GLOBAL HEALTH AND DISEASE Chapter 2 Chapter 2: Overview Introduction Burden of Disease Non communicable Disease Infectious Disease The Future of Infectious Disease Public Health and Healthcare Strategies Conclusion Introduction Development and management Understanding the environmental or national context Social and cultural beliefs The physical environment The political climate 3 3 Introduction Understanding the environmental or national context Economic development Social structures Types of diseases present in the population 4 4 Introduction Influence of population health needs Distribution of medical resources Provision of health services 5 5 Introduction Demands on healthcare systems Disease prevention Primary treatment Secondary treatment Tertiary treatment 6 6 Introduction Integration of the healthcare system with public health system Public health system responsibilities 7 7 Burden of Disease Measurement of disease Prevalence Incidence Disease specific mortality Case fatality rate Mortality rates 8 8 Burden of Disease Reporting the burden of disease Disability-adjusted life years (DALY) Quality-adjusted life years (QALY) Health expectancy Healthy life years Application of cost-benefit analyses 9 9 Burden of Disease Effect of measurement on appropriation of health resources Difficulties with collecting health statistics 10 10 Noncommunicable Disease Heart disease Cerebrovascular disease Respiratory infections HIVAIDS Chronic pulmonary disease Perinatal conditions Diarrheal disease Tuberculosis Malaria Respiratory tract cancers Top 10 leading causes of death Noncommunicable Disease Emergence of noncommunicable disease Heart disease Stroke Cancer 12 12 Noncommunicable Diseases Emergence of noncommunicable disease Chronic respiratory disease Mental illness Diabetes 13 13 Noncommunicable Disease Increasing impact on worldwide mortality Differences between communicable and noncommunicable disease World Health Organization projection 14 14 Noncommunicable Disease Risk factors for noncommunicable disease Lifestyle Environment Top ten leading causes of death worldwide 15 15 Noncommunicable Disease Cardiovascular disease Forms of disease Atherosclerotic disease Non-atherosclerotic disease 16 16 Noncommunicable Disease Cardiovascular diseases Types Coronary Artery Disease Heart Attack Congenital Heart Disease Aneurysm Heart Failure High Blood Pressure Stroke Arrhythmias 17 17 Noncommunicable Disease Cancer Risk factors Preventable risk factors 18 18 Noncommunicable Disease Factors Known To Increase Cancer Risk Age: can take decades to develop Lifestyle: Certain lifestyle choices Family history: 10% due to inherited condition Health conditions: Some chronic health conditions can increase risks Noncommunicable Disease Factors Known To Increase Cancer Risk Environment: may contain harmful chemicals Globalization: Rising consumption of tobacc ...

1. GLOBAL HEALTH AND DISEASE
Chapter 2
Chapter 2: Overview
Introduction
Burden of Disease
Non communicable Disease
Infectious Disease
The Future of Infectious Disease
Public Health and Healthcare Strategies
Conclusion
Introduction
Development and management
Understanding the environmental or national context
Social and cultural beliefs
The physical environment
The political climate
3
3
Introduction
Understanding the environmental or national context
Economic development
Social structures

2. Types of diseases present in the population
4
4
Introduction
Influence of population health needs
Distribution of medical resources
Provision of health services
5
5
Introduction
Demands on healthcare systems
Disease prevention
Primary treatment
Secondary treatment
Tertiary treatment
6
6

3. Introduction
Integration of the healthcare system with public health system
Public health system responsibilities
7
7
Burden of Disease
Measurement of disease
Prevalence
Incidence
Disease specific mortality
Case fatality rate
Mortality rates
8
8
Burden of Disease
Reporting the burden of disease
Disability-adjusted life years (DALY)
Quality-adjusted life years (QALY)
Health expectancy
Healthy life years
Application of cost-benefit analyses
9
9

4. Burden of Disease
Effect of measurement on appropriation of health resources
Difficulties with collecting health statistics
10
10
Noncommunicable Disease
Heart disease
Cerebrovascular disease
Respiratory infections
HIVAIDS
Chronic pulmonary disease
Perinatal conditions
Diarrheal disease
Tuberculosis
Malaria
Respiratory tract cancers
Top 10 leading causes of death
Noncommunicable Disease
Emergence of noncommunicable disease
Heart disease
Stroke
Cancer
12

5. 12
Noncommunicable Diseases
Emergence of noncommunicable disease
Chronic respiratory disease
Mental illness
Diabetes
13
13
Noncommunicable Disease
Increasing impact on worldwide mortality
Differences between communicable and noncommunicable
disease
World Health Organization projection
14
14
Noncommunicable Disease
Risk factors for noncommunicable disease
Lifestyle
Environment
Top ten leading causes of death worldwide

6. 15
15
Noncommunicable Disease
Cardiovascular disease
Forms of disease
Atherosclerotic disease
Non-atherosclerotic disease
16
16
Noncommunicable Disease
Cardiovascular diseases Types
Coronary Artery Disease
Heart Attack
Congenital Heart Disease
Aneurysm
Heart Failure
High Blood Pressure
Stroke
Arrhythmias
17
17

7. Noncommunicable Disease
Cancer
Risk factors
Preventable risk factors
18
18
Noncommunicable Disease
Factors Known To Increase Cancer Risk
Age: can take decades to develop
Lifestyle: Certain lifestyle choices
Family history: 10% due to inherited condition
Health conditions: Some chronic health conditions can increase
risks
Noncommunicable Disease
Factors Known To Increase Cancer Risk
Environment: may contain harmful chemicals
Globalization:
Rising consumption of tobacco; processed foods high in fats,
sugars, and salt
Declining consumption of fruit and vegetables
More sedentary activity levels
Noncommunicable Disease
Diabetes mellitus
Definition

8. Classification
Type 1
Type 2
Gestational
21
21
Noncommunicable Disease
Projections By The International Diabetes Federation
By 2025: people with diabetes expected to be 380 million
worldwide
80% living in the developing world
Each year, 7 million people develop diabetes, while 38 million
die of diabetes-linked causes
Noncommunicable Disease
Projections By The International Diabetes Federation
Diabetes affects 15%–20% of the adult population Asia, Middle
East, Caribbean
India has the largest number of diabetics followed by China, US
and Russia
Increasingly affects young & middle aged
More than half of diabetics in developing countries betw een 40
and 59 years old
Noncommunicable Disease
Mental illness
Global burden
Most common forms

9. Impact on the individual
Important facts
24
24
Facts About Mental Illness And Recovery
4/10 causes of disability = mental disorders
By 2020, major depressive illness will be the leading cause of
disability
Untreated mental illness in US costs $100 billion per year
Facts About Mental Illness And Recovery
Strikes individuals in their prime; without treatment:
Unnecessary disability
Unemployment
Substance abuse
Suicide
Homelessness
Inappropriate incarceration
Facts About Mental Illness And Recovery
Best treatments for serious mental illnesses today are highly
effective
With appropriate effective medication and a wide range of
services tailored to their needs, most people can live with
serious mental illnesses or reduce the impact

10. Early identification and treatment is vital
Stigma erodes confidence in system’s ability to detect and treat
effectively
Infectious Disease
Definition
Transmission
Emerging and re-emerging diseases
28
28
Infectious Disease
Increased global awareness of the burden of disease by
developed countries
Impact on their populations
Sense of justice
29
29
Infectious Disease
Vector-borne diseases
Factors for resurgence
Classification by type of pathogen
Examples:

11. Malaria
Zika Virus
30
30
Infectious Disease
Malaria
Infectious agent
Vector
Symptoms
Management
Treatment
Control
31
31
Infectious Disease
Water-borne diseases
Route of infection
Important organisms
Examples: Diarrheal Disease and Cholera

12. 32
32
Infectious Disease
Diarrheal disease
Impact
Control and management
33
33
Infectious Disease
Respiratory infection
Categorization
Examples: Tuberculosis and Influenza
34
34
Infectious Disease
Sexually transmitted disease
Impact of the HIV epidemic

13. Challenges to disease control
35
35
Infectious Disease
Human Immunodeficiency Virus/Acquired Immunodeficiency
Syndrome (HIV/AIDS)
Prevalence
Impact on sub-Saharan Africa
Control efforts
Challenges to meeting reduction goals
36
36
Infectious Disease
Zoonotic Infections
Infectious agent transmitted under natural conditions from
vertebrate animals to humans
Examples: salmonella, hantavirus disease, a hemorrhagic
disease
Avian Influenza: 7 types of influenza (type A)
Ebola Virus: identified in 1976 in the Congo with 318 cases, of
which 280 died

14. Infectious Disease
Immunization and other intervention programs
Preventable infectious disease
Mechanisms for reducing mortality
38
38
Infectious Disease
Emerging infectious diseases
New diseases
Contribution to disease emergence
CDC identified 18 bacteria resistant to antibiotics; placed into
three categories:
Urgent
Threat
Concerning
39
39
The Future of Infectious Disease
Cornerstones:
Early diagnosis, prevention, treatment
Challenges:

15. Climate change
Violence and war
Population migration
Rapid global transportation & communication
Declining infrastructure and Poverty
Antibiotic resistance
Viral and bacterial mutations
Lack of Infrastructure
Globalization
Public Health and Healthcare Strategies
Successful intervention of current and emerging diseases
depends on:
Integration public health and health services
Vigilant and well prepared professionals
Constant surveillance
Community health workers with the right skills
Countrywide policies: prepare, protect, respond
All nations to engage in new research
Conclusion
Requirement for constant disease surveillance
Requirement for high-level coordination
Other strategies
42
42

16. This Section Reserved
for Instructors
Suggested Discussion or Research Questions
General Question Categories
Structure and Evaluation Healthcare Services and Systems
Global Burden of Disease
Cultural Influences
Medical Travel and Tourism and Off Shoring
Health Communication, Marketing, Social Marketing
Data and Measurement
Policy, Strategy, and the Regulatory Environment
Global Health Leadership
International Best Practices
Discussion or Research Questions
Describe the different environmental and national contexts that
influence the development and management of a country’s
healthcare system.
What are they nonmedical services health systems provide in
the arena of public health and how do they impact community
health and well-being?
Discussion or Research Questions
Provide a brief description and application for the commonly
used population health indicators.
What are the implications of using measurements such as
quality-adjusted life years, health expectancy, and on decisions
made by national health systems?

17. Discussion or Research Questions
What are they nonmedical services health systems provide in
the arena of public health and how do they impact community
health and well-being?
Provide a brief description and application for the commonly
used population health indicators.
Discussion or Research Questions
What are the implications of using measurements such as
quality-adjusted life years, health expectancy, and on decisions
made by national health systems?
Describe the impacts that decreasing rates of communicable
diseases and increasing rates of communicable diseases have on
national health systems?
Discussion or Research Questions
Describe the impacts that decreasing rates of communicable
diseases and increasing rates of communicable diseases have on
national health systems?
Describe the factors that increase the risk of developing cancer.
Explain how changes in global transportation impact the
geographic distribution of communicable diseases.
Discussion or Research Questions
What environmental infrastructure deficiencies make control of
communicable diseases difficult in developing countries?
How do changing climactic conditions affect the incidence and
prevalence of vector-borne diseases?

18. Suggested Topic Areas To Use When Facilitating Discussions,
Projects, or Case Studies
Engagement of stakeholders
Effectively working in and managing teams
Learning how to get in front of the problem or identify
opportunities
Learning to communicate effectively
Assessment of solutions that fit the country
Embracing systems thinking
Recognize and embrace diversity
Sustaining the mission of health as well as health care
HCM500
Healthcare Systems
Instructor Name
Module 2
Prevalence and Management of Behavioral Healthcare
Module 2 Learning Outcomes
HCM500 Healthcare Systems
Describe how mental healthcare is structured and financed.
Discuss the relationship of regional differences and access to
behavioral/mental healthcare.

19. Discuss the incidence and prevalence of mental illness.
Discuss the mental healthcare system in terms of impact and
future challenges.
Highlight the learning outcomes for the module here.
2
Module Lecture
Overview of Behavioral Healthcare
Global Differences of Services and Access
Mental Health Statistics and Geographic Shortages
In this module, we examine how mental health services are
structured and financed. In many countries access to mental
health services are grossly insufficient for the large and
growing need of mental health patients. Cost-effective treatment
plans are available, but the stigma associated with mental
illness often prevents individuals from seeking treatment.
HCM500 Healthcare Systems
Use this slide to add additional course lecture slides/content as
needed. Remember the lecture should be 45-60 minutes in
length, so additional slides presenting appropriate course
materials is very important.
Add talking points to expand on each item in the outline.
3
Module Lecture
The delivery of mental health services is a complex
undertaking. It is important to have a basic understanding of the
prevalence of mental illness, concepts of access, and how some
nations finance mental health services.
An understanding of the shortage of mental health services and

20. the stigma associated with this topic can improve your
understanding of the issues and possible solutions.
HCM500 Healthcare Systems
Use this slide to add additional course lecture slides/content as
needed. Remember the lecture should be 45-60 minutes in
length, so additional slides presenting appropriate course
materials is very important.
Add talking points to expand on each item in the outline.
4
Module Lecture
A large percentage of individuals do not obtain health care for
their condition because the mental health infrastruc ture and
services in most countries are not suitable to support the
growing number of mental health patients. Also present is the
stigma and discrimination associated with mental illness which
prevents ill persons from seeking care they so desperately need.
It is estimated that mental health services are lacking in 40% of
countries, and 25% of countries have no budgets set aside to
address mental illness. (Stoskopf & Johnson, 2018)
HCM500 Healthcare Systems
Use this slide to add additional course lecture slides/content as
needed. Remember the lecture should be 45-60 minutes in
length, so additional slides presenting appropriate course
materials is very important.
Add talking points to expand on each item in the outline.
5
Module Lecture
Mental health is defined as emotional, psychological, and social
well-being. Mental Health influences how we think, feel, and

21. act.
It controls how we handle stress and relate to others, and it
effects the choices we make.
Mental health is important at every stage of life, from childhood
and adolescence through adulthood.
HCM500 Healthcare Systems
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needed. Remember the lecture should be 45-60 minutes in
length, so additional slides presenting appropriate course
materials is very important.
Add talking points to expand on each item in the outline.
6
Module Lecture
Some signs of mental health incidents include but are not
limited to:
Eating or sleeping too much or too little
Having low or no energy
Having severe mood swings
Feeling helpless or hopeless
Unexplained aches and pains
HCM500 Healthcare Systems
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needed. Remember the lecture should be 45-60 minutes in
length, so additional slides presenting appropriate course
materials is very important.
Add talking points to expand on each item in the outline.
7

22. Module Lecture
In its Mental Health Action Plan 2013-2020, the World Health
Organization (WHO) noted that depending upon the local
context, certain vulnerable groups may be at a higher risk of
suffering from mental health conditions. These may include:
Individuals with chronic illnesses,
Individuals living in poverty,
Individuals exposed to humanitarian emergencies (e.g., natural
disasters or conflict),
Unemployed individuals,
Victims of domestic abuse,
The elderly
HCM500 Healthcare Systems
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needed. Remember the lecture should be 45-60 minutes in
length, so additional slides presenting appropriate course
materials is very important.
Add talking points to expand on each item in the outline.
8
Module Lecture
Important
Mental illness does not discriminate—individuals of all ages,
races, religions, or income levels are affected. Mental illnesses
are true health conditions and are not the consequence of such
things as poor upbringing or a personal weakness.
HCM500 Healthcare Systems
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needed. Remember the lecture should be 45-60 minutes in

23. length, so additional slides presenting appropriate course
materials is very important.
Add talking points to expand on each item in the outline.
9
Module Lecture
Meeting the medical needs of mental health patients is a
challenge as many countries do not have adequate resources to
meet the increasing demands of the mental health population.
Individuals who suffer from mental illness and do not receive
treatment are more likely to suffer from such things as
unemployment, substance abuse, homelessness, inappropriate
incarceration, and unnecessary disability (Stoskopf & Johnson,
2018).
The costs of mental illness can be associated with such things as
lost productivity, the costs of accessing critical services like the
emergency department, and costs associated with incarceration.
HCM500 Healthcare Systems
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needed. Remember the lecture should be 45-60 minutes in
length, so additional slides presenting appropriate cour se
materials is very important.
Add talking points to expand on each item in the outline.
10
Module Lecture
What are the impacts of mental illness?
When does mental illness strike?
Is mental illness treatable?

24. HCM500 Healthcare Systems
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needed. Remember the lecture should be 45-60 minutes in
length, so additional slides presenting appropriate course
materials is very important.
Add talking points to expand on each item in the outline.
11
Module Lecture
HCM500 Healthcare SystemsIf and when you feel the need,
would you be willing to consult a
psychiatrist?Yes25.2%No74.8%Feel ashamed when visiting a
psychiatristYes14.8%Slightly31.4%No53.8%Perceived reasons
for mental illness (multiple response)Social
factors84.9%Economic factors23.5%Environmental
factors22.9%Educational factors19.2%Biological or genetic
factors1.6%Family factors1.2%Religious
factors1.4%Drugs1.0%Other factors1.3%
Responses to interviews and surveys conducted as part of a
study of knowledge and awareness of mental health and mental
health treatments among a sample of the Saudi population
(Mahmoud, 2018).
Use this slide to add additional course lecture slides/content as
needed. Remember the lecture should be 45-60 minutes in
length, so additional slides presenting appropriate course
materials is very important.
Add talking points to expand on each item in the outline.
12
Module Lecture
The World Health Organization (WHO) (2017) reported that

25. over 300 million people worldwide suffer from depression,
noting that it is the single greatest contributor to global
disability.
Violence, displacement, arranged marriages and a host of other
topics have facilitated the increase of mental illness in the
Middle East.
Unfortunately, the stigma around mental health has crippled
individuals who desperately need mental health services
(Pocock, 2017).
HCM500 Healthcare Systems
Use this slide to add additional course lecture slides/content as
needed. Remember the lecture should be 45-60 minutes in
length, so additional slides presenting appropriate course
materials is very important.
Add talking points to expand on each item in the outline.
13
Module Lecture
The Ministry of Health (MOH) has taken a proactive approach
to decrease the gap in mental health services with the
establishment of the Comprehensive Health Guidance Initiative
– Primary Mental Care Program.
Comprehensive primary mental health services needed to meet
the overarching goal of alleviating suffering.
Increase the availability of services
Make mental health care part of general healthcare
Train and license more mental health professionals
Address developmental disorders in children
HCM500 Healthcare Systems

26. Use this slide to add additional course lecture slides/content as
needed. Remember the lecture should be 45-60 minutes in
length, so additional slides presenting appropriate course
materials is very important.
Add talking points to expand on each item in the outline.
14
Module 2 Assignment Requirements
Critical Thinking Assignment
Topic: Mental Health
Key issues:
Global mental health challenges
The prevalence of mental health disorders in KSA
Access to mental health services in KSA
Barriers to receiving mental health services in KSA
Quiz
Covers Modules 1 & 2
HCM500 Healthcare Systems
Add talking points regarding the key topics and concepts
students will need to know for the assignments.
This can span 2 or more slides if necessary to clearly cover the
assignments.
Delete the assignment/discussion/quiz bullet(s) for modul es that
don’t contain those.
15
Questions
Take advantage of this opportunity to seek further clarification.
HCM500 Healthcare Systems

27. Depending on the level of the course, students may have more
questions related to the process rather than content. Encourage
questions about course content here, too.
16