in 1995 and 34 in 2010.
- People cant work - impact on personal and national economics - worst African agricultural work force, decrease by 10-12% by 2020.
- Family members become cararers - they cant work either,
- Increased morbidity = derease in productivity,
- GDP decreased by 2% in AIDS affected countries.
- Drugs to treat cos $10,000 per year - impacts on national and personal economics.
Impact of life style - Stigma, cant travel, less money, increased illness, lower life expectancy.
Management - Education, contraception, develop vaccine, drugs.
HIV/AIDs cont... Thailand
- Educating population - military radio, every gout department educated.
- School programme - education and entertainment - Mr Condom, Sankes and Rubbers.
- Contraception - available everywhere, free at Cabbages and Condoms restaurants, given out on public transport, Cops and Rubbers.
- Religion - monks blessed condoms
1991 - 1995 - new cases reduced by 90% - 7.7 million lives saved.
Non - communicable disease - CHD
Westernisation - fast foods, cars and less manual work.
Impacts on health - clogging of arteries- cholesterol and fatty material, this reduces flow flow and therfore oxygen to the heart. Shortness of breath/ tiredness. Chest pain -angina. Heart attack.
Causes - tabacco, alcohol, diet, lack of exercise.
Impacts on lifestyle - decreased physical activity, daily medication, change of diet, decreasing smaoking and drinking, more visits to the doctor - restricts personal freedom, family of sufferer.
Impact on economic development:
- Medical costs- NHS and personal costs - medicine, time off work - personal and national productivity.
- Cost of treatment - 76 million dollars to treat people over 65 years, per year in America.
Management - education about diet/ causes, diet changes, exercise iniciatives, food labelling, charities such as the British Heart Foundation - money for research.
Food and Health - Malnutrition
Where the human body does not recieve sufficient nutrience to promote healthy development.
Undernourishment - not getting sufficient amount of calories for healthy development.
Caused by - diet.
Concequences - weakned immune system, 30 million die per year of starvation, 800 million suffer cronic malnutrition.
Scurvey - malnutrition of vitamin C + Anemia - malnutrition of iron.
Causes - LEDC, Lack of education about certain food - eggs, father make decisions- no health care.
Impacts - increased time in hospital, impaired immune system, weakness, slower wound healing.
Solutions - UNICEF Aid- nutrition packs, education, promote non-government organisations e.g. Oxfam and WHO.
Food and Health - Famine
3 factors - food shortage, starvation, increased mortality.
- Political - war
- Environmental - drought, desertification
- Economic - not enough money for the price of food
- Social - population increase.
- Political - vote out government, possible civial war.
- Economic - loss of work force, too ill to work, aid.
- Environmental - over grazing - desertification
- Social - loss of family and friends
- Short term - aid, famine releif - send food. Issues with over dependece.
- Long term - higher yielding crops, gm crops, fertilisers, birth control, education, political stability, prop national debt.
Case Study of Famine
- failed harvest
- population increase by x2 since 1980's
- food price incease by x3 since 1980's
- over farming.
- 10% of pop starving
- Spiral of decline - less food = starving = weaker = less able to farm = less food.
Solutions - foreign aid - band aid, education- farming, irregation - gets enough rain but it runs away due to poor land, dams.
Food and Health - Obesity
USA - 60% of adults in the USA are overweight or obese. This has doubled since 1980.
Increased energy dense foods - calories (40% of meals eaten out in the USA, more convenient foods (25%- 1 in 4 people get fast food daily), less exercise (^0% of the USA get no exercise at all), Increase of portion size.
Health - CHD, diabetes (1 in 3 children set to get diabetes), increased risk of stroke, cancer and liver damage.
Economic development - cost of health care, loss of productivity, less mobile, sick off from work, cost of bigger ambulances.
Education - food labelling, suagr or fat tax,portion size regulation, decrease cost of exercise. All of these impact personal freedom.
Case Study of Obesity
60% of the adults in the US are overweight or obese = 100 million people - this amount has not doubled since 1980. Obesity is 2nd only to smoking as a cause of preventable death in the USA. 1 in children set to get diabetes - if you get it before 15 years old, you loose 17 years of life expectancy.
- Increse in eating out - 40% of meals are eaten out.
- Increase in fast food restaurants - 1 in 4 Americans visit a fast food restaurant everyday.
- Increase in convenience of getting food - deliveries.
- Increse of portion size.
- 60% of Americans get no exercise at all.
Solutions - increase exercise, nutritious foods, limit intake, gastric band, promote healthy eating and foods, limit advertising fast food, sugar/ fat tax.
Impacts - stroke, type 2 diabetes, CHD, liver damage, colon cancer, breast cancer, low self-esteem, depression.
TNC = Transnational Corporation
A TNC is a company that operatesin at least 2 countries.
It is common for TNC's to have a hierarchial structure where the head quarters and research + development department are in the country of origin and the manufacturing plants are over seas.
Q- Why + how do TNC's run their business on a global scale?
How- TNC's have a hierarchial structure where the head quarters and research + development department are in the country of origin and the manufacturing plants are over seas.
Why- cheaper labour and provide jobs in developing countries.
Q- Why do TNC's operate on a global scale?
Cheaper labour, cheaper tax,less strict environment regulations, achieve economies of scale (cheaper to do things in bulk), technology makes it easier to run corporations on a national scale (email, skype, internet etc)
Globalisation = the close economic independence between the leading nations of world trade, investment and cooperative commercial relarionships.
Increasing connections between countries/ continents/ nations economically.
Pharmaceutical TNC's - Pfizer
- HQ in the USA- New York.
- Research and development in the UK (and operations) - expertees in medicine & excellent facilities.
- Marketing and distribution in Poland- cheap but developed in terms of resources and communication.
- Manufacturing in India & Senegal - cheap labour, less strict health and safety.
Good- Pizer ans GlaxoSmithKine (GSK) sent 600 million doses of pneumonia vaccine at discounted price to 74 poorest countries. Helping developing countries develop health care systems. Working on new edicine e.g. malaria and HIV. Making medicines more affordable. They have started the International Trachoma Initiative and have supported 180,000 sight saving operations and distribiuted 38 million antiboitic treatments.
Bad- charge more for branded medicines. Use marketing (catchy names) to sell more e.g. Advil.
Trovan Scandal, Nigeria- 1996 - Experimental drug trials in Nigeria for meningitis. They didnt tell parents about trial- Pfizer claimed they were illiterate. It already had poor test results on animals! 11 died, others deaf, blind and paralised. They then had to bribe their way out of it - seemed to work.
Health Care Approaches
Pluralistic - USA, life expectancy 78 - Paid for by consumer with insurance - 44 million do not have cover. Many thousands of health facilities acting independently. Basic care has recently been provided by the government - medicaid (medical care for the poor) and Medicare (medical care for the poor elderly.)
Emergent - India, life expectancy 66 - Hospitals in cities (500:1 - d to p), many rural areas lack clinics (7,000:1 - doctor:patient ratio). Government support suponsored mobile clinics in Tamil Nadu.
NHS- UK, life expectancy 80 - Free at source, paif through taxation, concentrated to primary care trusts. Pay for prescriptions, £7.10 in England but over 80% free. Some private facilities. 1:600 p to d ratio.
Insurance - France, life expectany 81 - WHO best in world. Uses social security backed by insurance schemes. Patient pays on spot but is reimbursed 70% of the cost, 100% for long term illness. 3 doctors per 1000.
Socialised - Cuba, life expectancy 78 - State provided, physicians are state employed, facilities spublic owned, sate role is very effective. never 20 minutes away from a doctors office. Daily visits from doctors, cheap drugs.
- Responsible for about 5 million deaths a year.
- Tabacco is responsible for causing at least 25 diseases.
- By 2020, WHO expects the world death toll to be 10 million from smoking, 17.7% of all deaths in developed countries.
- Stroke - increased risk
- Diabetes - increased risk
- Cancers - lung cancer is the most common- kills 20,000 in the UK every year.
- Heart attack - incresed risk
- Heart bypass
- Reduced life expectancy- 50% more likely to have a smoking related death at middle ages.
- Emphysema - uncurable - makes it very difficult to breath.
- Premature death if you start smoking between the ages of 11-15 years- hooked for life.
Smoking in pregancy - babies cant gain weight and develop- sudden infant dealth syndrome & respiratory problems more likely - asthma, pnumonia.
The Tobacco Industry
- 5.5 trillion cigarettes smoked each year.
- 1.1 billion smokers in the world.
- Ruins lungs.
- Impacts health- cancer, lung disease, emphysema
- 5x more likely to have a heart attack
- Increased risk of stroke
- 22x more likely to get lung cancer.
How is smoking reduced?
- Age restriction
- Bans - UK 2007
- Stop advertisement
- Warnings on packages
- Making smoking illegal- Butan.
British American Tobacco
Good points, Bad points
Provide services for shops e.g. Painting - This was used for sneaky advertising, painting shop colour of cigarette packages.
Malawi farmers make 8x more from tobacco employment, money (60% of exports)
They put on music festivals - Nigeria - have to buy a pack of cigarettes to get in and youth is targeted.
Put on competitions that can make people rich and win prizes - Urges people to buy more packs in order to try and win (ruining health to win)
Consumer choice- single stick sales - can choose how many you want to buy - promotion of single stick sales mean that half a class of 11-14 year olds smoke in Maritius.
Benefits workers for the company in London - get richer.
- BAT controls 92% of Nigerias market.
- BAT advertise cigarettes in Nigeria by- holding music festivals to target young people, cigarette logos everywhere, single sticks.
- In mauritius a third of all children smoke- 90% of smokers start before the age of 19.
- In Mauritius they BAT advertise cigarettes by- painting shops same colour as cigarette packs and single sticks.
- BAT own 98.9% of the market in Mauritius.
- In Malawi most people dont smoke.
- BAT advertie smoking in Malawi by- posters and possible prizes from buying cigarettes.
BAT released some e-cigarettes called Vype:
Good - helps people stop smoking and less damaging to health.
Bad - addictive, can advertise them on tv, dont actually know if they are totally safe and adverts are glamorised.
Health and Morbidity in the UK
Reasons for variations:
- Age structure - in areas such as Dorset- highest percentage of old people- most cancer
- Income - low vs high
- Occupation type- manual labour vs office jobs
- Education- in schools about disease.
- Environment and pollution- open space vs inner city, temperature, warmth, weather.
In terms of life expectancy there is a North - South divide with highest life expectancy in the South-East and the lowest life expecancies in the North particularly Scotland (Glasgow).Plus, the main industrial areas have lower life expectancies.
Regional Variations in Life Expectancy - UK
Overall, lower for men, higher for women. It is also increasing overall. Long life expectancies are getting longer and shorter life expectancies are getting longer but more slowly.
Highest life expectancy for men and women is Kensington and Chelsea- 86 women, 82 men.
Lowest life expectancy for men and women is Glasgow - 76 women, 69 men. This is 10 or more years less than Kensington and Chelsea.
Suggest reasons for the differences between the regions:
- Investment - larger in London than other areas.
- Jobs- better job, better lifestyle.
- Education- better education- better job- better socio-economic status.
- Power of neighbourhood- can leave, do leave.
- Income- high, low.
- Location- inner city, rural-urban fringe.
Access to Facilities - healthcare, nutrition and f
- Less mobile with age, less access to health care
- Less mobile = less exercise.
- Young people unable to drive themselves to health care. - old people less mobile so cant take themselves to health care.
- Women show higher rates of morbidity- self reported illness and higher use of health services.
- Men have higher rates of mortality- LE five years shorter.
- Women feel more pressure to look healthy/ attractive.
- Strong links between income and levels of health.
- Wealthy can access better health care - they can pay for private care.
- Wealth can allow you to buy healthier food, go to gyms etc.
Factors Affecting Health in our Local Area
NHS - 1948 after war. More difficult to manage as costs have risen, life expectancy had increased and medical advances. Paid through national insurance out of wages.
In 2013 the government changed the organisation of the NHS and created 240 Clinical Commissioning Groups (CCG's). These are groups of health care professionals (doctors, dentists etc) and elected local people that decide the way to deliver health care for a certain region.
Arguments for change - cover a smaller area - more focused, local health care professionals know best how to deliver healthcare locally. NHS set free from political interferance.
Arguments against change - Beginning of privatisation for NHS - competition, NHS Cumbria is run by CCG- Previous system is Private Care Trust.
Providers of health care in our local area:
The Cumbrian Clinic- Whitehaven, Bupa- Penrith, The Highgrove Clinic- Carlisle, St Christophers- charity based palative care, Air Ambulance- charitable.
Tackling Health Issues in our Local Area
- Stop Smoking Services - Cumbria
- Out reach group
- Free stop smoking kit
- Cumbria Joint health and wellbeing- smoking stragety
- E-cigarettes more available
- Alcohol Divergent Scheme- drink driving
- Cumbria Alcohol Strategy- info booklet
- Tackling Alcohol in South lakeland- videos
- CADAS- Cumbria Alcohol and drugs Advisory Service - free
Cumbria action for health, slimming world, weight watchers, Cumbria health and wellbeing boards rule,affordable opportunities e.g. sports programmes, target parenting-areas-eating.