1) Bhopal
a.Plant exploded that released chemicals, killed 500 000 people over time,
nobody pr ioritized their healt h, foreign company, preventable but didnt
take precautions before WTO. Lack of regulation. Moral responsibility.
India taking passive approach to not enforcing regulation. Need strong
public civic activity. Exploitation possible by unequal power relations.
2) Alma-Ata
a.Improving the social economic and politica l infrastructure in places. Not
vertical, or narrow approaches. Take t he stance that development blocks
disease (chapter 4). Focus on primary health care, calling for social justice.
block means stop social political and economic conditions MATTER
3) Health inequali ties, health inequities, health disparities
a.Health inequalities: a) individ health differences b) healt h dif ferences
related to dif ferent s es conditions c) health differences related to popn
b. Health inequities: differences being preventable
c.Health disparities: differences in health status between different groups
4) Social vs societal determinants of health
a.Social: social charact within which living t akes place- relational
b. Societal: political, economic, societal things that shape healt h structures
5) Cross subsidies in healt h f inancing:
a.Cross subsidy is one part of the popn helping to subsidizing services for
another part of the popn- targeted health program for homeless ppl in
Toronto- done thru income taxes t hey themselves not benefitting
6) Health system typologies:
a.How they are funded and financed
b. Canada: public funding, private admin (bc doctors not employees of
province) national health insurance
c.UK_ national health services national health services
d. Table 12-2, t able 12-5
7) Why the Bamako initiative not sustainable?
a.Bamako initiative: supported by WHO and IMF/World Bank, going
through structur al readjustment programs
b. Cost recovery: taking money for service at point of service
c.Not enough disposable income, and because of that ppl would avoid care
d. Sliding fee scales do not solve the problem because not well implemented,
not followed unifor mly, more expensive to administer t han money you
would retrieve
8) Mc Keown t hesis:
a.Chapter 2 box2-3
b. What are the reasons for t he modern mortality decline?
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