Oct, 5 (week 4, lecture 4) chp 5
-health related info and knowing how to obtain it is essential to taking action to improve health.
-plays a vital role in helping to identify needs and shape solutions.
-not all deaths recorded; most of 50 million deaths each year lack medical certification
-social, political and economic factors for illness and death are insufficiently captured by routine health
-many factors that influence health do not qualify as health statistics (rain, pollution, transport, etc.)
-one of first priorities is to secure reliable health statistics collection. But data costs money. Where
disease occurrence is highest, the numbers are the least trustworthy.
-two assumptions: disease and death are medicalized processes that are certified by trained medical
practitioners and publicly recorded. There is an agreed upon disease classification process universally
applied by doctors through common diagnostic procedures.
-International classification of diseases (ICD): cultural and economic factors limit adoption
*****Table 5-1 Uses for statistical health data (11 uses listed)
-detailed census date gives a voice to the voiceless.
-health data used in public sphere for info regarding political system, education campaign.
-Vital for determining whether goals and priorities are being met.
-mortality and morbidity data can help provide causal explanations
-have to make correlations between behaviours and health outcomes. Example: smoking causes
-use of data in terms of deciding what variables are important.
-primary reason for collection of health data is to track trends in population health status at the level of
coutnreis, regions and subpopulations.
-health data employed to measure success or limitations of medical or health promotion intervention, or
social and economic policies.
-health data used to compare populations with and between countries to evaluate effects of programs
and policies, in order to use successful experiences in the future.
-Health impact Assessment (HIA): considered health impact of both public and private sector policies in
diverse arenas including zoning, transport, labour, energy, education. Calls for action and accountability
on part of decision makers for promotion of health and reduction of health disparities.
Monitoring and compliance under the 2007 international health regulations (196-8)
-smallpox: eradicated but re-emerged as bioterrorist threat
-under surveillance: malaria, polio
-annual report on actions taken and progress achieved in improving health of people.
-International Health Regulations (IHR): national governments notify WHO of cases or outbreaks of
certain diseases, and of measures taken to prevent their spread
-public EMG international concern if:
1- constitutes a public health risk to other states through international spread of disease
2- potentially requires a coordinated international response.
-notification within 24 hours of first official case
-International Sanitary Regulation (ISR): adopted by WHO in 1951 as legal instrument to protect against
international spread of diseases.
-following SARS in 2003, WHO held a series of meetings to update international health regulations.
-Update included mandatory reporting of public emergencies.
-prior to that the only mandatory reporting was for the four diseases listed above. Reason for
update had to do with Chiv[o}Á}]vPP]vP}µlP]vPZ^Z^}µl]v
-Cases reported a week after the President of the USA went on his planned visit to Mexico.
Reporting is very calculated by governments
-early detection can lead to knowledge of their cause, and important steps can be taken to minimize
hazards. New conditions can be discovered before larger population groups are exposed.
Limitations to health data:
-highly sensitive and laden with political overtones.
-may be pressure for governing bodies to distort figures
-concern with international trade or tourism may prompt cases of cholera to be reported as
-data may be interpreted to support a particular position (ex. Pro or against smoking, guns, etc.)
-biased or selective info to get money or public attention
Types of Health Data (199)
-Population data: number of people in population and their attributes (sex, age, ethnicity, religion,
-vital statistics: births, deaths, marriages, by sex, age and cause
-health statistics: morbidity by type, severity, and outcome( monitor levels of health and disease, rather
than death. Difficult to obtain, extremely costly, need trained healthcare workers, etc.)
-health services statistics: number and types of facilities and services available; distribution,
qualifications, and functions of personnel; hospital and health care center operations (the health care
systems capacity; doctors, nurses, hospitals, clinics, etc.)
-data on social inequalities in health: social factors that lead to inequalities in health ( look at each of the
other four categories in terms of their breakdown on social class, sex/gender, racial/ethnic origins,
-need to look beyond disease manifestation and think through economic consequences.
-ex. Disabled person have stigma associated with them, so less likely to have job
-societal variable- measure of social welfare and security, distribution of power and resources- vital to
health related decision making.
Census Taking (204)
Preconditions for conducting a census
-sponsorship: legal basis
-universality: everybody taken into account. Problematic because homeless people, babies, illegal
immigrants, refugees, illiterate people, those living in very remote areas are all missed.
-simultaneity and specified time: what a sense of a snapshot in time because you want accurate data
before demographics change drastically.
Oct, 5 (week 4, lecture 4) chp 5. Health related info and knowing how to obtain it is essential to taking action to improve health. Plays a vital role in helping to identify needs and shape solutions. Not all deaths recorded; most of 50 million deaths each year lack medical certification. Social, political and economic factors for illness and death are insufficiently captured by routine health statistics. Many factors that influence health do not qualify as health statistics (rain, pollution, transport, etc. ) One of first priorities is to secure reliable health statistics collection. Where disease occurrence is highest, the numbers are the least trustworthy. Two assumptions: disease and death are medicalized processes that are certified by trained medical practitioners and publicly recorded. There is an agreed upon disease classification process universally applied by doctors through common diagnostic procedures. International classification of diseases (icd): cultural and economic factors limit adoption. *****table 5-1 uses for statistical health data (11 uses listed)