04 Dec What are the shared health problems of megacities and remote
1-
What are the shared health problems of megacities and remote
rural areas? What are the different health concerns or urban and
rural areas?
2-
What are good and not-so-good ways to help people during and
after a humanitarian crisis (such as an earthquake, tsunami, or
hurricane)?
3-
Identify one new healthy behavior you would like to adopt (such as eating more vegetables or exercising more often). Select one of the theories of behavior change and use that framework to identify your barriers to change and identify actions you can take to overcome those barriers.
4- What are the major interventions that are promoting health for young adults?
GLOBAL HEALTH
THIRD EDITION
INTRODUCTION TO
Kathryn H. Jacobsen, MPH, PhD George Mason University
Fairfax, Virginia
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Library of Congress Cataloging-in-Publication Data Names: Jacobsen, Kathryn H., author. Title: Introduction to global health / Kathryn H. Jacobsen. Description: Third edition. | Burlington, MA: Jones & Bartlett Learning, [2019] | Includes bibliographical references and index. Identifiers: LCCN 2017044502 | ISBN 9781284123890 (paperback: alk. paper) Subjects: | MESH: Global Health | Communicable Diseases | Health Promotion | Social Determinants of Health | Health Transition Classification: LCC RA441 | NLM WA 530.1 | DDC 362.1—dc23 LC record available at https://lccn.loc.gov/2017044502
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iii
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3.8 Governance and Politics . . . . . . . . . . . . . . . . . . . . .61
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63
Chapter 4 Environmental Determinants of Health . . . . . . . . . . . . . . . . . . . 65
4.1 Environmental Health and the SDGs . . . . . . . . .65
4.2 Water, Sanitation, and Hygiene . . . . . . . . . . . . . .67
4.3 Energy and Air Quality . . . . . . . . . . . . . . . . . . . . . . .75
4.4 Occupational and Industrial Health . . . . . . . . . .81
4.5 Urbanization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84
4.6 Sustainability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88
4.7 Climate Change and Health . . . . . . . . . . . . . . . . .92
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .94
Chapter 5 Health and Humans Rights . . . 98 5.1 Health and Human Rights . . . . . . . . . . . . . . . . . . .98
5.2 Access to Basic Human Needs . . . . . . . . . . . . . 101
5.3 Access to Health Services . . . . . . . . . . . . . . . . . . 103
5.4 Access to Medicines . . . . . . . . . . . . . . . . . . . . . . . 106
5.5 Health and Natural Disasters . . . . . . . . . . . . . . . 108
5.6 Conflict and War . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
5.7 Bioterrorism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
5.8 Health in Prisons . . . . . . . . . . . . . . . . . . . . . . . . . . 118
5.9 People with Disabilities . . . . . . . . . . . . . . . . . . . . 119
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
Chapter 6 Global Health Financing . . . . . 126 6.1 Personal and Public Health . . . . . . . . . . . . . . . . 126
6.2 Health Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
6.3 Paying for Personal Health . . . . . . . . . . . . . . . . . 131
6.4 Health Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . 133
6.5 Paying for Global Health Interventions . . . . . 135
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii
New to This Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . viii
About the Author . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x
Chapter 1 Global Health Transitions . . . . . . 1 1.1 Defining Global Health . . . . . . . . . . . . . . . . . . . . . . . 1
1.2 Health Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.3 Prevention Science . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
1.4 Health Transitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
1.5 World Regions and Featured Countries . . . . . .12
1.6 Global Health Security . . . . . . . . . . . . . . . . . . . . . . .17
1.7 Globalization and Health: Shared Futures . . . .18
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
Chapter 2 Global Health Priorities . . . . . . 21 2.1 Global Health Achievements . . . . . . . . . . . . . . . .21
2.2 Prioritization Strategies . . . . . . . . . . . . . . . . . . . . . .23
2.3 Health Metrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27
2.4 Millennium Development Goals . . . . . . . . . . . . .34
2.5 Sustainable Development Goals . . . . . . . . . . . . .36
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41
Chapter 3 Socioeconomic Determinants of Health . . . . . . . . . . . . . . . . . . . 42
3.1 Health Disparities and the SDGs . . . . . . . . . . . . .42
3.2 Economics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
3.3 Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
3.4 Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
3.5 Employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55
3.6 Minority Populations . . . . . . . . . . . . . . . . . . . . . . . .57
3.7 Migrant and Refugee Health . . . . . . . . . . . . . . . . .59
Contents
iv Contents
9.4 Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
9.5 Other Respiratory Infections . . . . . . . . . . . . . . . 206
9.6 Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208
9.7 Immunization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210
9.8 Vaccine-Preventable Infections . . . . . . . . . . . . 212
9.9 Viral Hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
9.10 Meningitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218
Chapter 10 Malaria and Neglected Tropical Diseases . . . . . . . . . . 224
10.1 Malaria, NTDs, and Global Health . . . . . . . . . 224
10.2 Parasites: Protozoa and Helminths . . . . . . . . 227
10.3 Malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228
10.4 Malaria Interventions . . . . . . . . . . . . . . . . . . . . . 229
10.5 Dengue and Other Arboviruses . . . . . . . . . . 233
10.6 Chagas Disease and Trypanosomiasis . . . . . 236
10.7 Leishmaniasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
10.8 Schistosomiasis . . . . . . . . . . . . . . . . . . . . . . . . . . 237
10.9 Lymphatic Filariasis . . . . . . . . . . . . . . . . . . . . . . . 238
10.10 Onchocerciasis . . . . . . . . . . . . . . . . . . . . . . . . . . 239
10.11 Leprosy, Buruli Ulcer, and Trachoma . . . . . 240
10.12 Rabies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
10.13 Soil-Transmitted Helminths . . . . . . . . . . . . . 242
10.14 Other Neglected Tropical Diseases . . . . . . 244
10.15 Eradication. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
10.16 Emerging Infectious Diseases . . . . . . . . . . . 250
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252
Chapter 11 Reproductive Health . . . . . . 257 11.1 Reproductive Health and Global Health . . 257
11.2 The Fertility Transition . . . . . . . . . . . . . . . . . . . . 259
11.3 Population Planning. . . . . . . . . . . . . . . . . . . . . . 263
11.4 Family Planning . . . . . . . . . . . . . . . . . . . . . . . . . . 264
11.5 Infertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 268
11.6 Healthy Pregnancy . . . . . . . . . . . . . . . . . . . . . . . 269
11.7 Maternal Mortality and Disability . . . . . . . . . 272
11.8 Neonatal Health . . . . . . . . . . . . . . . . . . . . . . . . . . 275
11.9 Gynecologic Health . . . . . . . . . . . . . . . . . . . . . . 279
6.6 Official Development Assistance . . . . . . . . . . . 136
6.7 Multilateral Aid . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
6.8 Foundations and Corporate Donations . . . . 140
6.9 Personal Donations . . . . . . . . . . . . . . . . . . . . . . . . 142
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Chapter 7 Global Health Implementation . . . . . . . . . . . 148
7.1 Global Health Interventions . . . . . . . . . . . . . . . 148
7.2 Local and National Governments . . . . . . . . . . 150
7.3 International Cooperation . . . . . . . . . . . . . . . . . 151
7.4 The World Health Organization and the United Nations . . . . . . . . . . . . . . . . . . . . .153
7.5 International Health Regulations . . . . . . . . . . . 156
7.6 Global Partnerships . . . . . . . . . . . . . . . . . . . . . . . . 158
7.7 The Nonprofit Sector . . . . . . . . . . . . . . . . . . . . . . 159
7.8 The Corporate Sector . . . . . . . . . . . . . . . . . . . . . . 161
7.9 Research and the Academic Sector . . . . . . . . 162
7.10 Measuring Impact . . . . . . . . . . . . . . . . . . . . . . . . 163
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
Chapter 8 HIV/AIDS and Tuberculosis . . . 167 8.1 HIV/AIDS, TB, and Global Health . . . . . . . . . . . . 167
8.2 Viruses, Bacteria, and Fungi . . . . . . . . . . . . . . . . 168
8.3 HIV and AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170
8.4 HIV/AIDS Epidemiology . . . . . . . . . . . . . . . . . . . 173
8.5 HIV Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . 179
8.6 Other Sexually Transmitted Infections . . . . . . 183
8.7 Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
8.8 TB Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
8.9 Antimicrobial Resistance. . . . . . . . . . . . . . . . . . . 189
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
Chapter 9 Diarrheal, Respiratory, and Other Common Infections . . . . . . . . . . . . . . . . . 195
9.1 Infectious Diseases and Global Health . . . . . 195
9.2 Diarrheal Diseases . . . . . . . . . . . . . . . . . . . . . . . . . 198
9.3 Diarrhea Interventions . . . . . . . . . . . . . . . . . . . . . 200
Contents v
14.4 Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . 346
14.5 Other Cardiovascular Diseases . . . . . . . . . . . . 348
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 349
Chapter 15 Other Noncommunicable Diseases . . . . . . . . . . . . . . . . . 351
15.1 The Epidemiologic Transition and Global Health . . . . . . . . . . . . . . . . . . . . . . . . .351
15.2 NCDs and Behavior Change . . . . . . . . . . . . . . 355
15.3 Chronic Respiratory Diseases . . . . . . . . . . . . . 358
15.4 Tobacco Control . . . . . . . . . . . . . . . . . . . . . . . . . . 360
15.5 Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363
15.6 Chronic Kidney Disease . . . . . . . . . . . . . . . . . . 366
15.7 Liver and Digestive Diseases . . . . . . . . . . . . . . 367
15.8 Neurological Disorders . . . . . . . . . . . . . . . . . . . 368
15.9 Genetic Blood Disorders . . . . . . . . . . . . . . . . . . 369
15.10 Musculoskeletal Disorders . . . . . . . . . . . . . . . 371
15.11 Sensory Disorders . . . . . . . . . . . . . . . . . . . . . . . 372
15.12 Skin Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . 374
15.13 Dental and Oral Health . . . . . . . . . . . . . . . . . . 374
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 375
Chapter 16 Mental Health . . . . . . . . . . . . 381 16.1 Mental Health and Global Health . . . . . . . . . 381
16.2 Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 382
16.3 Bipolar Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . 383
16.4 Depressive Disorders . . . . . . . . . . . . . . . . . . . . . 383
16.5 Anxiety Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . 385
16.6 Alcohol and Drug Use Disorders . . . . . . . . . . 385
16.7 Other Mental Health Disorders . . . . . . . . . . . 387
16.8 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 388
16.9 Autism and Neurodevelopmental Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .390
16.10 Dementia and Neurocognitive Disorders 391
16.11 Mental Health Care . . . . . . . . . . . . . . . . . . . . . 391
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 392
Chapter 17 Injuries . . . . . . . . . . . . . . . . . . 396 17.1 Injuries and Global Health . . . . . . . . . . . . . . . . 396
11.10 Men’s Reproductive Health . . . . . . . . . . . . . . 279
11.11 Sexual Minority Health . . . . . . . . . . . . . . . . . . 280
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281
Chapter 12 Nutrition . . . . . . . . . . . . . . . . 285 12.1 Nutrition and Global Health . . . . . . . . . . . . . . 285
12.2 Macronutrients . . . . . . . . . . . . . . . . . . . . . . . . . . . 286
12.3 Protein-Energy Malnutrition . . . . . . . . . . . . . . 288
12.4 Food Security and Food Systems . . . . . . . . . 293
12.5 Micronutrients . . . . . . . . . . . . . . . . . . . . . . . . . . . 295
12.6 Iodine Deficiency Disorders . . . . . . . . . . . . . . 297
12.7 Vitamin A Deficiency . . . . . . . . . . . . . . . . . . . . . 297
12.8 Iron Deficiency Anemia . . . . . . . . . . . . . . . . . . 298
12.9 Other Micronutrient Deficiencies . . . . . . . . . 300
12.10 Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . 302
12.11 Overweight and Obesity . . . . . . . . . . . . . . . . 304
12.12 Food Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 308
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311
Chapter 13 Cancer . . . . . . . . . . . . . . . . . . . 315 13.1 Cancer and Global Health . . . . . . . . . . . . . . . . 315
13.2 Cancer Biology . . . . . . . . . . . . . . . . . . . . . . . . . . . 316
13.3 Cancer Epidemiology . . . . . . . . . . . . . . . . . . . . 316
13.4 Cancer Risk Factors and Prevention . . . . . . . 320
13.5 Cancer Screening and Diagnosis . . . . . . . . . 324
13.6 Cancer Treatment . . . . . . . . . . . . . . . . . . . . . . . . 326
13.7 Lung Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 328
13.8 Breast Cancer and Cervical Cancer . . . . . . . . 328
13.9 Prostate Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . 332
13.10 Liver Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . 332
13.11 Esophageal, Stomach, and Colorectal Cancers . . . . . . . . . . . . . . . . . . . . . . .333
13.12 Other Cancers . . . . . . . . . . . . . . . . . . . . . . . . . . 334
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 335
Chapter 14 Cardiovascular Diseases . . . . 338 14.1 Cardiovascular Disease and Global Health 338
14.2 Ischemic Heart Disease . . . . . . . . . . . . . . . . . . . 342
14.3 Cerebrovascular Disease (Strokes) . . . . . . . . 344
vi Contents
Chapter 19 Promoting Healthy Adulthood and Aging . . . . . . 425
19.1 Aging and Global Health . . . . . . . . . . . . . . . . . 425
19.2 Health Promotion in Early and Middle Adulthood . . . . . . . . . . . . . . . . . . . .428
19.3 Health Promotion for Older Adults . . . . . . . . 430
19.4 Caring for Aging Populations . . . . . . . . . . . . . 431
19.5 Health Promotion Across the Life Span . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .434
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 434
Chapter 20 Global Health Careers . . . . . . 436 20.1 Career Pathways in Global Health . . . . . . . . . 436
20.2 Global Health Education . . . . . . . . . . . . . . . . . 437
20.3 Experiential Learning in Global Health . . . . . . . . . . . . . . . . . . . . . . . . . . .439
20.4 Global Health Matters . . . . . . . . . . . . . . . . . . . . 440
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 442
Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .443
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .468
17.2 Transport Injuries . . . . . . . . . . . . . . . . . . . . . . . . . 400
17.3 Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 402
17.4 Drowning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 403
17.5 Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 404
17.6 Other Unintentional Injuries . . . . . . . . . . . . . . 405
17.7 Intentional Injuries . . . . . . . . . . . . . . . . . . . . . . . 405
17.8 Interpersonal Violence . . . . . . . . . . . . . . . . . . . 406
17.9 Gender-Based Violence . . . . . . . . . . . . . . . . . . . 407
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 408
Chapter 18 Promoting Neonatal, Infant, Child, and Adolescent Health . . . . . . . . . 410
18.1 Progress in Child Survival . . . . . . . . . . . . . . . . . 410
18.2 Improving Neonatal Survival . . . . . . . . . . . . . 415
18.3 Promoting Infant and Child Health . . . . . . . 417
18.4 Promoting Early Childhood Development 419
18.5 Children with Special Needs . . . . . . . . . . . . . . 419
18.6 Health Promotion for Older Children . . . . . 420
18.7 Health Promotion for Adolescents . . . . . . . . 421
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 423
vii
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across the income spectrum. For example, the SDGs include targets for preventing new hep- atitis B virus infections; reducing the number of adults who die from cardiovascular diseases, cancers, and other noncommunicable diseases before their 70th birthdays; reducing the suicide mortality rate; increasing access to treatment for substance use disorders; and reducing deaths from road traffic injuries and violence. These conditions affect people in every country, and all countries have the opportunity under the SDGs to track their progress toward improving health metrics related to these concerns.
This third edition of Introduction to Global Health is a book for the SDG era. The socioeconomic and environmental determi- nants of health are presented in the context of the SDGs. The shifting landscape for financ- ing and implementing global health initiatives is described in expanded chapters on payers and players. Chapters on infectious diseases, reproductive health, and nutrition are comple- mented by new chapters on noncommunica- ble diseases, mental health, and injuries. The similarities and differences in the conditions that cause illness and death in featured coun- tries representing diverse world regions and income levels are illustrated with estimates from the Global Burden of Disease (GBD) project, which now produces annually updated profiles of health status in every country. (Dis- closure: the author is a GBD collaborator.) The global health agenda has expanded to cover all of the world’s people, and this book provides a positive, forward-looking perspective on the numerous actions that are helping promote the health, well-being, and security of people across the lifespan and across the globe.
The first and second editions of Intro- duction to Global Health were written during the Millennium Development
Goals (MDG) era of global health. The MDGs spelled out an ambitious plan for significantly reducing global poverty between 2000 and 2015. They were wildly successful. The num- ber of people living on less than $1 per day dropped substantially during the first 15 years of the 21st century. As a growing number of global health partnerships set agendas for change and financed action plans, significant progress was made toward alleviating hun- ger, preventing maternal and child mortality, and controlling HIV/AIDS and malaria.
The next generation of global goals—the Sustainable Development Goals (SDGs)—were launched at the end of 2015. They spell out 17 goals for enhancing human flourishing by 2030, including targets related to poverty reduction, hunger, health, education, gender equality, clean water and sanitation, affordable and clean energy, decent work, infrastructure and tech- nology development, human rights, sustainable urbanization, responsible production and con- sumption, climate and environment, peace, and governance. The SDGs seek to promote pros- perity while upholding human rights, protect- ing the planet, and fostering peace and security. All of the goals are interdependent, and all are inextricably tied to health. Improvements in any of the 17 areas will yield benefits for popula- tion health, and improvements in public health will enable other SDGs to be achieved.
Most of the MDGs were targeted at improv- ing quality of life among the world’s poorest people. The SDGs retain those aims but add a lengthy list of objectives that apply to countries
Preface
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Chapter 6 is a new chapter that describes the health system models used in various countries and explains the funding mecha- nisms used to pay for global health activities. Chapter 7 features the diversity of entities involved in implementing and evaluating global health interventions, including gov- ernmental and intergovernmental agen- cies, nonprofit organizations, and for-profit corporations.
Chapters 8 through 17 present the health conditions that account for the greatest burden of disease globally. Each chapter begins with a section that explains why the featured topic is considered to be a global health issue, and each chapter emphasizes the interventions that can reduce the impact of adverse health conditions on individuals and populations. Health met- rics from the Global Burden of Disease (GBD) collaboration are used to i
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