1
Q
advocates and policymakers need a ____ to exercise human right to healthy life
A
understanding of factors that are detrimental to health, and how they are different for various population ctors
vary across populations
2
Q
Global Burden of Disease (G B D) is a
A
is a measure of total health loss from hundreds of diseases and injuries including the risk factors with the disease s and injuries
3
Q
what is the Global Burden of Disease Study
A
keep records of all available information about the causes of
deaths and disabilities in the world
Then DALYs are used to report on the health status of countries across the globe
4
Q
The G B D study is an ongoing that does what
A
process
quantifies the burden of premature mortality and disability for major diseases or disease groups by countries.
5
Q
Data of GBD is broken down into?
A
- age
- sex
- race
6
Q
how does thee GBD tool organize disease and illnesses into ?
A
3 groups
7
Q
what is group #1
A
communicable diseases, and maternal, neonatal, and nutritional conditions
8
Q
group #2
A
Non-communicable diseases
9
Q
group 3
A
injuries
10
Q
The GBD numbers and findings are continually updated by
A
WHO researchers
11
Q
Communicable, maternal, neonatal, perinatal, and nutritional disorders examples
A
tuberculosis, H I V, malaria
represent 2 out of every 10 deaths that occur globally.
12
Q
Communicable, maternal, neonatal, perinatal, and nutritional disorders occur largely in
A
low-income populations due to inadequate access to healthcare, specifically/ largely preventative care.
13
Q
group 1 global rate of death
A
estimated at 20%, the rate is 50% in low socio-demographic index (SDI) regions, and only 5% in high SDI regions
14
Q
Non-Communicable Diseases
A
- (e.g. coronary artery disease, cancer, mental illness
- account
for about 7 out of 10 deaths globally.
-
15
Q
out of the three health categories, the majority
of deaths are due to
A
non-communicable diseases
16
Q
Non-Communicable Diseases and deaths rates
A
Despite accounting for roughly 70% of deaths globally, many of the lower S D I countries do not have a
rate this high. In 2019 N C Ds were responsible for 41% of deaths in low S D I regions, and 88% in high S
D I regions.
17
Q
Injuries
A
- car crashes, suicide, and war injuries
18
Q
injuries and death rates
A
This category represents the largest difference between the sexes, with injuries accounting for 12% of
overall male deaths and 6% of female deaths in 2019.
19
Q
why might the difference between sexes be so vast?
Why might Canadian Indigenous populations be more at risk of dying by injury?
A
, men engage in more unsafe behaviour and employment than women, and are less likely to
be protected by someone else, whereas women might be protected by their brother, father, etc.
Indigenous populations may be less likely to seek or receive poor medical treatment when injured as a
result of stigma and historical oppression
20
Q
The S D I takes into account the
A
income per person, educational
attainment, and fertility rate.
21
Q
Disability Adjusted Life Years (DALY) is a
A
measure of overall disease burden, which is expressed as the
cumulative number of years lost due to ill-health, disability, or early death.
22
Q
To incorporate disability and mortality into a single measure of burden
A
Years Lived with Disability (Y L
D) is used
23
Q
Y L D multiplies the
A
number of years a person has a condition that affects their quality of life
- . Each
condition has a weighting factor between 0 and 1, 0 being perfect health and 1 being death. The rating
is indicative of the degree to which a disease negatively impacts an individual’s life.
24
Q
perfect health disability weight factor
A
0
25
chronic insomnia disability weight factor
0.10
26
congestive heart failure disability weight factor
0.20
27
multiple sclerosis disability weight factor
0.41
28
blindness disability weight factor
0.59
29
alzhimer's dementia disability weight factor
0.66
30
death disability weight factor
1
31
what is the years of life lost (YLL) equation
YLL= (# of deaths) x (life expectancy - age of death)
32
the Y L L equation places more weight on
illnesses that result in early mortality because
dying young has a bigger impact on both the individual and society at large.
33
The Institute for Health Metrics and Evaluation (I H M E) created an
interactive tool to analyze
global health trends from 1990 to present. This tool enables you to see how patterns of disease change
over time and to compare disease trends by country, age, and sex.
34
The Institute for Health Metrics and Evaluation (I H M E)
An independent population health
research center at U W Medicine, part of the University of Washington, that provides rigorous and
comparable measurement of the world's most important health problems and evaluates the strategies
used to address them. I H M E makes this information freely available so that policymakers have the
evidence they need to make informed decisions about how to allocate resources to best improve
population health.
35
Communicable diseases spread from
one person to another, from an animal, or even the environment,
to a person.
36
how does spread of diseases and illness occur
through airborne droplets or bodily fluids containing a virus,
bacterium, or parasite.
37
Nutritional, maternal, and neonatal conditions are often grouped with
communicable diseases in the study of G B D commonly referred to as group one
38
Communicable diseases such as H I V, tuberculosis, and malaria, present a significant burden
for low
income countries over 50% of total DALYs in some Low S D I countries
39
what are "the big three" disease
H I V, tuberculosis, and malaria,
40
H I V- stats
- Globally, 38 million people are living with H I V as of 2019, 19% of which are unaware of their status
- Over 68,000 individuals are currently living with H I V in Canada, 14% of whom are unaware of their H I
V status.
41
Tuberculosis- stats
- In 2019, 10 million people contracted T B worldwide
- In Canada there were 1,796 cases of active
tuberculosis reported.
- Two populations - foreign-born individuals and Indigenous Peoples - accounted
for the majority of cases
42
Malaria - stats
- In 2019, there were an estimated number of 229 million cases of malaria worldwide.
- The Canadian
infectious disease surveillance system has reported an average of 538 malaria cases per year since
1990, and Statistics Canada reported an average of one death per year.
43
Human immunodeficiency virus (HIV)-what is it
disease that attacks the body’s white blood cells and weakens the body’s immune system
44
HIV and end of 2019
there were 38 million people in the world living with H I V with only 67% of them
having access to antiretroviral therapy
45
HIV in 2019
690 000 people lost their lives to H I V, while 1.7 million
new infections were diagnosed
46
HIV to date
has taken 33 million lives, making it one of the major
global public health issues
47
HIV mechanism of action
H I V infects white blood cells called helper T cells destroying them over time and eventually causing
Acquired Immunodeficiency Syndrome (AIDS).
48
transmission HIV
H I V is spread from person to person via bodily fluids (i.e. semen, vaginal fluids, blood, and, to a lesser
degree, breast milk).
49
HIV treatment and prevention
typically treated using antiretroviral therapy (A R T), which can greatly prolong life and
suppress symptoms, but does not cure the disease
50
Prevention strategies for H I V include:
* Single condom use
* Elimination of mother-to-child spread with A R T during pregnancy and breastfeeding
* Testing and counselling services
* Harm reduction for people who use drugs, including needle and syringe programs
51
Antiretroviral Therapy (A R T):
A treatment that consists of taking multiple antiretroviral drugs
simultaneously to inhibit the different stages of the virus’s life cycle.
52
Social and economic factors have placed the Indigenous peoples in Canada at
a higher risk of HIV/AIDS compared to non-Indigenous Canadians
53
In 2017, Indigenous Peoples accounted for only ____ f Canada’s total population, yet made up ____ of total H I V cases
- 4.9%
- 20.1%
54
what contributes to the increase risk of HIV/AIDS in indigenous peoples
Socioeconomic factors
- domestic violence
- stigma
- discrimination
- injection drug us
- mistrust and
lack of health services
55
Among the total Indigenous population, Indigenous youth are
at a greater risk of contracting HIV/AIDs
56
why are Indigenous youth at increased risk of HIV
- a lack of health education services and denial of this crisis has resulted in a low-perceived risk of the virus in youth
- substance use (injection) putting them at 22 times more at risk
57
barriers to substance use harm reduction programs
- the lack of on-site methadone treatment and the need to travel to off-site methadone programs
- ong distance travelling and a lack of
counselling and support for these Indigenous methadone patients
58
many Indigenous
communities also have
stigma around treatment programs
59
what is the perferred treatment method
abstinence-
based therapy is the preferred treatment method.
This is because many members of the communities
view methadone treatments as “replacing one drug with another”
60
how did stigma around Indigenous and substance use treatment developement
due to the
lack of health education services and access to information regarding medication-assisted treatment in
these communities
61
holistic approach to H I V and AIDS,
other communicable diseases, and co-morbidity issues.
Canadian Aboriginal
Aids Network (C A A N
62
Canadian Aboriginal
Aids Network (C A A N
is a not-for-profit established in 1997 that represents over 340 member
organizations and individuals to ensure access to H I V and AIDS related service
63
The C A A N promotes a
Social Determinants of Health Framework through advocacy, and provides
accurate and up to date resources on these issues in a culturally relevant manner for Aboriginal
Peoples wherever they reside
64
Tuberculosis (T B) is caused by
Mycobacterium tuberculosis; a bacterium that has infected one quarter of
the world’s population (nly 5-15% of those infected will develop an active T B infection)
65
TB higher risk for
people with a compromised immune system, such as those who are malnourished or
co-infected with H I V
66
In 2019, T B infected
10 million people and was responsible for 1.4 million
deaths
67
Mechanism of Action of TB - affects
usually attacks the lungs (pulmonary), but can also affect other parts of the body (extrapulmonary), including lymph nodes, kidneys, urinary tract, and bone
68
Mechanism of Action of TB when someone has it
bacteria in their body but does not feel sick or show symptoms,
they have latent T B (L T B)
- If L T B goes untreated, approximately 5-10% of infected individuals will
develop active T B.
- Individuals with active T B show signs and symptoms, and are considered infectious
69
TB transmission
- is primarily an airborne disease that is spread through the air from person to person
70
Treatment and Prevention TB
- LTB can be treated and cured with antibiotics as a means to prevent active T B from developing.
- active TB they have to take multiple antibiotics for 6-9 months to kill all the bacteria
(compared to 3-4 months for latent infection)
71
If someone is exposed to or infected by an individual with multi-drug resistant T B (M D R T B
preventative treatment may not be an option
72
, T B infection rates among First Nations individuals living on reserve is
more than
40 times that of the non-Indigenous Canadian population.
73
why are Indigenous individuals are at greater risk of contracting and developing active T B
due to lack of
health promoting conditions.
74
due to lack of
health promoting conditions.
living in overcrowded and poorly ventilated
homes, lack of food security, and comorbidities such as diabetes, H I V, etc
75
in 2016, the active T B rates among Inuit living in Inui Nunangat was more than
300 times
the rates of the non-indigenous Canadian population.
76
In 2017, Jane Philpott, then Minister of
Indigenous Services, and the Inuit Tapiriit Kanatami announced the
launch of an Inuit T B Task Force
to study T B rates in Indigenous communities.
77
In early 2018, an explicit commitment was made to
eliminate T B among Inuit in Inuit Nunangat by 2030, with an interim reduction in the reported rate of
active T B of at least 50% by 2025
78
By the end of 2018, the Inuit Tapiriit Kanatami released an
Inuit Tuberculosis Elimination Framework.
79
six focus areas highlighted in the Inuit Tuberculosis Elimination Framework ;1
Enhance T B care and prevention programming
80
the Inuit Tuberculosis Elimination Framework ; 2
Reduce poverty, improve social determinants of health and create social equity
81
the Inuit Tuberculosis Elimination Framework ; 3
Empower and mobilize communities
82
the Inuit Tuberculosis Elimination Framework ; 4
Strengthen T B care and prevention capacity
83
the Inuit Tuberculosis Elimination Framework ; 5
Develop and implement Inuit specific solutions
84
the Inuit Tuberculosis Elimination Framework ; 6
Ensure accountability for T B elimination
85
Inuit Tapiriit Kanatami:
The national representational organization protecting and advancing the rights
and interests of Inuit pin Canada
86
what is malaria caused by
- the parasite Plasmodium, which can be transmitted between humans by
mosquitoes
87
_____ is more prevalent but less deadly than HIV
Malaria
88
stats of malaria 2019
229 million cases and 409 000 deaths
89
where carries the greastest burden of malaria
The W H O Africa region
- 94% of all
global cases in 2019
90
africa region with most malaria
Nigeria, the Democratic Republic of the Congo, United Republic of Tanzania, Burkina
Faso, Mozambique, and Nige
91
in 2019 children under 5 and malaria
children under five accounted for 67% of all malaria deaths
worldwide
92
Mechanism of Action malaria
- After a dormant period in the liver, Plasmodium enters the bloodstream and infects the red blood cells,
often causing them to burst.
-
93
evidence that Plasmodium impairs the
ability of key cells of
the immune system to trigger an efficient immune response, which might explain why patients with
malaria are susceptible to a wide range of other infections and fail to respond to several vaccines
94
symptoms of malaria
headache, abdominal pain, chills, shaking, fever, and sweats. Malaria can cause
seizures, anemia, jaundice, heart failure, kidney failure, coma, and even death
95
Transmission of malaria
Plasmodium is transmitted through mosquito bites that allow the parasite to enter the bloodstream
- NOT by being near a person with disease
96
Malaria Transmission Cycle
First infected mosquito --> First infected person --> Infected liver cells ---> Infected red blood cells ---> Second
infected mosquito ---> Second infected person
97
malaria treatment and prevention
is curable using anti-malarial drugs, and preventable using insecticide-treated
mosquito nets and indoor sprays
98
what are one of the most prevention stategies for malaria?
Insecticide-treated mosquito nets
- reducing infection up to 80% in some
regions
99
issues with the mosquito nets
access to these nets are the leading barrier to their use.
100
barriers to insecticide-treated mosquito nets in Western Kenya.
- attitudes
- ease of use
101
Attitudes
a combined site analysis indicated that not using an available bed net was associated with the attitudes
that taking malaria drugs is easier than using a bed net and that use of a bed net will not prevent
malaria
102
Ease of Use
individuals with an unused bed net in the household were more likely to indicate that bed
nets are difficult to use, that purchased bed nets are better than freely distributed ones, and that bed
nets should only be used during the rainy season
103
in order to look at common factor and potential root cuases for communicable disease it is imperative to look at
both the potential cause of disease by considering stoical, environmental, and biological factors and the pops affected by the disease
104
H I V Population Most Affected
Children in Africa - almost
90% of global childhood H I
V death occurs in the African
region
105
H I V Population Causes of Disease
* Lack of regular H I V testing and
counselling
* Limited access to antiretroviral therapy
(ART) for mothers and children in rural
regions
* High level of stigma surrounding H I V,
particularly for pregnant women
106
TUBERCULOSIS Population Most Affected
People in India -
approximately one quarter
of T B cases occur in Indi
107
TUBERCULOSIS Population Causes of Disease
- T B is exacerbated by malnutrition and
tobacco smoking, which are common in
India
* Early T B detection and drug adherence
are not emphasized in India’s healthcare
system
108
MALARIA Population Most Affected
Sub-Saharan Africa -
approximately 90% of
malaria cases and deaths
occur in Sub-Saharan Africa
109
MALARIA Population Causes of Disease
- Africa is an ideal climate for mosquitos,
with long warm spells and intense rainy
seasons
* Human immunity can be relatively low in these regions of Africa
110
what are not technically communicable diseases?
maternal, neonatal, and nutritional conditions
111
what are considered with communicable diseases when they are not technically that kind?
maternal, neonatal, and nutritional conditions by the GBD tool (supported by WHO)
112
why have they been grouped together
- a significant
interplay between these conditions and communicable diseases (The conditions can either exacerbate
the symptoms of communicable diseases or completely mask them)
- condition itself can be a result of a communicable disease
113
another reason why maternal, neonatal, and nutritional conditions are a part of communicable diseases
because maternal, neonatal, and
nutritional disorders are seen more frequently in low SDI countries, much like communicable diseases
114
Nutritional deficiencies account for nearly ___ of total DALYs
2%
115
what do nutritional conditions include
protein energy malnutrition,
iodine deficiency, dietary iron deficiency, and vitamin A deficiency
116
what is the most common nutritional disorder in the world?
Iron deficiency
117
effects of iron deficiency
range from impaired development in children to decreased work
productivity in adults.
118
link of iron and communicable diseases
is that two very common infections in Africa,
malaria and intestinal worms, are significant contributors to anemia
119
what is Protein Energy Malnutrition (PEM)
a form of severe calorie or protein deficiency (in other words,
starvation)
120
PEM large impact on who?
on children due to their lower protein intake,
especially once they stop breastfeeding
121
P E M is less common but more severe than
iron deficiency - significant developmental
impacts and 6 million deaths each year
122
common maternal conditions
* Maternal hemorrhage
* Maternal sepsis and other infections
* Maternal hypertensive disorders
* Obstructed labour and uterine rupture
* Maternal abortion miscarriage
* Ectopic pregnancy
* Indirect maternal deaths
* Late maternal deaths
* Maternal deaths aggravated by H I V
123
Maternal hemorrhage:
also known as Postpartum Hemorrhage (P P H), is when a woman has heavy
bleeding after giving birth
124
Maternal sepsis
Maternal sepsis is a severe bacterial infection, usually of the uterus (womb), which can
occur while women are pregnant women or most commonly, in the days following childbirth
125
Maternal hypertensive disorders
Hypertensive pregnancy disorders, lead to a higher blood pressure.
These disorders, which include chronic hypertension, gestational hypertension, preeclampsia, and
eclampsia, are common, complicating 5% to 10% of pregnancies.
126
Obstructed labour and uterine rupture
Labour is considered obstructed when the presenting part of
the fetus cannot progress into the birth canal, despite strong uterine contractions. Obstructed labor is
the leading cause of uterine rupture worldwide
127
three main impacts of
maternal conditions and maternal health
impacts on children, economic impacts, and
social justice impacts
128
impact on Children
* 70% those who live in absolute poverty are women
* Women are more likely to spend what they make on their family
* Maternal deaths are rooted in women’s powerlessness and their unequal acces
129
Maternal deaths are rooted in women’s powerlessness and their unequal access to:
o Employment
o Finances
o Education
o Basic health care
130
Economic Reasons
- Poor care and/or nutrition of the mother often leads to
- Motherless children are
131
Poor care and/or nutrition of the mother often leads to
o Decreased stability in the home
o Poor health/death of child
o Low birth weight
132
Motherless children are:
o Less likely to get an education
o More likely to die
133
Social Injustice
* Building a woman’s trust in healthcare increases preventative care for the whole family
* Maternal health interventions are among the most cost effective in health
* Building solid maternal health services strengthens the whole health care system
- Empowering women leads to more equal access of power and resources and leads to positive
change
134
Neonatal health accounts for only the first
28 days of life
135
neonatal period
when providing
appropriate care is crucial to ensure a newborn’s chances of survival and further lay the foundations
for a healthy life
136
The main causes of neonatal death are
1. Infections (i.e. leading to sepsis) (36%)
2. Pre-term (28%)
3. Birth trauma (23%
137
Some interventions aimed at improving neonatal health include
1. Prenatal visits
2. Skilled birth attendants
3. Emergency care
4. Postnatal care
138
COVID - 19 classified as
communicable
disease
139
Communicable diseases typically affet
low income countries and populations
disproportionately
140
COVID 19 and Indigenous population in canada
while many people feared that remote Indigenous
communities would be disproportionately affected by COVID-19, the exact opposite occurred
141
Indigenous populations/ communities during covid
Extraordinary public health measures taken by Indigenous communities contributed to the low
number of cases according to health officials
142
the rates of covid and Indigenous communities after a while
effect did not last as First Nations
people, living on reserve almost doubled the odds of COVID-19 death
143
did not last as First Nations
people, living on reserve almost doubled the odds of COVID-19 death - why
factors including high burden of pre-existing conditions, reduced access to health care, inadequate
access to housing, food, and clean water
144
what / where did Indigenous communities have a better response to the first wave of covid
swiftly instituted their own
versions of public health measures, often learned and passed down through centuries of elders' oral
histories
145
Non-communicable diseases cannot
be spread from one person to another
- eventhough in some cases, the behaviours that lead to them can be though of as contagious
146
what accounts for the highest burden of disease worldwide?
Non-communicable diseases (64% of DALYs in
2019)
147
where are Non-communicable diseases prevalent
high, middle, and low-income population
148
in the last century, cardiovascular diseases (C V Ds) have gone from
a minor disease to the number one cause of death globally
149
researchers and physicians alike define C V D as
synonymous with ischemic
heart disease (heart attacks);
150
W H O tends to describe C V Ds as
large category that includes multiple conditions.
151
what is the cuase of the increase in prevalence of CVD
due to people living
longer lives and partly because of changes in lifestyle leading to increased C V D risk factors
152
examples of CVD
- coronary heart disease
- cerebrovascular heart disease
- peripheral arterial disease
- congenital heart disease
- rheumatic heart disease
153
coronary Heart Disease
Disease of the blood vessels supplying the heart muscle
154
Cerebrovascular Heart Disease
Disease of the blood vessels supplying the brain
155
Peripheral Arterial Disease
Disease of the blood vessels supplying the arms and legs.
156
Congenital Heart Disease
Malformations of heart structure existing at birth
157
Rheumatic Heart Disease
Damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria
158
80% of worldwide C V D deaths
occur in
low and middle income countries
159
why do majority of CVD deaths occur in middle to low income countries
because of their larger populations
160
C V D typically develop
mid-life (impacting the socioeconmic status of the person)
161
two interventions of C V D.
- Access to Medication
- Education & Accessibility
162
Access to Medication
- Innovative public health research trying to increases drug access
- available worldwide but expensive for some
- Generic versions could be cheaper to increase accessibility
163
Education & Accessibility
- Increased education as well as stronger public policy and awareness toward healthy living
- some communities, there are additional barriers to physical activity and healthy
food such as geographical location, unaffordability, and lack of programming that make it increasingly
difficult to live a healthy and active lifestyle
164
the risk factors of CVD
- high blood pressure
- high cholesterol
- diabetes
- tobacco use
- unhealthy diet
- physical inactivity
- obesity
165
Cancer is an
umbrella term for the collection of disease where the body’s cell begins dividing
uncontrollably without cell death, which eventually can begin to spread to other parts of the bod
166
The most common types of cancer found worldwide are
- lung
- breast
- colorectal
- prostate
- skin
- stomach
167
key points from The Global Burden of Disease Cancer Collaboration 2017 study about cancer
* Cancer is ranked 2nd in global deaths, Y L L, and DALYs.
* 51% of cancer cases occurred in countries of high S D I, but only 30% of cancer deaths
and 24% of cancer DALYs.
* The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived
with disability.
* Globally, the odds of developing cancer during a lifetime (ages 0-79 years) were 1 in 3 for men and
1 in 4 for women. These odds differ substantially among S D I quintiles
168
Around ____ of global cancer cases are preventable
40%
169
what do most prevention strat for cancer focus on
education to
increase avoidance of common risk factors or providing national intervention through updated
policies
170
Tobacco prevention strategies
* Raising tobacco taxes.
* Requiring by law 100% smoke free environments in all indoor workplaces and public spaces.
* Put health warnings on all tobacco packaging.
* Establishing a national cessation program in health care facilities
171
what is the greatest avoidbale risk factor for cancer mortality
tobacco
172
Obesity Global
prevention strategies include
* Developing national dietary and physical activity guidelines.
* Promoting public awareness campaigns about the links between cancer and obesity, unhealthy
diet, and physical inactivity
173
Alcohol Global
prevention strategies include:
* Raising public awareness, especially among young people, about alcohol related health risks,
including cancer, using gender specific messaging.
* Developing and implementing a national policy aimed at reducing the overall level of alcohol
consumption
174
infections Global prevention strategies include
* Implementing universal immunization using one of the recommended immunization schedule
175
Carcinogens revention strategies include
* Stopping the use of asbestos.
* Ensuring safe drinking water.
* Identifying workers, workplaces, and worksites with exposures to carcinogens
176
Radiation Prevention strategies include
* Provide information about sources and effects of all types of radiation.
* Ensure regular safety training of all radiation workers.
* Promote U V risk awareness and U V protection action
177
Mental illnesses are another form of
non-communicable diseases
178
mental illnesses are still feared and misunderstood by many people, leading to
stigmatization.
179
G B D and Economic Impact - mental health
mental, neurological and substance use disorders make up 10% of the global burden of disease and
30% of non-fatal disease burden
- global economy loses about $1 trillion U S D per year in productivity due to depression and
anxiety
180
Childhood Rate and Onset - mental health
Around 1 in 5 of the world's children and adolescents have a mental health disorder and about half of mental health disorders begin before the age of 14
181
Depression
Depression is one of the leading causes of disability, affecting 264 million people
182
Suicide
Almost 800,000 people die by suicide every year; 1 person dies from suicide every 40 seconds. Suicide
is the second leading cause of death in individuals aged 15-29 years
183
Severe Mental Disorders
around 1 in 9 people in geographical locations affected by conflict have a moderate or severe mental
disorder
184
People with severe mental disorders die
10 to 20 years earlier than the general population
185
Mental Health Workers
vary from below 2 per 100,000 population in low-income countries to
over 70 per 100,000 in high-income countries
186
Policies - mental health
Less than half of the 139 countries that have mental health policies and plans report having these
aligned with human rights conventions
187
what is the WHO special initiative for mental health (2019-2023)
a five year plan set to work towards a
vision where all people achieve the highest standard of mental health and well-being
- seek universal health coverage for mental health in 12 countries
188
The G B D defines injuries as
death or disability due to the direct or indirect result of a physical force, immersion, or exposure, including accidental, interpersonal, or self-inflicted forces as well as war, conflict, violence, and natural disasters
189
GBD and injuries
Out of three major categories, communicable diseases, non-communicable diseases, and injuries,
injuries account for the smallest portion of deaths, contributing to 7.6% of all deaths.
190
who are injuries death rates higher for?
males than females
191
what are the top injury deaths in 2019
-falls
- road injuries
- self-harm
- interpersonal
violence.
192
From 2010 to 2019, the age-standardized death rate due to injuries decreased by
19.4%.
193
Interpersonal Violence:
Interpersonal violence may be physical, sexual, or psychological (also called
emotional violence), and it may involve deprivation and neglect.
194
what age group has the highest DALYs due to injury?
10-24
lowest 0-5
195
injires and geogrpahic areas
- rates of particular cause of injury varies between geographic area
196
Self-harm is the number one cause of injury in
Eastern European males
197
Interpersonal violence is the
biggest cause of injury in
males living in Central Latin America.
198
how many people die from suicide every year
800,000
199
2018 suicide rates and the age
children 10-14 and second in 15-34 in canada
200
Suicide rates are also
significant in populations that experience
(isolation and discrimination)
L G B T Q 2 s+
population, refugees and migrants, and Indigenous Peoples.
201
income and suicide
79% of global suicides in 2016 occurred in low
and middle income countrie
202
while suicide is part of the injuries category, it is very closely
tied to
mental illness, which is part of the non-communicable diseases group
203
suciide and Indigenous population
die at a rate of 3 times higher than non-Indigenous canadian
204
During the “Sixties scoop” and when Residential Schools were
established what were the effects
Indigenous communities, families, political structures, and economic foundations were shattered
- causing intergenerational trauma, marginalization, and systemic racism since colonization - increasing rate of sucicde
205
The last Residential School closed in.
1996. - so opression and cultural genocide occurs for over 100 years
206
Intergenerational trauma occurs when
trauma experienced by one generation is passed down to other
generations.
207
models that attempt to explain the transmission of intergenerational trauma
- sociocultural
- psychological
- physiological
208
The sociocultural model explains
intergenerational trauma through parenting styles and exposure to
environmental factors that may impact a child’s development
209
SOCIOCULTURAL MODEL based on
the assumption
that children are directly influenced by the home environment they are raised in
210
sociocultural model and intergenerational trauma how does it relate?
Many Indigenous
children were raised in the residential schooling system where they were subjected to abuse, neglect,
and high levels of stress.
s these children grow and become parents, they may lack the skills and
knowledge to create a nurturing family environment and to support their own children. A cycle of
negative parenting behaviours then ensues and results in intergenerational trauma
211
The psychological model explains
intergenerational trauma based on the understanding that a child’s
brain development can be significantly impacted if during the early years of development they are
subjected to harsh conditions.
212
psychological model suggests
that a child’s brain development, and ability to self regulate, may be affected if their basic needs are not met
- children raised in poor conditions may develop cognitive delays and negative coping strategies that can heavily impact their lives in the future
213
psychological mode and intergenerational trauma
- In the residential schooling system, many
children were unable to develop a sense of trust and security with the majority of people around them.
-
214
The physiological model explains
intergenerational trauma through biological factors and
predisposed genetic factors
215
The physiological model suggests
when a child is subjected to excess levels of stress, there
are abnormal levels of cortisol, dopamine, and serotonin, which may affect brain development
- which affect the ability to process and handle stressful environments = learning disability
216
Epigenetic theories suggest
that high levels of maternal stress can influence in-utero development
and actually alter the function of some genes in the offspring
217
Epigenetic theories and changes in gene
function can occur preconception, affecting the germ-line (from either parent) or in-utero due to high
maternal stress during pregnancy, and can result in negative responses to stress in the offspring.
218
Epigenetic
Epigenetics is the process of altering gene activity and expression through external
modifications to D N A. These external modifications turn genes "on" or "off” and although they do not
change the D N A sequence, they affect how cells "read" genes.
219
suicide impacts three different groups of Indigenous Peoples in Canada.
- first nations
- metis
- inuit
220
FIRST NATIONS and suicide
- 3x higher than the non-Indigenous rate.
- 2x higher for First Nations people living on reserve compared to those not living
on reserve.
- significantly higher percentage of suicide amongst the lowest income quintile compared to Métis and Inuit communities
-
221
what accounts for 78% of the excess risk of death by suicide in First Nations communities
Geographic location, household income, labour force status, level of education, and marital status
222
MÉTIS and suicide
- the rate of suicide for Métis people is 2x higher
than the non-Indigenous rate
-
223
The labour force status profile of Métis is similar to non-indigenous people, so
this factor
contributes a smaller excess risk of suicide in Métis communities compared to the First Nations
and Inuit communities
224
INUIT and suicide
- 9x higher than the non-Indigenous rate
- highest in youth, especially males living in Inuit
Nunangat
225
suicide risk factors that significantly impact the Inuit population.
Substance use, depression, post-traumatic stress disorder, and romantic relationship breakups
226
protective factors are defined as
biological, psychological,
family, or community level that are associated with a lower likelihood of problem outcomes or reduce
the negative impact of a risk factor on problem outcomes
227
Protective factors for Indigenous youth may include
* High community knowledge of the Indigenous language
* Secure Indigenous titles to traditional lands
* Self-governance, leading to control over essential services (such as health care, education, police,
fire department)
* School attendance
* Sustainable employment
* Easy access to social support and tailored mental health services
228
global health advocates and stigma around suicide
there responsibility to help reduce it
229
methods of reducing stigma around suicide
- language
- respect
- advocate
230
language : reducing stigma
words used to describe suicide may themselves be stigmatizing
- commited was seen as a criminal act which it isnt anymore
231
respect and reducing stigma
- becoming more common and safe for people to share their experiences with suicide
- respecting the
decisions of individuals who choose not to discuss their experiences. Not all people are eager to talk
about their experience, and that should not impact the level of support they receive
232
Advocate and reducing stigma
- use your voice
- People who are
experiencing a mental health problem or survivors of suicide should not be expected to navigate
advocacy by themselves
233
preventive methods of suicide
- policy
- media
- access
- stigma
- follow-up
234
Policy
help reduce suicide through multiple avenues.
235
media
- Responsible media reporting - not sensationalize can may reduce the rates of suicide.
- sharing safe messages on social media.
236
access
reducing and limiting access to the means of suicide (e.g. firearms)
237
stigma
Reducing barriers that make people think the wrong thing may help prevent, and decrease rates of suicide
238
follow up
with people who have attempted suicide, or who have thought about suicide
239
the Millennium Summit of the United Nations (U N) in 2000, 189 U N member states and 23
international organizations agreed to what
adopting eight international development goals
(Millennium Development Goals (MDGs)
240
Millennium Development Goals (M D Gs) are aimed to
meet the needs of the world’s less fortunate.- who may be lower income etc..
241
what happend int 2015 with the MDGs
were expanded to 17 sustainble development goals (SDGs)
242
the 8 MDGs
1. Eradicate Extreme Poverty and Hunger
2. Archive Universal Primary Education
3. Promote Gender Equality and Empower Women
4. Reduce Child Mortality
5. Improve Maternal Health
6. Combat H I V / AIDS, Malaria, and Other Diseases
7. Ensure Environmental Sustainability
8. A Global Partnership for Development
243
MDG 1 A Global Partnership for Development
* To halve the proportion of people whose daily income is less than $1.25.
* To achieve full and productive employment, as well as decent work for all, including young people
and women.
* To halve the proportion of individuals suffering from hunger in the period between 1990 and 2015
244
MDG 2 Archive Universal Primary Education
To ensure that children universally - will be able to complete a full course of primary education by 2015.
245
MDG 3 Promote Gender Equality and Empower Women
To eliminate gender disparity in primary and secondary education by 2005, and in all levels of
education by 2015
246
M D G GOAL 4
Reduce Child Mortality
to reduce the under-five mortality rate by two-thirds in the period between 1990 and 2015
247
M D G GOAL 5
Improve Maternal Health
* To reduce the maternal mortality ratio by 75 percent.
* To achieve universal access to reproductive health.
248
M D G GOAL 6
Combat H I V / AIDS, Malaria, and Other Diseases
* To halt and start to reverse the spread of H I V / AIDS by 2015.
* To achieve global access to treatment for H I V / AIDS for those who need it by 2010.
* To have ceased and started reversal of the incidence of malaria and other major diseases by 2015
249
M D G GOAL 7
Ensure Environmental Sustainability
* To integrate the principles of sustainable development into every nation’s policies and
programmes, and also reverse the depletion of environmental resources.
* To reduce biodiversity loss and achieve a substantial reduction in the rate of loss by 2010.
* To halve the proportion of the universal population without sustainable access to clean and safe
drinking water and basic sanitation by 2015.
250
M D G GOAL 8
A Global Partnership for Development
* To further develop an open, predictable, rule-based, non-discriminatory trading and economic
system.
* To address the special needs of the least developed countries.
* To deal exhaustively with the debt problems of developing nations.
* To provide access to affordable essential drugs in the developing world - in collaboration with
pharmaceutical companies.
* To avail benefits of new technologies, especially information and communications, in collaboration
with the private sector.
251
when did the MDGS come to an end
2015 and created a report
252
Some of the many achievements towards the M D Gs include:
* A significant decline in global poverty; the number of people living in extreme poverty declined by
more than half.
* An increased primary school net enrolment rate in the developing regions.
* A decline in the under-five mortality rate globally, by more than half.
* A decline in the maternal mortality rate worldwide.
* An increase in the number of girls attending school globally and elimination of the gender disparity
in primary, secondary, and tertiary education.
253
Some of the major challenges reported in the MDG report include
* The persistence of gender inequality.
* Big gaps between the poorest and richest households, and between rural and urban areas.
* The persistence of conflict as the biggest threat of human development.
* The disproportionate impact of climate change and environmental degradation on people living in
poverty results in great suffering, and undermines the progress achieved.
* The millions of people still living in poverty and hunger, without access to basic services.
254
How does child mortality relate to income of a country? How has child mortality changed over
time?
Child mortality is inversely related to income. Child mortality is lower in countries with a higher income
(gross domestic product per person). Globally, child mortality has decreased over time.
255
the MDG report empahzies
the critical role of the social determinants of health and how they influence well-being of the vulnerable populations
256
what are 2 SDoH affect individuals health globally?
gender inequality and income gaps
257
Gender Inequality
Compared to men, women face greater discrimination
258
women face greater discrimination in
* access to work,
* access to economic assets, and
* participation in private and public decision-making.
259
who are more likely to live in poverty?
women
260
Income Gap
There is a large income gap between the least wealthy and most wealthy households
261
income gap impacts children in what ways?
* Children from the poorest households are more than twice as likely to be developmentally
stunted as
* Children in this poorest are four times as likely to not be enrolled in school.
* Under-five mortality rates are almost twice as high for children in the poorest households
compared to children in the richest.
262
compare and constrast the MDgs and SDGs
MDGs: Focused on reducing extreme poverty and improving basic human needs in developing countries.
SDGs: Aim for sustainable development for everyone, balancing social, economic, and environmental goals.
- The SDGs were created to build on and improve the MDGs
GLPH 271
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