Maternal and Child Health + Global Health
Who runs global health?
*UN agencies *Development Banks *Bilateral and foreign aid agencies *Foundations *Research funders *NGOs *Technical agencies *Partnerships *Consulting
companies *Universities *Pharma/industry
Chronic exposure to social and economic disadvantage leads to accelerated decline in physical health outcomes and could partially explain racial disparities in a wide array of health condition.
What is this referring to?
Weathering hypothesis
What is the main cause of injury-related deaths?
#1. Poisoning... overdose!
Mental Health includes our emotional, psychological, and social well-being.
Mental Illness - health conditions involving changes in emotion, thinking, or behavior (or a combination
of these)
• A person can experience poor mental health and not be diagnosed with a mental illness.
• Likewise, a person diagnosed with a mental illness can experience periods of physical, mental, and
social well-being
What is the Healthy People Initiative?
Through 10-year national objectives, the HHS Healthy People Initiative helps individuals, organizations, and communities committed to improving health and well- being address public health priorities.
What factors increase infant mortality?
Factors increasing infant mortality
• Number one risk factor is poverty
• Reasons why low SES increases risk:
• Environmental hazards
• Poor nutrition
• Maternal risk behaviors
• Smoking, alcohol, illegal drugs
• Social factors
• Young maternal age, violence, out of
wedlock birth, stress, lack of social support
• Lack of prenatal care
Describe the Latinx Health Paradox.
Despite having poorer healthcare access and other social disadvantages, Latinx immigrants have, on average, better health outcomes than U.S.-born Latinx individuals.
What are the major public health injuries?
Motor vehicle injuries
Poisoning
Firearms injuries
Occupational injuries*
Injuries from domestic
violence
Nonfatal TBI (e.g.
concussions)
Hippocrates believed there were 4 categories of mental illness (mania, melancholia, paranoia, epilepsy) that resulted from an imbalance in the 4 Humours (blood, phlegm, yellow bile, black bile).
How is this idea related to current knowledge of mental illness?
Hippocrates proposed an imbalance of the Humours, while diagnosis are currently based on the imbalance in our brain’s chemicals.
What are WHO’s urgent health challenges in the 2020s?
Elevating health in the climate debate
Delivering health in conflict and crisis
Making healthcare fairer
Expanding access to medicines
Stopping infectious diseases
Preparing for epidemics
Protecting people from dangerous products
Investing in the people who defend our health
Keeping adolescents safe
Earning public trust
Harnessing new technologies
Protecting the medicines that protect us
Keeping health care clean
What is governance?
A web of formal and informal relationships (governments, NGOs, the private sector, multilateral organizations, philanthropies and various partnerships and funds)--> the way in which the global health system is managed
Explain why racial/ethnic minorities experience greater risk for COVID19.
Living conditions - may live in multigenerational household, may have many people in household
Working conditions - essential worker jobs
Inequities that increase risk: Discrimination, healthcare access and utilization, occupation, educational, income, and wealth gaps, housing
Who is most vulnerable to injuries? (gender, race, age, SES)
• They are the leading cause of death for ages <45.
• Higher injury rates exist for groups with lower SES.
• Males have higher injury rates than females.
• Blacks have lower injury mortality than whites.
– Except, blacks have higher homicide rates.
What did Eugenics aim to do?
Eugenics movement aimed to reduce the rates of physical and mental illness, hereditary diseases, and ‘morally deviant behaviors’ by “breeding out” (forced sterilization) disease, disabilities and so-called undesirable characteristics from the human population.
Why is being uninsured a problem?
◦Don’t obtain preventive care
◦Postpone getting care when ill
◦Don’t take their medications
◦Receive care in the emergency department
◦Are more likely to be hospitalized for preventable illnesses
◦Are less likely to survive serious illnesses
◦Health care costs are a major cause of personal bankruptcy in the US
What is a major challenge in global health? Give an example.
Possible answers:
*Who has the power
*Neo-colonization
Examples will vary.
What are health disparities? Provide one example of a racial/ethnic health disparity.
Preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.
Ex. will vary; life expectancy, healthcare coverage, obesity, etc.
What are the 3 Es of injury prevention?
Education, Enforcement (speed limits, seat belts), Engineering (divided highways, rumble strips, separate bike lanes)
What was one of the main factors that led to deinstitutionalization?
Development of psychiatric drugs:
•1940s – Developed first drug for severe mental illness (Thorazine)
•1950s - Develop first antipsychotic medications (Haloperidol/Haldol)
What is the Children's Health Insurance Program?
*Passed by Congress in 1997 to cover children (< 19) whose families earn too much to receive Medicaid but too little to afford insurance
-Jointly run and funded by Federal and state governments
-Services provided through Medicaid and separate CHIP programs
-Eligibility varies by state◦Upper income limit ranges from 170% to 400% of the Federal poverty level
◦Some cover pregnant women
◦States can enroll lawful immigrants but don’t have to
2020 – CHIP covered 9 million children◦Typically, about 1/3 of US children
What is the Colorado Family Planning Initiative?
• In 2008, the Colorado Department of Public
Health and Environment (CDPHE) secured
funding from a private donor to launch the
Colorado Family Planning Initiative (CFPI)
• Between 2009 and 2015, provided training,
operational support and low- or no-cost long-
acting reversible contraceptives (LARCs) to
low-income women statewide.
Why does the relationship between SES and health look differently for different race/ethnicities?
The added burden of race; When we control for SES, Black-White health gap persists.
Using the chain of causation, break down a potential host, agent, and environment for a motor vehicle accident.
•Host – human who can get the
disease Example: Anyone driving on the road
• Agent – pathogen, contaminant,
toxin that causes the disease Example: Poor breaks in automobile
• Environment – extrinsic factors
affecting the agent and opportunity for exposure Example: Icy roads, weather causing unsafe driving conditions
What is it called when a person as two or more disorders at the same time or one after another?
Comorbidities
Explain Medicaid vs. Medicare.
Medicare:
-Passed by Congress in 1965 to provide health insurance for 65 or older; Younger people with disabilities
◦End-Stage Renal Disease (kidney failure requiring dialysis/transplant)
◦US citizens or permanent residents
-Covers about ½ of expenses◦Most get supplemental plans or Medicaid
-Meant to be paid for by 2.9% payroll tax◦Split by employers & employees
Medicaid:
-Passed by Congress in 1965 to provide health insurance for the poor◦Income must be below a certain % above of the Federal Poverty Level (FPL)
◦In 2021, for a household of 4 persons, the poverty level is $26,500
-Jointly run and funded by Federal and state governments
-Federal government requires states to cover low-income people in “mandatory eligibility groups”◦65 or older
◦Disabled
◦Children
◦Pregnant women or an adult caring for a child
-States can expand beyond these groups if they want