INTL 340 Lecture Notes - Lecture 3: Social Exclusion, World Health Assembly, Michael Marmot
2 Jul 2018
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Department
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Week 2 Class 1
Review:
● Alma-Ata principles: HFA, PHC; Health v. Medical Care
○ not just universal access to medical care or health insurance but access to primary
care
● Tensions between PHC and SPHC
● Challenge of measurement
● Gov and inter-gov responsibility for health
Results of UNICEF child survival campaign (example of selective primary health care)
● increases immunizations and use of ORT
● Immunization rates reach 80% or more (from 15% at start of campaign)
● Child malnutrition rates reduced, almost in half in some countries
● An estimated 12 million children’s lives saved (1980-1990)
● “Cost effective” — GOBI accomplished for less than $10/child
Disparities in child health persist
● one problem with SPHC: limited impact on overall health system/infrastructure
● International disparities in IMRs persist
○ IMRs: Infant mortality rates= # deaths per 1,000 live births in a population
■ important because its a good sensitive measure of actual nation population
health
■ first population based measure we’re looking at (epidemiological indicator)
■ indicates broader underlying social inequalities
○ “Excess deaths” = preventable deaths
Health disparities: Challenge for GH (global health)
● Epidemiological data provides us the ability to compare the health status of populations, to
identify disparities, to determine where to focus resources in order to reduce disparities
across populations
● We need statistical measures of population morbidity and mortality to do this (RATES,
standardize for pop size)
WEEK 2 NEW MATERIAL
● marmot 2006 is an important reading as well as link and phelan
Topics
● Social determinants of health
● Whitehall Studies
● Social gradient of health
● “In Sickness & in Wealth” video
Marmot & the Whitehall Studies
● Sir Michael Marmot: social epidemiologist
● Director, Whitehall Studies
○ his first studies
● Chair, WHO Commission on Social Determinants of Health
Social Determinants of Health
● How society is organized impacts health
○ income and income distribution; social inequality
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Alma-ata principles: hfa, phc; health v. medical care. Not just universal access to medical care or health insurance but access to primary care. Results of unicef child survival campaign (example of selective primary health care) Immunization rates reach 80% or more (from 15% at start of campaign) Child malnutrition rates reduced, almost in half in some countries. An estimated 12 million children"s lives saved (1980-1990) Cost effective gobi accomplished for less than /child. One problem with sphc: limited impact on overall health system/infrastructure. Imrs: infant mortality rates= # deaths per 1,000 live births in a population. Important because its a good sensitive measure of actual nation population health. First population based measure we"re looking at (epidemiological indicator) Epidemiological data provides us the ability to compare the health status of populations, to identify disparities, to determine where to focus resources in order to reduce disparities across populations.
