Topic: World Health Threats Aim: How do countries undergo an epidemiologic transition? Do Now: Describe what you feel are some of the greatest health threats to the United States and the world today.

Epidemiology Branch of medicine concerned with the incidence, distribution, and control of diseases that affect large numbers of people Rely heavily on geographic concepts such as scale and connection Epidemiologic Transition Model: Focuses on the specific causes of death in each stage of the demographic transition

World Health Map http://www.healthmap.org/en/

Stage 1- ‘Pestilence and Famine’ Infectious & parasitic disease key causes of human death (e.g. - the Black Plague of 1348/1349) About 25 million Europeans died, ½ of the continent’s population Huge impact on economic, social, and political makeup of nations

Stage 2- Receding Pandemics Disease that occurs over a wide geographic area and affects a high proportion of a given population HIV/AIDS in Africa (modern day) Cholera in the 19th century

Cholera in the Nineteenth Century: Distribution of cholera victims and water pumps to prove that the cause of the infection was contamination of the pump near the corner of Broad and Lexington streets

The highest rates of HIV infection are in sub-Saharan Africa The highest rates of HIV infection are in sub-Saharan Africa. India and China have relatively high numbers of HIV-positive adults, but they constitute a lower percentage of the total population.

Stages 3 & 4: Degenerative & Human-Created Diseases Decrease in deaths from infectious disease (Polio, AIDS, Cholera, Yellow Fever, etc) Increase in deaths from chronic disorders, primarily heart diseases and various cancers Stage 4 (Olshansky, Ault) Degenerative diseases are delayed due to medical advances

Stage 5 ? Possible increase in CDR Reemergence of infectious and parasitic diseases. 3 possible factors: Evolution: diseases genetically evolve to be resistant to medicine (i.e.- Malaria) Poverty: Diseases that are expensive to cure affect LDC’s the most (i.e.- tuberculosis) Improved Travel/Globalization: Increased travel within countries and between them causes increase in spread of infectious disease

The first cases of avian flu were recorded in Southeast Asia The first cases of avian flu were recorded in Southeast Asia. How did it diffuse?

Death from tuberculosis is a good indicator of a country's ability to invest in health care, because treating the disease is expensive.

Why Do Some Regions Face Health Threats? Health Care Countries possess different resources to care for people who are sick Expenditures on health care More than 15 percent of total government expenditures in Europe and North America Less than 5 percent in sub-Saharan Africa and South Asia

Health Care Systems Developed Countries Public service available at little or no cost Government pays more than 70 percent of health-care costs in most European countries Private individuals pay about 30 percent of the expense Developing Countries Private individuals must pay more than half of the cost of health care. U.S. is an exception to these generalizations Private individuals are required to pay about 55 percent of health care costs making its health care more closely resemble a developing country

FIGURE 2-42 HEALTH CARE EXPENDITURES The lowest levels of per capita health care expenditure are in sub-Saharan Africa and South Asia. HEALTH CARE EXPENDITURES The lowest levels of per capita health care expenditure are in sub-Saharan Africa and South Asia.

Globalization Effect on health in developing countries? http://www.youtube.com/watch?v=2VdMqmVtnOM