HLTC24H3 Lecture Notes - Retrovirus, Artificial Insemination, Organ Transplantation

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8 Apr 2012
Epidemiologic profiles of global health and disease
Health of infants and children
ON AVG 26 thousand children die daily, nearly all from preventable diseases
Although rates are dropping all over world, the gains are not equitably distributed.
Advances have been made in high and middle income countries but for underdeveloped
countries, especially in sub Saharan Africa, there has even been a stagnation or decline of IMR
-IMR is often cited as the most sensitive indicator of a general level of “development”
-High IMR’s reflect underlying inadequacies in socioeconomic and sanitary conditions.
Many of the leading causes of high IMR are preventable through structural and policy
-According to conventional public health model, 75% of neonatal and 60% of child
deaths could be readily prevented with a set of 20 proven interventions. i.e. skilled
attendant at delivery; immunization and antibiotic treatment for pregnant women and
newborns, practices during delivery, and exclusive breast feeding for the first 6 months
of life.
-Toddlers are subject to a variety of illnesses, and this can create a disadvantage due to
educational and occupational challenges and difficulties in social and physical
-Interventions to improve child survival include providing potable water, improving
sanitation and cooking facilities, and oral rehydration therapy for diarrhea.
Health of adults
-Adults face more chronic health problems, rates of many noncommunicable diseases
are much higher in adults than among children i.e. cancer, cardiovascular disease.
-Adult’s deaths, illnesses, injuries and disabilities reduce productivity and family
income. In addition, many adult illnesses are chronic, and place heavy social and
financial burdens on health services and caregivers.
-Aging populations are a result of factors such as improvements in health and its
determinants throughout the life course, and decreased fertility rates.
-Older persons have higher rates of morbidity owing in large part to accumulated life
factors that determine illness, such as exposure to environmental toxins, or poor
-They also suffer more from falls and depression
These include viral, bacterial, and parasitic infections transmitted through sex and
primarily, although not exclusively, affecting genitalia and reproductive organs
STIs are preventable through barrier methods of protection. i.e. condoms.
The spread of STIs is largely determined by factors beyond choice of contraception, such
as commercial sex, forced sex, migrant labour, gender disparities, and an overall lack of
access to health services.
Most bacterial STIs are curable through short course antibiotic therapy, and many viral
STIs can be managed through medication and improvements in immunologic status.
Factors such as stigma, cost and availability of services often inhibit ppl from seeking
Women’s health
-Women in many societies have limited economic and social power, attain lower levels
of education than men, and lack legal autonomy.
-This are some of the factors which lead to gender specific health problems, as they are
somewhat disregarded.
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-Maternal mortality shows the largest discrepancy b/w developed and developing
countries. > lack of proper infrastructure for prenatal care, poor resource allocation, and
low priority given to women’s health result in enormous deficiencies in maternal health
care, and low presence of skilled attendants for delivery and postpartum care in low
income countries.
-i.e. in Africa, women have a lifetime risk of 1 in 20 of dying from pregnancy-related
causes, where in developed countries that risk lies at 1 in 2000.
-There are 3 main types of care which have been underlined as essential for pregnant
-Poorly performed abortions are an important cause of maternal mortality.
-Another leading cause of maternal death is preventable infections resulting from poor
hygiene, primarily in the health care delivery setting, and contamination during child
Men’s Health
-Men experience higher rates of mortality than women and are overrepresented in many
illness categories such as cardiovascular disease, HIV/AIDS and physical injury
-Men’s roles are primarily breadwinners in numerous societies may lead them to travel
and work in dangerous/stressful settings, and result in illness and or injury.
Lesbian transgender, gay bisexual health issues
-At least 4 countries around the world criminalized same sex behavior in both men and
women, and an additional 35 solely criminalize it for men.
-For LGBT ppl, health concerns go well beyond specific needs, such as reproductive
health or surgical services.
-Societal homophobia and heterosexism combine to jeopardize LGBT health through
discrimination in housing and employment; lack of social security benefits; harassment
and stress; isolation; physical abuse and violence, imprisonment.
Health of indigenous populations
-Indigenous groups consistently experience higher mortality rates and worse health than
no indigenous populations. i.e. in Canada first nation’s communities have higher
prevalence rates of heart disease, diabetes and TB.
-Social inequalities in health b/w indigenous ppls and dominant groups are related to
historic colonization processes and to the ongoing practices of social, economic,
political, and cultural oppression.
-Through colonization “virgin” indigenous populations were exposed to new diseases,
this mortality was also due to military, social, economic aspects of colonial conquest.
-It leads to the loss of means and subsistence, cultural practices, and social systems.
-Mainstream public health authorities and researchers typically seek biomedical or
behavioral explanations for the health inequalities b/w indigenous and no indigenous
groups, citing genetic and dietary differences, different rates of mental health disorders,
and supposed differences in proclivity violence.
-Recently increasing attention has focused in socioeconomic factors, including poor
living conditions, substandard schools, chronic unemployment, and persistent
-Disease of marginalization and deprivation
-Many diseases occur primarily as a result of marginalization and deprivation that is
extreme poverty, substandard living conditions, geographic isolation and political
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