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Tuesday, June 27, 2017

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Part One - Issues in Public Health – A Global Introduction
Jacqueline Beretta

July, 2004

Some Staggering World Statistics

Two weeks ago at the Harvard Global Leadership Forum in Shanghai, China Dr. Barry R. Bloom, Dean of the School of Public Health at Harvard University, gave the following statistics to a huge crowd.

  • 1.2 billion people live on less than $1 a day
  • 2.8 billion people live on less than $2 a day
  • 20,000 people are born each day adding to our 6.2 billion world population
  • In 68 countries, less than 4% of the population is under 15 years old
  • There are currently 31 civil or foreign wars being fought today
  • In the United States today we are spending $1.6 trillion annually on patient care

A Few Global Killers

   AIDS

  -  40 million people are currently living with Aids

  - Of that, 19.2 mil are women

  -  Of that, 3.1 million are children

  -  5 million new infections annually

  -  3.1 million deaths annually

 

     What Exactly is AIDS?

   According to the CDC,
   AIDS stands for Acquired
  Immunodeficiency Syndrome
.

 



Acquired – means that the disease is not hereditary but develops after birth from contact with a disease causing agent (in this case, HIV).

Immunodeficiency – means that the disease is characterized by a weakening of the immune system.

Syndrome – refers to a group of symptoms that collectively indicate or characterize a disease. In the case of AIDS this can include the development of certain infections and/or cancers, as well as a decrease in the number of certain cells in a person's immune system.

A diagnosis of AIDS is made by a physician using specific clinical or laboratory standards.

AIDS is caused by infection with a virus called human immunodeficiency virus (HIV). This virus is passed from one person to another through blood-to-blood and sexual contact. In addition, infected pregnant women can pass HIV to their babies during pregnancy or delivery, as well as through breast feeding. People with HIV have what is called HIV infection. Some of these people will develop AIDS as a result of their HIV infection.

HIV (human immunodeficiency virus) is the virus that causes AIDS. This virus may be passed from one person to another when infected blood, semen, or vaginal secretions come in contact with an uninfected person's broken skin or mucous membranes*. In addition, infected pregnant women can pass HIV to their baby during pregnancy or delivery, as well as through breast-feeding. People with HIV have what is called HIV infection. Some of these people will develop AIDS as a result of their HIV infection.”

“*A mucous membrane is wet, thin tissue found in certain openings to the human body. These can include the mouth, eyes, nose, vagina, rectum, and opening of the penis.” - CDC Division of HIV/AIDS Prevention found at http://www.cdc.gov/hiv/dhap.htm .

“CDC's initiative, Advancing HIV Prevention: New Strategies for a Changing Epidemic , is aimed at reducing barriers to early diagnosis of HIV infection and increasing access to quality medical care, treatment, and ongoing prevention services for those diagnosed with HIV. These pages include descriptions of the initiative and how it is to be implemented, as well as other guidance and information critical to its success.”

According to Dr. Bloom, “If we do not stop this epidemic, the situation will become so severe by 2025 that 25% of our workforce could die.” Citing that national programs are currently providing good information and condoms, Bloom stated that this epidemic could be controlled.

This year the World Health Organization (WHO) issued a report titled Changing History that calls for “a comprehensive HIV/AIDS strategy that links prevention, treatment, care, and long-term support.”

Lee Jong-wook, Director General of the World Health Organization said “ In spite of many difficulties, technology has made important advances and international investment in health has at last begun to flow. Most of the increased funding is for the fight against HIV/AIDS. It brings a welcome and long overdue improvement in the prospects for controlling the worst global epidemic in several centuries.”


  Tuberculosis

  -  87 million new
     cases per year
  -  3 million deaths per year
  -  2 billion infected
  -  Estimated 10 – 15 mil US
      citizens have latent TB
      infection – of which 10%
      will lead TB later in their
      lives   
  -  Death, loss of income,
      and treatment cost $16
      billion annually
  -  To reach a 50% reduction
      in death could cost $900
      million annually


What Exactly is Tuberculosis?

 “According to the CDC, TB, or tuberculosis, is a disease   caused by bacteria called Mycobacterium tuberculosis.   The bacteria can attack any part of your body, but they   usually attack the lungs. TB disease was once the leading   cause of death in the United States.

 In the 1940s, scientists discovered the first of several drugs   now used to treat TB. As a result, TB slowly began to   disappear in the United States. But TB has come back.    Between 1985 and 1992, the number of TB cases   increased. The country became complacent about TB and   funding of TB programs was decreased. However, with   increased funding and attention to the TB problem, we have   had a steady decline in the number of persons with TB. But   TB is still a problem; more than 16,000 cases were reported   in 2000 in the United States.

People who are infected with latent TB do not feel sick, do not have any symptoms, and cannot spread TB. But they may develop TB disease at some time in the future. People with TB disease can be treated and cured if they seek medical help. Even better, people who have latent TB infection but are not yet sick can take medicine so that they will never develop TB disease.

TB is spread through the air from one person to another. The bacteria are put into the air when a person with TB disease of the lungs or throat coughs or sneezes. People nearby may breathe in these bacteria and become infected.

When a person breathes in TB bacteria, the bacteria can settle in the lungs and begin to grow. From there, they can move through the blood to other parts of the body, such as the kidney, spine, and brain.

 
TB in the lungs or throat can be infectious. This means that the bacteria can be spread to other people. TB in other parts of the body, such as the kidney or spine, is usually not infectious.

People with TB disease are most likely to spread it to people they spend time with every day. This includes family members, friends, and coworkers.”

CDC Division of Tuberculosis Prevention at http://www.cdc.gov/ncidod/diseases/submenus/sub_tuberculosis.htm .

The CDC states “TB is the leading killer of young adults worldwide – nearly 1/3 of the worlds population is infected with the latent bacteria that causes TB.

According to the CDC, Persons born outside the US account for half of all US TB cases. 25% of these cases were from Mexico.”


U.S. OBESITY AND OVERWEIGHT
  -   Leads to over 400,000 deaths annually
  -   In 2000 nearly 59 million people were
      obese in the US
  -   Costs $117 billion per year
  -   63% of Texas adults are overweight or
       obese
  -   29% of Texas high school students are        overweight or at risk of becoming
       overweight.
  -   The obesity rate among Texas adults
       doubled between 1990 and 2002
  -   Some related diseases are diabetes, heart
      disease, stroke, certain cancers, gallbladder
      disease, sleep apnea, and osteoarthritis

  For more information visit http://www.cdc.gov/ .

Why are so many people
 overweight or obese today?

  According to the CDC, “There are a
  number of factors that influence
 
overweight or obesity, including:

  Behavior—eating too many calories
  while not getting enough physical
  activity.

  Environment—home, work, school, or
  community can provide barriers to or
  opportunities for an active lifestyle.

  Genetics—heredity plays a large role in   determining how susceptible people are
   to overweight and obesity. Genes also
  influence how the body burns calories    for energy or stores fat.

Behavioral and environmental factors are the main contributors to overweight and obesity and provide the greatest opportunities for prevention and treatment.

The more overweight you are, the more likely you are to have health problems. Weight loss and regular exercise can help improve the harmful effects of being overweight. Studies show if you are overweight or obese, losing 5–10% of your body weight can improve your health.”


"We need to take diabetes very seriously as individuals and as a nation," said CDC's director, Dr. Jeffrey P. Koplan. "This study sends a clear message that American lifestyles, including inactivity and poor nutrition, are having a dramatic influence on our health and will ultimately increase the need for diabetes care in the future." CDC Division of Overweight and Obesity at http://www.cdc.gov/nccdphp/dnpa/obesity .

Public Health

Public health used to be just about preventing disease and finding ways to cure them. Today, according to Dr. Bloom, Public Health organizations have expanded their reach to do the following:

Prevent Disease
Deal with populations and policies
Process, metrics and analysis that measure performance
Deal with environmental health
Deal with health policy and finance

According to Dr. Julio Frank, Minister of Health in Mexico, public health has grown stronger “for taking system wide issues onboard in their efforts to help societies figure out how to allocate their resources to health.”

Disease does not know boundaries, and every country needs to collaborate in order to produce some long-term positive progress. Dr. Dean Jamison, Director of the Center for Pacific Rim Studies, and Director of the Program on International Health, Education and Environment at the University of California, Los Angeles, said “ some benefits of a good health system transcended national borders and offered global public goods—including, for example, knowledge about disease prevention, good surveillance for infectious diseases, the findings of intervention research, sharing of health data, and the development of new products such as vaccines. There are therefore strong arguments, he said, for richer countries to support the work of poorer countries and for all nations to share the benefits. Our future together as a species can only be successful if we collaborate .

The USA

Today the most common diseases we face in our country are cardiovascular disease, cancer, neuropsychiatric disorder, diabetes, and pulmonary disease. The US is like many other countries in their inefficiency of gathering data and distributing healthcare equally. We will talk more about these issues in Part II.

All facts and figures were gathered from the Department of Health and Human Resources, Center for Disease Control and Prevention found at http://www.cdc.gov .



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