A lecture on global health delivered during the Think Global Asia-Pacific Workshop on Global Health in Medical Education, December 19, 2011, University of the Philippines Manila
This document was produced for a Webinar for the Association of Directors of Public Health (ADHP www.adph.org.uk ) on 27th April 2017 in partnership with Public Health England (PHE www.gov.uk/phe) Hertfordshire County Council (www.hertfordshire.gov.uk) and the Health Psychology in Public Health Network (HPPHN www.hppn.org.uk ).
A lecture on global health delivered during the Think Global Asia-Pacific Workshop on Global Health in Medical Education, December 19, 2011, University of the Philippines Manila
This document was produced for a Webinar for the Association of Directors of Public Health (ADHP www.adph.org.uk ) on 27th April 2017 in partnership with Public Health England (PHE www.gov.uk/phe) Hertfordshire County Council (www.hertfordshire.gov.uk) and the Health Psychology in Public Health Network (HPPHN www.hppn.org.uk ).
This presentation was given for the staff of King Fahad Medical City in Riyadh, 11-14 May, 2016
Its content included:
Ethics of public health and health promotion
Ethics of disasters and emergency medicine.
Resource allocation .
DISCLAIMER:
This presentation is based on Hussein GM, Alkabba AF, Kasule OH. Professionalism and Ethics Handbook for Residents (PEHR): A Practical Guide. Ware J, Kattan T (eds). 1st Edition. Riyadh, Saudi Arabia: Saudi Commission for Health Specialties, 2015. AND
Training material presented to the East Mediterranean Public Health Network (EMPHNET) course on Public Health Ethics (Amman, 2014)
Global Health Equity and the Social Determinants of HealthRenzo Guinto
From the workshop "Closing the Gap in OUR Generation: Reducing health inequities through action on the global and local determinants of health" held last March 5-9, 2013 in Baltimore, Maryland, USA during the 62nd General Assembly March Meeting of the International Federation of Medical Students' Associations (IFMSA). Brought to you by the IFMSA Global Health Equity Initiative (http://www.ifmsa.org/Activities/Initiatives/The-IFMSA-Global-Health-Equity-Initiative).
For more information about the workshop, visit http://www.scribd.com/doc/131377723/Closing-the-Gap-in-OUR-Generation-PreGA-Final
A presentation by Karen Nelson, MBA, MSW, RSW, of the Ottawa Hospital, made to social workers at their 2013 Annual Meeting. A very thorough overview with significant research supporting the link between Social Determinants of Health and healthcare outcomes.
(HEPE) Introduction To Social Determinants Of Health (Hepe) 1antz505
Many youth leaders are compelled to do work with community based non-profit and local public health agencies as both a service learning and philanthropic component in their development as young professionals. However, despite invaluable experiential learning, students often don\'t comprehend key overarching issues such as health disparities, social determinants of health, health policy and community organizing. To address this gap and optimize their community based work, the Health Disparities Student Collaborative (HDSC), a Boston-based student group under Critical MASS for eliminating health disparities and the Center for Community Health Education Research and Service Inc. (CCHERS), developed a curriculum for students designed to broaden their perspectives while working with local public health, non-profit/community organizations and to develop their interest and ability to visualize the power of their collective voice as students and contributors to social justice work. The curriculum utilizes peer education and webinar software and covers three main topics: Current State of Health Disparities, Social Determinants of Health, and Youth Activism on Health Disparities/Social Determinants of Health. HDSC has collaborated with local partners CCHERS/Critical MASS and the Community Based Public Health Caucus (CBPHC) Youth Council to develop this comprehensive “Health Equality Peer Education” training.
Social Determinants and Global Health
Julius Global Health, Julius Center, University Medical Center Utrecht, The Netherlands.
For more information: www.globalhealth.eu
This presentation was given for the staff of King Fahad Medical City in Riyadh, 11-14 May, 2016
Its content included:
Ethics of public health and health promotion
Ethics of disasters and emergency medicine.
Resource allocation .
DISCLAIMER:
This presentation is based on Hussein GM, Alkabba AF, Kasule OH. Professionalism and Ethics Handbook for Residents (PEHR): A Practical Guide. Ware J, Kattan T (eds). 1st Edition. Riyadh, Saudi Arabia: Saudi Commission for Health Specialties, 2015. AND
Training material presented to the East Mediterranean Public Health Network (EMPHNET) course on Public Health Ethics (Amman, 2014)
Global Health Equity and the Social Determinants of HealthRenzo Guinto
From the workshop "Closing the Gap in OUR Generation: Reducing health inequities through action on the global and local determinants of health" held last March 5-9, 2013 in Baltimore, Maryland, USA during the 62nd General Assembly March Meeting of the International Federation of Medical Students' Associations (IFMSA). Brought to you by the IFMSA Global Health Equity Initiative (http://www.ifmsa.org/Activities/Initiatives/The-IFMSA-Global-Health-Equity-Initiative).
For more information about the workshop, visit http://www.scribd.com/doc/131377723/Closing-the-Gap-in-OUR-Generation-PreGA-Final
A presentation by Karen Nelson, MBA, MSW, RSW, of the Ottawa Hospital, made to social workers at their 2013 Annual Meeting. A very thorough overview with significant research supporting the link between Social Determinants of Health and healthcare outcomes.
(HEPE) Introduction To Social Determinants Of Health (Hepe) 1antz505
Many youth leaders are compelled to do work with community based non-profit and local public health agencies as both a service learning and philanthropic component in their development as young professionals. However, despite invaluable experiential learning, students often don\'t comprehend key overarching issues such as health disparities, social determinants of health, health policy and community organizing. To address this gap and optimize their community based work, the Health Disparities Student Collaborative (HDSC), a Boston-based student group under Critical MASS for eliminating health disparities and the Center for Community Health Education Research and Service Inc. (CCHERS), developed a curriculum for students designed to broaden their perspectives while working with local public health, non-profit/community organizations and to develop their interest and ability to visualize the power of their collective voice as students and contributors to social justice work. The curriculum utilizes peer education and webinar software and covers three main topics: Current State of Health Disparities, Social Determinants of Health, and Youth Activism on Health Disparities/Social Determinants of Health. HDSC has collaborated with local partners CCHERS/Critical MASS and the Community Based Public Health Caucus (CBPHC) Youth Council to develop this comprehensive “Health Equality Peer Education” training.
Social Determinants and Global Health
Julius Global Health, Julius Center, University Medical Center Utrecht, The Netherlands.
For more information: www.globalhealth.eu
The field concerned with the study of health and disease in the defined community or group.
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The Return of Liberalism_Sagar Parajuli.pptxSagarParajuli9
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based on an enhanced understanding of culture and history, priorities, assets, partners, and promising strategies unique to and common across rural communities and regions.
Michael Meit, MS, MPH, Co-Director, NORC Walsh Center for Rural Health Analysis, NORC at the University of Chicago, Bethesda, MD
the Conditions(social, economic, and physical) in the environment- environments (e.g., school, church, workplace, and neighborhood) in which people live, learn, work, play, worship, age and system put in place to deal with the illness.
Impacts a wide range of health, functioning, and quality-of-life outcomes and risks.
These circumstances are in turn shaped by the wider set of forces; social, political and economic.
The patterns of social engagement and sense of security and well-being are also affected by where people live.
Presented by Clem Bezold and Trevor Thompson
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This presentation covers three key messages:
Climate justice (rechtvaardigheid) is a concept that should be at the heart of the climate change discourse, and is tied to the causes, consequences and interventions
Climate change results in inequitable (onrechtvaardige) health outcomes: case study of the Netherlands
Twitter & social media is a great way to tap into the climate justice conversation and hear the lived experience of people
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Maternal- and child health in Global Health
Julius Global Health / Julius Center / University Medical Center Utrecht
More information? www.globalhealth.eu
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Anti ulcer drugs and their Advance pharmacology ||
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The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...
Social determinants & Global Health
1. Social determinants of health
Week 3: Social determinants and health equities
Monday February 10, 2020 (class 3a)
Dr. Joyce Browne, MD PhD
Course Global Health, UCU
@JoyceBrowne | J.L.Browne@umcutrecht.nl
2. Social determinants
& global health
Joyce Browne, MD PhD
Julius Center, UMCU
The Netherlands
Global Health Summer School, July 2019
@JoyceBrowne | J.L.Browne@umcutrecht.nl
2
3. Learning objectives
• To understand the social determinants of health,
how they operate, and how they can be changed to
improve health and reduce health inequalities.
• Recognize and address the social gradients that
occur in a global health context
• To discuss how commercial and corporate
determinants influence heath
3
6. The social determinants of health
are the circumstances in which
people are born, grow up, live,
work and age, and the systems
put in place to deal with illness.
These circumstances are in turn
shaped by a wider set of forces:
economics, social policies, and
politics.
Definition: social determinants
6
8. Health inequalities can be defined as
differences in health status or in the
distribution of health determinants between
different population groups. (..) It is
important to distinguish between
inequality in health and inequity.
Definition: health inequities
8WHO glossary of terms
9. Health inequalities can be attributable to:
1. Biological variations or free choice
– Unavoidable?
2. External environment and conditions
mainly outside the control of the
individuals concerned.
– Unnecessary and avoidable / unjust
and unfair?
If so: the resulting health
inequalities also lead to inequity in
health.
Definition: health inequities
9WHO glossary of terms
11. Inequality or inequity in health outcome?
Can you come up with examples?
• Inequality which is not an inequity
• Inequality which is an inequity
12
12. How do you measure social economic position (social status)?
13
13. How is an individual’s social economic position
(social status) operationalized?
• Three levels:
– Individual
– Household
– Neighborhood
– (Country)
• Various time intervals
• Which factors are commonly used to describe social
economic position?
14
14. How is social economic position (social status)
operationalized?
Factors commonly used to describe social economic
position
– Education
– Income
– Occupation
– Social class
– Race/ethnicity
– Gender
15
15. Why are we talking about social determinants?
http://www.kingsfund.org.uk/time-to-think-differently/trends/broader-determinants-health 16
16. Why are we talking about social determinants?
http://www.kingsfund.org.uk/time-to-think-differently/trends/broader-determinants-health 17
17. Cite as: "Health Policy Brief: The Relative Contribution of Multiple Determinants to Health Outcomes," Health Affairs, August 21, 2014
http://www.healthaffairs.org/healthpolicybriefs/
18. Cite as: "Health Policy Brief: The Relative Contribution of Multiple Determinants to Health Outcomes," Health Affairs, August 21, 2014
http://www.healthaffairs.org/healthpolicybriefs/
20. Historical context of the Social Determinants in
Health (1)
1948
• WHO constitution: acknowledgement of “impact of social and political
conditions on health” and need for intersectoral to achieve health gains.
1950s-
1960s
• Little regard for social contexts, strong focus on technology and disease-
specific campaigns.
1978
• Alma-Ata Declaration on Primary Health / Health for All.
Asserted need to strengthen health equity by addressing social conditions
through intersectoral programs
1980s
• Limited political will
- Neoliberal governments in many European countries and the US with
market-oriented reforms in health care
- Structural Adjustment Programs for developing countries: reduced
government’s social and public spending
• At the same time: biomedical paradigm was challenged: Black Report (UK)
21
21. Historical context of the Social Determinants in
Health (1)
1948
• WHO constitution: acknowledgement of “impact of social and political
conditions on health” and need for intersectoral to achieve health gains.
1950s-
1960s
• Little regard for social contexts, strong focus on technology and disease-
specific campaigns.
1978
• Alma-Ata Declaration on Primary Health / Health for All.
Asserted need to strengthen health equity by addressing social conditions
through intersectoral programs
1980s
• Limited political will
- Neoliberal governments in many European countries and the US with
market-oriented reforms in health care
- Structural Adjustment Programs for developing countries: reduced
government’s social and public spending
• At the same time: biomedical paradigm was challenged: Black Report (UK)
22
22. Historical context of the Social Determinants in
Health (1)
1948
• WHO constitution: acknowledgement of “impact of social and political
conditions on health” and need for intersectoral to achieve health gains.
1950s-
1960s
• Little regard for social contexts, strong focus on technology and disease-
specific campaigns.
1978
• Alma-Ata Declaration on Primary Health / Health for All.
Asserted need to strengthen health equity by addressing social conditions
through intersectoral programs
1980s
• Limited political will
- Neoliberal governments in many European countries and the US with
market-oriented reforms in health care
- Structural Adjustment Programs for developing countries: reduced
government’s social and public spending
• At the same time: biomedical paradigm was challenged: Black Report (UK)
23
23. • Published in 1980 by the
Thatcher Government
(over a Bank Holiday
Weekend)
• Analysis of General
Household Survey (GHS)
data (collection started
in 1970), by occupation
as an indicator of SES
The Black Report
Full report available at: http://www.sochealth.co.uk/resources/public-health-and-wellbeing/poverty-and-inequality/the-
black-report-1980/
24
25. Class differences were
also observed for
different causes of
adult mortality
• Infectious and parasitic diseases
• Endocrine, nutritional and
metabolic diseases
• Diseases of the nervous system,
digestive system, genic-urinary
tract
• Accidents, poisonings and
violence
26
26. Historical context of the Social Determinants in
Health (2)
1980s-
1990s
•Increase in scientific evidence for SDH (e.g. Whitehall
studies, UK)
•Political landscape: (social-)democrats and continued
market system approach
2004
• Commission on Social Determinants of Health
(CSDH)
2008
• CSDH Report published
2013
• Statement of the UN Platform on Social
Determinants in Health about the post-2015
development agenda
2019
27
27. • British Civil Services
• Prospective cohort study
(1967-1977)
• 18 000 male servants
between 20-64
Conclusion:
• Social gradient based on
seniority/occupation in
overall mortality and
range of specific diseases
Whitehall I
28
28. • British Civil Service, London
offices
• Prospective cohort, start
1985
• 10,308 civil servants
between 35-55 (33%
female)
Conclusions:
• Social gradient in
morbidity for men and
women
• Causal factors identified
– lifestyle (smoking, lack of
physical activity, obesity,
biometric markers), early life
factors, the way work is
organized, work climate, social
influences
Whitehall II
Bosma et al, 1998
29
29. Historical context of the Social Determinants in
Health (2)
1980s-
1990s
•Increasing scientific evidence for SDH (e.g. Whitehall
studies, UK)
•Political landscape: (social-)democrats and continued
market system approach
2004
•Commission on Social Determinants of Health (CSDH)
2008
•CSDH Report published
2013
•Statement of the UN Platform on Social Determinants
in Health about the post-2015 development agenda
2019
30
30. Historical context of the Social Determinants in
Health (3)
1980s-
1990s
•Increasing scientific evidence for SDH (e.g. Whitehall
studies, UK)
•Political landscape: (social-)democrats and continued
market system approach
2004
•Commission on Social Determinants of Health (CSDH)
2008
•CSDH Report published
2013
•Statement of the UN Platform on Social Determinants
in Health about the post-2015 development agenda
2019
•Just Societies: Health Equity and Dignified Lives.
Report of the Commission of the PAHO on Equity and
Health Inequalities in the Americas
31
31. Just Societies
• What are differences between the report on the CSDH
and Just Societies?
32. Just Societies
• What are differences between the report on the CSDH
and Just Societies?
– Regional focus
33. Just Societies
• What are differences between the report on the CSDH
and Just Societies?
– Regional focus
– Identification of new themes as ‘critical factors slowing
progress towards the goal for people in the Region to lead
a dignified life and enjoy the highest attainable standard
of health’:
• Climate change, environmental threats, relationship with land,
continuing impact of colonialism racism and history of slavery
38. Conceptual framework differences
• Emphasis on structural racism, colonialism, and
importance of relationships to land.
• Consistent with the SDGs, but with greater emphasis on
the environment and climate change.
• More explicit focus on human rights, and greater
emphasis on inequities according to gender, ethnicity,
sexual orientation, life stage, and disability.
• Emphasis on leading a ‘dignified life’ as a desired
outcome—aligned with greater health equity.
49. Implementation of any policy or intervention
requires involvement of various actors
• Who actors/stakeholders should be involved?
51
50. Implementation of any policy or
intervention requires involvement of
various actors
Health
Development
Strategies
Multilateral
Organizations
Civil society
Bilateral
organizations
National
governments
Private sector
Philanthropic
organizations
Community - National – International
52
52. 1. Improve daily living conditions
2. Tackle inequitable distribution
of power, money and resources
3. Measure and understand the
problem and assess the impact
of action
CSDH recommendations
56
53. 1. Improve daily living conditions
Equity from the start (life course), fair
employment, healthy living and work
conditions, social protection, universal health
care
2. Tackle inequitable distribution of
power, money and resources
Health equity in all policies, fair financing,
market responsibility, gender equity, political
empowerment, good global governance
3. Measure and understand the
problem and assess the impact
of action
Monitoring, research, training
Global movement
CSDH recommendations
57
54. Just Societies recommendations
# Recommendation
1 Achieving equity in political, social, cultural, and economic structures
2 Protecting the natural environment, mitigating climate change, and
respecting relationships to land
3 Recognize and reverse the health equity impacts of ongoing colonialism
and structural racism
4 Equity from the start: early life and education
5 Decent work
6 Dignified life at older ages
7 Income and social protection
8 Reducing violence for health equity
9 Improving environment and housing conditions
10 Equitable health systems
11 Governance arrangements for health equity
12 Fulfilling and protecting human rights
58. Tobacco: example of commercial & social
determinant and effective policy (SDG 3.A)
59. Public health analysis of the power of the
corporate sector
Commercial determinants of health:
“a synergistic, multidisciplinary field that addresses the
drivers and channels through which corporations
propagate the non-communicable diseases
pandemic.”
• Expanded the term ‘corporate determinants of
health’, coined by Miller in 2013
61. Channels through which influence is
exerted
Marketing: enhances desirability and
acceptability of unhealthy
commodities
Extensive supply chains: amplify
company influence around the globe
Lobbying: impede policy barriers
Corporate social responsibility
strategies: deflect attention and
whitewash tarnished reputations
62. What is necessary for an effective response?
McKee and Stuckler (2018):
“at the heart of an extremely complex subject lies the
nature of power. An effective response to the corporate
and commercial determinants of health must address
the power imbalance between the global corporations,
which are accountable only to their owners and
shareholders, and governments, which are accountable
to their citizens”
63. Four ways corporations exert power & how
to balance this (1)
They identify four ways corporations exert power and
to to restore a balance to align corporate behavior
more to public good.
NB, power includes
• Visible power: laws and regulations
• Hidden power: access to key decision makers or
rules or procedures that include or exclude certain
groups
64. Four ways corporations exert power & how
to balance this
1. Defining the narrative
2. Set the rules and procedures by which society is
governed
3. Determine the rights, living and working conditions of
ordinary people
4. Take ownership of knowledge and ideas
65. What can be done about it?
• Challenge dominant narratives
– E.g. with social determinants: focus how people’s choices
are structured by forces outside their immediate control
– Illuminate how corporate actors share narratives
• Shape norms for health policymaking, support measures
that impose checks and balances on corporate power
– FCTC Article 5.3: excludes tobacco industry from health
policy making
• Support communities that have stood up
– E.g. US: local administrators that have adopted soda taxes,
by evaluate it’s impact
• Alignment with other social movements
– E.g. health and environment
66. Tobacco: example of commercial & social
determinant and effective policy (SDG 3.A)
67. • Social determinants play a major role in all aspects of health
and disease, and can be categorized in structural and
intermediate affects through various pathways.
• The importance of SDH and health equity is increasingly
internationally recognized and applied, for example in the
SDGs
In conclusion
74
68. Want to know more about social
determinants?
• Online Social determinants game
www.playspent.org
75
