IDSB04H3 Chapter Notes - Chapter 6: Coronary Artery Disease, Infection, Maternal Death

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Chapter 6: Epidemiologic Profiles of Global Health and Disease
¾ Public Health Epidemiologic Terms
o Analytic study, census, communicable disease, death rates, birth rates, , exposure,
fertility rate, incidence, Infant Mortality Rate (IMR), life expectancy, maternal death,
MSM (men who have sex with men), notifiable disease, population pyramid,
standardization, stratification, trend
o Adjustment t a summarizing procedure for a statistical measure in which the effects of
compositional differences are adjusted
o Case fatality t (# of deaths from a disease/ # of diagnosed cases of that disease) x 100
o Disability-adjusted life year (DALY) t a measure of burden of disease on a population
and effectiveness of interventions
¾ Leading causes of morbidity and mortality
o Coronary heart disease (CHD), cancer and stroke are the leading causes of death t CHD
is found in both high and low-income countries
o Denmark (high-income/highly redistributive) has a high life expectancy (78yrs), low
child and IMR (5deaths/1000births), but high mortality rate from cancer and leading
causes of death (l.o.c.d) due to heart disease, stroke, pulmonary disease and cancer
o Egypt (middle-income/partially redistributive) has lower life expectancy (68yrs), higher
child IMR (25 to 35deaths/1,000) than Denmark and l.o.c.d from heart disease, stroke,
and hypertension
o Nigeria (low-income/marginally redistributive) has life expectancy (46yrs) IMR =
100deaths/1000births (1/5 children die before 5yrs), l.o.c.d HIV/AIDS, malaria, measles
and TB t 50% of deaths due to communicable disease
o ^/víõõìU}uuµv]o]µñõ9}(Zv]]o]Çu}vPZÁ}o
poorest 20%...[among the rich] non-communicable diseases caused 85% of death and
¾ The Coming Plagues: Non-communicable Disease
o Communicable diseases causes high DALY rates in low-income countries but non-
communicable diseases are expected to exceed communicable disease in all income
groups by 2015
o Though changing risk factors can reduce the death by non-communicable diseases,
large-scale intervention can be taken (e.g. reducing salt in processed food, taxing
tobacco products, and increasing disease screening and disease-control measures)
o Prevention:
Primary prevention t prevention of exposure or infection and promotion of
good health (e.g. immunizations, pap smears, condom use, diet and exercise)
Secondary prevention t early detection (e.g. screening, checking bp, blood tests,
x-rays, physical exams, etc)
Tertiary prevention t disease management
¾ Health in infants and children
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o With improved sanitation, maternal and infant nutrition, vaccination and primary health
care interventions globally IMR has decreased but IMR is still a concern as is seen with
child deaths (b4 5yrs) in poorest populations 2 to 3 times more likely than in more
affluent nations.
o Malnutrition increases susceptibility to disease and chronic undernutrition has adverse
health effects as well lowering workplace productivity.
o Provision of skilled attendant at delivery, immunization, antibiotic treatment for
pregnant women and newborns, hygienic practices during delivery, and breast feeding
(etc) can prevent 75% of neonatal and 60% of child deaths
o Interventions for improving child survival include improving sanitation and cooking
facilities, provision of potable water, and oral rehydration therapy for diarrhea.
o Education and employment is a concern for the world youth in extreme poverty,
particularly women, as can be seen in decline in female attendance post primary school
and higher unemployment among young women due to gender discrimination
Lack of sexual health education programs affects the incidence of HIV/AIDS
¾ Health of adults
o Though adults have greater immunity than children they have higher rates of non-
communicable diseases and adult heath plicy are not emphasized. Adult health illness
o Disability t Difference between disability and impairment t disability: results from
medical, physical and environmental factors determined from social discrimination and
Poverty is a cause and consequence of disability and in low-income countries
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o ^P]vP}µo]}vµo}((}µZ]u}Àuv]vZoZv]
determinants through the life course, and decreased fert]o]Ç_~îñò
o Injecting drug use (IDU) t Harm reduction strategies are practiced in some countries
and local municipalities offering safe injection locations, clean needles and disposable
facilities, etc for injecting drug users t this has helped to reduce the spread of disease
via sharing needles
o Dental health t dental health is a concern among the poor, in developing countries
there is insufficient number of dentists and globally dentists are financially inaccessible
to low-income families. Commercial foods, insufficient exposure to fluorides, and costs
of tooth brushes are also dental health issues.
¾ t}uv[ZoZ
o Gender-specific health problems can result from the limits on economic and social
power, lower levels of education and lack legal autonomy that women face te.g. they
o Women tend to have more morbidity and physical disabilities than men
o Maternal mortality is higher in developing countries because of lack of sufficient
infrastructure for prenatal care, resource allocation, etc. Other concerns they may live
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