1. International Health NUR 410 Community Focused Nursing Catherine T. Horat

2. Community health nursing need for knowledge interactions with new immigrants client exposure to potential health hazards identification of potential risks awareness of health concerns worldwide has impact on health

3. State of World Health Life expectancy worldwide average 65 years Decrease in death rates Decrease in infant mortality

4. Comparison Developing Countries –Life expectancy 1950 40 years 1995 64 years –Infant mortality 1950 287/1000 live births by time reached age 5 years 1995 90/1000 More Developed Countries –Life Expectancy 1950 67 years 1995 77 years –Infant Mortality Varies with countries

5. Comparison Hong Kong 2.97Hong Kong Germany 4.2 Germany Canada 4.82 Canada Greece 5.63 Greece Korea, South 7.18Korea, South Canada 4.82 Canada India 57.92 India China 25.28 China Mexico 21.69Mexico Jamaica 12.81Jamaica KoreaNorth24.84 KoreaNorth Haiti 74.38Haiti

6. Overview of international health Health for All by year 2000 –first proclaimed 1977 at World Health Assembly –reinforced 1978 at International Conference on Primary Health Care where Alma Alta Kazakhstan sponsored by WHO, UNICEF

7. –major components health education environmental sanitation training village health workers maternal/infant immunization & family planning local preventive programs accessible, affordable tx medication availability nutrition programs acceptance of traditional medicine

8. Global Designations Developed country –stable economy –industrial –Technology Lesser developed country –unstable economy –little industry or technology

9. Major international health organizations Private/voluntary Philanthropic Professional and technological Private and commercial Governmental Intergovernmental

10. International health and economic development Divert financial resources to advance country’s market economy or develop technology Divert resources to develop underlying infrastructures Dependence on importation of drugs, vaccines, other health products Divert monies to military Improvements in over all health status contributes to its economic growth

11. Health care systems Who can utilize What kind of coverage Who provides Where is health care provided Who controls

12. Burden of Sickness and Disability Mortality figures do not capture effect Result from diseases that do not cause death –Loss of ability to work –Keep out of school –Slow economic and social development

13. The Global Burden of Disease (GBD) Losses from premature death plus Loss of healthy lives due to disability Nearly 9/10s occur in developing countries where only 1/10 of global health expenditures occur

14. Disability-Adjusted Life Year DALY Combine losses from –Premature death (difference between the actual age of death and life expectancy at that age in a low mortality population) –Healthy life that results from disability –Disproportionate burden on children Half of all DALYs worldwide

15. Key Elements of DALY Age at which disease or disability occurs How long effects linger Impact on quality of life

16. Effects on DALY By Single most important cause of ill health globally –Communicable diseases (44%) –Top 7/10 causes from communicable diseases Leading causes –Lower respiratory diseases –Diarrheal

17. Causes of DALYs Compared with Causes of Death DALYs 1.Lower Respiratory Diseases 2.Perinatal conditions 3.HIV/AIDS 4.Unipolar depressive disorders 5.Diarrheal Diseases 6.Ischemic heart diseases 7.Cerebrovascular diseases 8.Road Traffic accidents 9.Malaria 10.Tuberculosis Causes of Death 1.Ischemic heart diseases 2.Cerebrovascular diseases 3.Lower Respiratory Diseases 4.HIV/AIDS 5.Chronic Obstructive Lung Disease 6.Perinatal conditions 7.Diarrheal Diseases 8.Tuberculosis 9.Road Traffic accidents 10. Trachea, bronchus, and lung cancer World Health Report 2001

18. Health Problems of Children Lesser Developed Countries Diarrheal disease –leading cause of death/illness children 5 and under worldwide 2 million in developing countries –causes: nutritional deficits, viruses, bacteria, environmental toxins and parasites, contaminated food –Correct management save 90%

19. Health Problems of Children Lesser Developed Countries Nutrition –associated with poverty –leading nutrient deficiencies: protein, iron, Vit. A, calcium –women and children mostly affected –Malnutrition accounted for 6.6 million deaths of the 12.2 million deaths under- five years –Growth stunted, poor cognitive development, neurological deficits

20. Adults in Developing Countries Diarrheal diseases Tuberculosis Malaria Venereal Diseases Respiratory Infections Maternal and Perinatal illness

21. Maternal and Perinatal Health Maternal and women’s health –deaths remain high –family planning –good nutrition –prenatal care –safe birthing practices

22. Health Problems of Affluence Result from chronic non-communicable diseases Related to lifestyle –Arthritis –Cancer –Cardiovascular disease –Diabetes –Hypertension

23. Changing World Scene Negative Influences –Tobacco Use –Alcohol Use –Intentional Violence Suicides, Homicides, Warfare –Dietary Imbalances –Physical Activity –Automobiles –Environment –Workplace Injuries