Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
What is health?
Negative definition
the absence of disease, disability or
illness
But health is more than not being ill
Positive definition
a state of well-being
Health is also
culturally determined
a fundamental human right
What is health?
Health is a state of complete
physical, mental and social well-being,
not merely the absence of disease or
infirmity. 1946
ATTACK RATE
FANT MORTALITY
ASE-MORTALITY
What is health?
Health is a state of complete
physical, mental and social well-being,
not merely the absence of disease or
infirmity. 1946
Types of indicators
Mortality the number of people who die
Morbidity the number of people who
are ill
Well-being how well people feel
Number of
deaths
Causes of death in
developed countries
Number of
deaths
HIV-AIDS
2,678,000
3,512,000
Lower respiratory
infections
2,643,000
Stroke
3,346,000
2,484,000
Chronic obstructive
pulmonary disease
1,829,000
Diarrhea
1,793,000
Lower respiratory
infections
1,180,000
Cerebrovascular disease
1,381,000
Lung cancer
938,000
Childhood diseases
1,217,000
Car accident
669,000
Malaria
1,103,000
Stomach cancer
657,000
Tuberculosis
1,021,000
635,000
Chronic obstructive
pulmonary disease
748,000
Tuberculosis
571,000
Measles
674,000
Suicide
499,000
Mortality
Crude death rate number of deaths
per year in 1,000 people
Infant mortality rate number of
infants under one year old who die each
year, for every 1,000 babies born
Morbidity
Prevalence
The number of people who have disease
at a particular time
Incidence
The number of new cases occurring
within a set time period
countries
% of deaths caused
by infections, perinatal,
maternal and deficiency
diseases
% of deaths caused by
degenerative diseases
Richest 20%
85
Poorest 20%
59
32
ActionAid
Mortality
Life expectancy the average
number
of years a newborn child is expected to
live assuming conditions remain
constant
Death rate
Poverty
Education, especially of girls
Contraception
Environment
State and society/civil breakdown
Availability of health care
Gender
Determinants of Health
AIDS
What is AIDS?
Acquired Immunodeficiency
Syndrome
Destructs bodys immune system
Aids is caused by the virus HIV
HIV is Human Immunodeficiency Virus
The history
1959: AIDS first identified in the Belgian
Congo
1978: Gay men in US show first signs of
AIDS
1982: term AIDS used for first time
1983: Institute Pasteur finds the HIV
virus
1985: The FDA approves the first HIV
Symptoms
Flu-like symptoms
No symptoms
Fever, Fatigue, Diarrhea, Skin Rashes,
Night Sweats, Loss of appetite
Other possible affects include
Opportunistic infections, cancers, pneumonia,
and tuberculosis
Global Summary
720 000
North America
1.2 million
Caribbean
1.6 million
300 000
Latin America
1.8 million
510 000
Sub-Saharan Africa
25.8 million
870 000
7.4 million
Oceania
74 000
Country Level
Swaziland
38.8%
Botswana
37.3
Lesotho
28.9
Zimbabwe
24.6
S. Africa
21.5
Namibia
21.3
Zambia
16.5
Malawi
14.2
CAR
13.5
Mozambique 12.2
S. Africa 5,300,000
India 5,100,000
Nigeria
3,600,000
Zimbabwe
1,800,000
Tanzania 1,600,000
Ethiopia 1,500,000
Mozambique1,300,000
Kenya
1,200,000
DRC
1,100,000
USA
950,000
Antiretroviral (ARV)
Treatment
Behavioural counselling and provision of
condoms, clean needles and syringes must be
made available to people.
After testing positive, people living with HIV can
be offered care, treatment and support services,
including ARV if necessary.
Counselling and other services aimed at
prevention of secondary transmission, as well as
the provision of ARV to prevent mother-to-child
transmission, are an essential component of
follow-up services for individuals who test
positive.
Effective prevention programming and treatment,
care and support services therefore go hand-inhand.
Impacts
The impact of AIDS is devastating to the
economies of low and middle income countries
with high HIV prevalence.
These countries, already suffering from heavy
debt burdens, low productivity and weak
infrastructures are being further impoverished by
the scourge of AIDS.
There is strong evidence that investment in HIVrelated treatment and care can reduce
hospitalisations and other direct and indirect
costs of HIV/AIDS.
Brazil has completed a number of economic
analyses demonstrating significant cost-savings
and expenditures avoided since the introduction
of universal coverage of HIV-related treatments,
Impacts
Destruction of social capital
Knowledge base of society
Production sectors: agriculture,
industry
Weakening of institutions
Civil service, judiciary, armed forces,
education, health
Inhibition of private sector growth
Impacts
HIV treatment allows savings due to
avoidance of hospitalisations and lower
incidence of opportunistic infections.
In addition to prolonging the lives of
countless teachers, health workers,
farmers, students and other precious
human capital, it makes sense for
countries to invest in health care in
general, and HIV treatment specifically,
because access to care and treatment is a
human right.
Age in years
Projected population
structure in 2020
Males
Females
60
40
20
20
40
60
Population (thousands)
Source: US Census Bureau, World Population Profile 2000
Women
Women are infected up to 10 times
more easily than men
Social and economic factors increase
womens vulnerability
In RSA 75% of 15-24 years olds
infected are women, globally 47% of
total infections are in women
Women bear the social and economic
burden of the epidemic
Comprehensive care
There is no cure
Costs
It is clear, however, that the vast majority
of people living with HIV and in need of
treatment will not be able to afford to
cover the costs of their care.
Countries that have maximised treatment
access have done so through universal
access.
HIV care will need to be provided at a price
that is proportionate to local purchasing
power and for many people, in many
communities, in many countries, that
means HIV care and treatment must be
free
Ethiopia 2014
Kenya 2005
Zimbabwe 2005
Benefits
Treatment brings many wider benefits and its
effects on national development are also
substantial.
What makes AIDS uniquely destructive is that it
targets adults in the prime of their lives as
workers, parents and caregivers.
Treating HIV:
Water issues
Where drought conditions exist,
access to clean water is reduced,
further increasing the risk of infection
for adults, children and infants,
particularly those on formula feeding.
Clean water supplies and adequate
food must be part of an overall HIV
treatment, care and support package
Food issues
For much of the worlds population living
with HIV, the need for food remains an
overwhelming priority.
People living with HIV and AIDS need
substantial nutritional inputs (up to 50%
more protein) to fortify their compromised
immune systems.
Those suffering from hunger, famine
and/or nutritional deficits are more likely
to fall ill with opportunistic infections and
are less likely to be able to recover from
them.
Malnutrition is also one of the major
clinical manifestations of HIV disease.
Southern Province of
Zambia
SAPEP is a non-governmental
organisation which works in two rural
districts in Zambias Southern Province,
surrounding the towns of Monze and
Mazabuka.
The project used to be funded by the
government Family Health Trust. The
project was under-funded and has been
funded by PEPAIDS, a British-based
charity, since December 2002.
SAPEP employs two District Co-ordinators,
one in Monze and one in Mazabuka.
Their districts are divided into 20 Zones,
each with a part-time Zone Co-ordinator
Anti-AIDS Clubs.
Anti-AIDS Clubs had been running in Zambia
since 1991.
SAPEP took over in 2002
The Club Leaders organise activities
Competitions
drama/role-plays about HIV/AIDS transmission situations
Sport has proved to be a very effective way of reaching
the youth and giving health education, because it
attracts a large audience.
Cultural issues
Some practices and beliefs have a
direct effect on the transmission of
HIV.
For instance, it is believed that men
can cure sexually transmitted
diseases by having sex with a virgin
Family and tribal elders are also
expected to initiate young girls into
womanhood, through sexual
intercourse.
Poverty
For many people each day is, literally, a struggle for
survival.
Many women and young girls are forced into
prostitution, which obviously contributes to the
spread of HIV.
I visited three different areas in Monze with homebased care services. The majority of the patients we
visited had AIDS they were dying without any
food or pain relief.
For many people, AIDS meant their family had no
source of income as the sole earner was sick.
There were countless orphans who had lost both
parents to AIDS.
One woman I met had seven grandchildren to look
after, her own children having died from AIDS.
Geography
of an
Infectious
Disease:
HIV/AIDs
What is it?
AIDS =
acquired
immunodeficiency
syndrome
It is caused by
the human
immunodeficie
ncy
The virus
spread of
(HIV).
HIV..
See sheets
The global
KEY FACTS: hazard
A Disease Largely of
Poverty
Among all low- and middle-income
countries, HIV prevalence is strongly
correlated with falling protein
consumption, falling calorie
consumption, unequal distribution of
national income and, to a lesser extent,
labor migration.
Poverty not only creates the biological
conditions for greater susceptibility to
Causes of the
Epidemic.
Background
about
AIDS/HIV.
Aids/HIV in
Africa.
Strategies to
tackle the
epidemic.
Impacts on
African
Communities.
CHD - Symptoms
Some people experience
shortness of breath or chest
pain and make it to the
hospital in time to be treated.
Besides chest pain (angina)
and shortness of breath,
other occasional symptoms
include jaw pain, sweating,
and nausea.
CHD - Diagnosis
Doctors use a variety of tests to
detect heart disease.
One common test is the
electrocardiogram (ECG)
Symptoms of CHD tend to show
up when the person is exercising
because that's when the heart
needs a higher level of oxygen
delivery. However, for a person
with heart disease, the coronary
arteries can't deliver the amount
of oxygenated blood needed
because of the coronary artery
blockage. That's why stress tests
require the patient to perform a
strenuous activity under a
doctor's supervision, such as
walking or running on a treadmill.
CHD - Treatment
Bypass Graft if the blockages are too extensive
then artificial arteries are created that bypass the
affected areas. This open heart surgery is done under
general anaesthetic.
CHD - Treatment
Medication is always necessary to manage CHD. This
is normally:
1.Statins lowers cholesterol
2.ACE inhibitors & beta blockers Reduce stress on
the heart
3.Aspirin thins the blood.
Disease prevention
You can reduce
the risk of
developing
CHD by
exercising,
eating
healthily, and
not smoking.
Global morbidity as a
result of CHD
Homework
Research and find out about the recent Cholera
epidemic in S. Africa.
How is it being spread, contained, treated etc.
To what extent is the level of development in
Zimbabwe contributing to the outbreak?
BELL WORK
BELL WORK
In 2010,
an
estimat
ed 925
million
people
were
sufferin
g from
hunger.
BELL WORK
Children as
young as 3 are
being treated
for obesity
BELL WORK
In 2008, nearly 9
million children died
before they reached
their fifth birthday.
One third of these
deaths are due
directly or indirectly
BELL WORK
Why?
Food and
Health
MALNUTRITION
FAMINE
OBESITY
T.A.G.S.
Thinking Skill:
Assessment for learning:
Geographical Skill(s)/Skills for Life:
Success Criteria (Learning Outcomes for the lesson):
LEARNING OUTCOMES:
1)
2)
3)
What
What
What
Lesson Overview
Class
Case Studies
Differentiation
Personalised
Learning
Use of TA
SMSC
Literacy/Numeracy
Bell Work
New Information
Clarify Understanding
Apply
Plenary
Homework
Malnutrition
Undernourishment
Stunting
Overnourishment
Stunting
Periodic Famine
Overnourishment
Undernourishment
MALNUTRITION
Going without proper food can lead to serious
health implications:
Marasmus
(protein energy
malnutrition) by a
lack of protein and
energy with sufferers
appearing skeletally
thin.
BeriBeri
by vitamin B1
deficiency. It causes
severe fatigue and
cardiovascular
complications.
MALNUTRITION
Xeropthalmia by vitamin
A deficiency. It is a
leading cause of blindness
in LEDCs.
Pellagra by vitamin
B3 deficiency.
Anaemia is caused
by iron
deficiency and a
decrease
MALNUTRITION
Rickets
Is caused by a lack
of vitamin D. Leads
to a softening of
the bones leading
to fractures and
deformity.
Scurvy
is caused by vitamin C
deficiency. It leads to
spots on the skin,
spongy gums and
bleeding from the
mucous membranes.
Teeth may also fall
out. It has affected
sailors in the past.
HOMEWORK TASK 1
We are going to look at 2 case studies on
malnutrition UK and Niger. You need to have
3 highlighters and you must read through
the article and highlight:
Causes
Impacts
Solutions
Top Tip:
If you would rather create case study
summaries so you have a revision aid for exam
time then I would agree that this would be a
great idea as large articles can often be very
overwhelming at exam time. In addition, putting
in the hard work now will mean you have less to
do for your revision preparation.
FAMINE
Famine contains three elements: food shortage,
starvation and excess mortality.
It has a greater effect on the most
vulnerable in society as they have
low status, limited land and weak
purchasing and bargaining power.
Famine is caused by many complex factors
including: poor climatic and environmental
conditions, population growth, market failure or war.
The difference between famine and food crisis
is whether there is enough food aid to keep
starving people alive. If there is not then people die
and then there is a famine.
FAMINE
Famines are not always widespread. They can be
localised and can affect only one group or social class.
In areas affected by famine it is not uncommon to see
food available in markets and some agricultural
produce being exported.
Large scale famines occur as a result of the
following factors:
Drought which limits water supply when the rains
fail.
A population increase greater than the rate of
food production (e.g. sudden influx of refugees).
A rapid rise in the price of food stuffs and
animals this happens when the quality of farmland
and grazing declines, this leads to panic buying
making the situation even worse.
HOMEWORK TASK 2
Using the following resources:
Video:
http://www.youtube.com/watch?v=JJD880K1rYU
(or type into google/youtube endless famine,
Ethiopia, the video is about 18 mins long). You
must watch the whole video and make notes on
specific facts and figures which will then inform
your case study.
The brown textbook P.290
Action Aid Document
Independent internet research (optional)
You are to create a case study on famine in
Ethiopia.
Obesity
Definition
An excess of body fat which is
greater than 20%
The most common method of
measuring obesity is calculating an
individuals Body Mass Index (BMI).
This is calculated by dividing a
persons weight measurement (in
kilograms) by the square of their
height (in metres)
Predictions
A report, published in October 2007,
predicted that if no action was taken:
60% of men, 50% of women and 25%
of children in Britain would be obese
by 2050.
Without action 41-48% of men and
35-43% of women could be obese by
2030.
Dangers
Obesity can have a severe impact on
peoples health, increasing the risk of
type 2 diabetes, some cancers, and
heart and liver disease.
There is also a significant burden on
the NHS direct costs caused by
obesity are now estimated to be 5.1
billion per year (2013).
Measures
Leading soft drinks brands Lucozade,
Ribena and J20 are among the latest
brands to sign up to the
Responsibility Deals calorie reductio
n pledge
as part of the governments drive to
curb obesity levels.
Measures
Jan 2013 campagn from Change4life
exposes hidden facts about everday
foods.
Tv advert reveals that there is 17
cubes of sugar in a bottle of cola,
More than a wine glass full of fat in a
large pizza is to be shown on TV.
Measures
The government has announced
(March 2013) new funding for school
sport and PE worth 150m a year for
the next two years.
This is to promote an interest in sport
and healthy lifestyles for the future.
Part of Olympic legacy measures
Countries to be studied:
Peru
USA
Cuba
Egypt
Suriname
Finland
Australia
Argentina
Gambia
USA
Jamaica
Pakisatn
Average
life
expectan
cy
Maternal
deaths/1
00,000liv
e births
Child
mortality
rate
Diabetes
%
HIV/Aids
% of 1549 year
olds
Healthca
re
spending
% of GDP
Doctors
per 1000
people
70
110
39
1.9
1.9
3.6
75
82
16
5.4
5.4
4.3
30
79
0.1
7.2
5.7
32
81
6.2
0.1
6.4
25
71
87
20
7.2
1.5
2.7
64
500
100
8.5
0.1
0.7
78
17
8.0
0.6
6.8
26
57
137
2.2
2.2
2.4
3.2
70
84
33
9.8
<0.1
2.5
Answers
Average life
expectancy
Suriname
Argentina
Finland
Australia
Jamaica
Pakistan
USA
Gambia
Egypt
70
75
79
81
71
64
78
57
70
Maternal
deaths/100
live births
110
82
6
8
87
500
17
137
84
Child
mortality rate
Diabetes %
39
16
4
6
20
100
8
2.2
33
1.9
5.4
0.1
6.2
7.2
8.5
8.0
2.2
9.8
HIV/Aids % of
15-49 year
olds
1.9
5.4
7.2
0.1
1.5
0.1
0.6
2.4
<0.1
Healthcare
spending %
of GDP
3.6
4.3
5.7
6.4
2.7
0.7
6.8
3.2
2.5
Doctors per
1000 people
5
30
32
25
9
7
26
1
5
http://www.slideshare.net/kgphipps/geography-of-heal
th
Equality
Equality
Equality
Equality
Equality
of
of
of
of
of
public spending
final real income
access
cost
outcome
http://www.who.int/mediacentre/factsheets/fs319/en/#
Figure 4:
http://ucatlas.ucsc.edu/spend.php
Figure 5:
UK Trademark
Generic
A
B
Bactroban
mupirocin
Becloforte
beclomethasone
dipropionate
Becodisks
beclomethasone
dipropionate
Beconase Aq. Nasal Spra
y
Adartrel
ropinirole hydrochloride
Alkeran
melphalan
Altargo
retapamulin
Amoxil
amoxicillin
Andropatch
testosterone
Anectine
beclomethasone
suxamethonium chloride
dipropionate
Arixtra
Becotide Inhaler
fondaparinux sodium
beclomethasone
Atriance
dipropionate
nelarabine
Betnovate
Augmentin
betamethasone valerate
amoxicillin/clavulanate potassium
Avamys
C
fluticasone furoate
Avandamet
Cicatrin
rosiglitazone/metformin HCl neomycin sulphate
Avandia
Combivir
rosiglitazone maleate
zidovudine and
D
Daraprim
pyrimethamine
Dermovate
clobetasol propionate
Digibind
digoxin antibody fab
fragments
Doralese Tiltabs
indoramin
hydrochloride
E
Efcortelan
hydrocortisone
Epivir
lamivudine
Eumovate
clobetasone butyrate
What is the
difference?
Definitions
Generics
Off patent medicine
Transnationals
Globalisation
Lobbying
Globalisation
Globalisation:
the integration of economic social
cultural and political systems across
geographical boundaries.
Increasing economic and social
systems across geographical
boundaries.
It refers to increasing economic
integration of countries especially in
terms of trade and the movement of
capital.
Globalisation:True or false
True1.
True2.
True3.
Pharmaceutical companies
Key points
Globalisation
It refers to increasing economic
integration of countries especially in
terms of trade and the movement of
capital.
Medical exports
Worldmapper.org
Medical imports
Nearly 90% of the territories mapped are net medicine importers. There
is huge variation in the spending per person on imported medicines.
The highest spending per person is in Luxembourg, where US$ 406 is
spent on net imports of medicines per person, per year.
At the other extreme, in Tajikistan, only 9 US cents are spent per person
on net imports of medicines. This does not necessarily mean that there
is very little medicine in Tajikistan, because there might also be
domestic production of medicines and even exports of these. But for
this territory that is not significant.
Task
Make sure you have at least 3 points
for each perspective.
Write a conclusion to your argument
justifying why you think GSK is a hero
or a villain.
Female Smokers
There are women who smoke living in every territory in the world. But the
proportion of women who smoke varies from 1% in Azerbaijan to 47% in
Guinea. Of the total world female population over the age of 15 years,
10% are smokers. Some girls start to smoke before they reach the age of
15.
Male smokers
Worldwide there are four times more men that smoke than women. In
2002 there were 941 million male smokers, which was 43% of all men
aged over 15 years old. The largest population of male smokers lives in
China - where men are more likely to smoke than not to smoke. Even
Puerto Rico and Sweden, with the lowest percentages of men who smoke
still have 17% who are smokers.
http://news.bbc.co.uk/1/hi/health/medical_notes/473673.stm
Use this website to annotate the body to show the effects of smoking
Health Risks
Heart attacks and strokes. Smokers
are five times more likely to have a
heart attack than non-smokers.
Smoking also increases the risk of
having a stroke
Lung problems. Men who smoke
increase their chances of dying from
lung cancer by more than 22 times.
For women the giure is 12 times.
Health Risks
Cancer. Smoking increases the risk of
oral, uterine, liver, kidney, bladder,
stomach and cervical cancers, and
leukaemia.
Smoking and young people. People
who start smoking aged 11-15 are 3
times more likely to die a premature
death than someone who takes up
smoking at the age of 20
Source:worldmapper.org
Tobacco TNCs
USA
India
Tackling
Smoking
China
May 2008 smoking
banned in most public
places in the lead up to
the Olympic Games.
Part of a move to
encourage healthier
lifestyles.
Australia
Smoking banned in
most public places,
including Bondi Beach.
The cities of Freemantle
and Perth have banned
smoking in outside
dining areas.
Duncan Bannatyne
http://www.globalissues.org/article/533/tobacco
http://www.ash.org.uk/
ASH is an anti smoking pressure group
www.forestonline.org/
A pro smoking pressure group
www.bat.com
British American Tobacco
http://www.who.int/tobacco/resources/publicati
ons/tobacco_atlas/en/index.html
World Health Organisation tobacco atlas a very
in depth look at global patterns and the
tobacco industry.
CHD in the UK
Income
Those suburban
middle-class
residents with access
to facilities such as
gyms and health
clubs are healthier.
Environm
ent and
pollution
An increase in
childhood leukaemia
in the west linked to
Factors
affecting
regional
variations in
health and
morbidity
Barker
P.304
Smith
Yellow
sheet
Red sheet
(2nd side)
Include
locations
Educati
on
Those who are
more educated
are also those in
Diseases of
ageing are
more likely to
be found in
areas where
populations are
ageing (e.g.
Alzheimers in
Eastbourne.)
Not working is
linked to poor
health.
Occupatio
n type
Stress at work
is linked to
heart disease.
Older people have
respiratory problems....
Manufacturing industry
in inner cities in the
Started 1948
Has been more difficult to manage as time has gone on (costs have
risen as people living longer and medical advances increasing)
Year 2000 Government produced NHS Plan
Creation of primary care trusts (PCTs)
This is the care provided by the people you see when you first have a
health problem e.g. doctors, pharmacists, dentists, opticians
NHS Direct
All of the above are managed by local PCT. Control about 80% of
NHS budget
Nutrition
AGE
WEALTH
GENDER
Healthcare
Exercise Facilities
Nutrition
AGE
Different attitudes to
nutrition over time?
Healthy Schools
Jamie Oliver?
Meals on Wheels
service
WEALTH
What supermarkets
do we have?
Healthcare
West Berkshire = ageing,
therefore specific facilities
given priority
Cervical Cancer? Targets
particular age groups
Teenage pregnancies
Private health care e.g.
BUPA
No waiting lists
arguably better
treatment?
Exercise Facilities
Less accessible for elderly (less
mobile). Facilities cater for those
with cars more and more
Less accessible for under 16s
cost, local area may have ack of
fields, some gyms have
restrictions
GENDER
Different attitudes to
food and diet
Contraceptive clinics
Sexually transmitted
diseases, teenage
pregnancies, breast
screening services
aimed at specific gender
http://www.westberks.gov.uk/index.aspx?articleid=8406