1. Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Unit II Health Care: National and International Perspectives

2. Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Chapter 3 National and International Health Perspectives

3. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Population Health Historical perspectives  Decline in deaths from infectious diseases  Increase in deaths from chronic diseases  Increase in individuals living with disabilities

4. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Determinants of health in populations Factors  Individual  Familial  Social  Environmental How do these factors influence the health of populations?

5. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Environmental challenges – global perspective Impact on population health Global atmospheric change Ecotoxicity Depletion of natural resources

6. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Measuring Health Status Global burden of disease Disability adjusted life year Life expectancy Risk factor surveillance Global mortality estimates

7. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Leading Causes of Death Worldwide 53.9 million deaths worldwide 31% due to cardiovascular diseases 25% due to infectious diseases 13% due to cancers 11% due to injuries

8. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Maternal and Women’s Health Issues Majority of maternal deaths occur in developing countries Role of prevention in decreasing maternal death rates Provision of necessary health care services  Family planning  Maternity care  Neonatal care

9. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Health of Infants and Small Children Decreased infant mortality rate globally Infant mortality trends in the U.S. Low birth weight infants Teen pregnancy Malnutrition

10. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Health of Older Children and Adolescents HIV/AIDS Teen pregnancy Tobacco

11. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Health Trends and Patterns Infectious diseases  13 million deaths worldwide in 1999  Developing countries more severely impacted  Tuberculosis  HIV/AIDS  Malaria

12. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Tuberculosis Single largest cause of death in mid 19 th century 2.9 million deaths annually Resurgence of TB in 1990s Major global health concern

13. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Acquired Immunodeficiency Syndrome Global epidemic 2.6 million deaths in 1999 (APHA, 2000) 5.6 million individuals newly infected in 1999 (APHA, 2000)

14. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Malaria 300 – 500 million cases annually 1 million deaths each year Primarily endemic in poverty stricken nations

15. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Other Major Causes of Death and Disability Injuries and accidents Chronic diseases Cancer Tobacco use Obesity Alcohol abuse

16. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Mental Illness and Mental Disorders Major contributor to disability Major depression Alcohol dependence Bipolar affective disorder Schizophrenia Dementia Obsessive Compulsive Disorder

17. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 World Mental Health Perspectives Lack of adequate mental health care Undue suffering and premature death

18. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Violence Homicide Cycle of violence Goal is to break the cycle Role of community health nurse

19. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Population Characteristics – Projected Changes Decline in fertility Decline in mortality rates Growth of elderly population Increased population growth in developing nations

20. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 What is the impact of population changes on health care demands?

21. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 3 Community Health Nursing Role Intervention at individual, family, and aggregate levels Public health Disease prevention Health promotion Build partnerships to create healthier communities Participate in policy making International focus