miércoles, 4 de febrero de 2009

Rates in Public Health (week 2)

Public Health
“Is the science and art of (1) preventing disease, (2) prolonging life, and (3) promoting health and efficiency through organized community effort for A- sanitation of the environment
B- control of communicable diseases
C- education of individuals in personal hygiene
D- organization of medical and nursing services for early diagnosis and preventive treatment of disease, and
E- development of the social machinery to insure everyone a standard of living adequate for the maintenance of health,
Organizing these benefits as to enable every citizen to realice his birthright of health and longevity”
(Winslow, 1920)

Measurements in Public Health
Counts
Rates – proportions
A number gives you minimal information
In order to make sense, you divide cases / population
Once you multiply this proportion by a given, fixed amount, you can compare rates
Over time
With other societies

Some Important Rates
Infant Mortality Rate
Number of children dying under a year / total births
Also: neonatal and post-neonatal mortality
Maternal Mortality Rates
Life expectancy at birth
Actuarial analysis
Population annual growth rate
Rates of prevalence of diseases
Rates of vaccination, hospital births

Infant Mortality Rate
Probably the single most important health indicator together with life expectancy
Correlates closely with per capita GDP, levels of health expenditures
Provides, in one single statistic, the general status of any given society or country

Some Issues of Poverty in Guatemala (week 1)

Basic Concepts in Health and Poverty (Week 1)

Health
Merriam-Webster:
“The condition of being sound in body, mind, or spirit; specially freedom from physical disease or pain”
World Health Organization
“A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”
(International Health Conference, New York, 1946)

WHO uses the psycho-bio-social model: Venn Diagram of Health

An example of psycho-bio-social elements impacting health
Malaria
–Biological
Presence of mosquito / parasite
Person’s natural or acquired immunity
Body response to infection
–Social
Type of housing
Availability of Health services
General sanitation in community
–Psychological
Response by patient to disease

Poverty
“The state of having little or no money and few material posessions”
The Princeton Dictionary
“In the US, the state of living in a family with income below the federally defined poverty line”
US Dept. of Economy
“A condition characterized by severe deprivation of basic human needs, including food, shelter, safe drinking water, sanitation facilities, education, and information”
Copenhagen Declaration, UN Summit on Social Development
“Poverty is set at an income level of US $ 2 or less ($2.15 for 2007), and extreme poverty at an income level of $1 or less ($1.08 for 2007)
World Bank

“For the past 8 years, we have become poorer. During the rainy season we suffer since we can only afford very little. We need many things, food above all. We do not own a place to live and can not afford to pay rent…”
A Maya K'akchiquel field hand (1994)

Official Poverty Line in Guatemala
INE – Instituto Nacional de Estadistica
–Poor: Q 6,754 / person / year
–Extremely Poor: Q 3,206 / person / year
51% of Guatemalans are poor
15.2% are extremely poor
Indigenous are 75% poor, and 27.4% extremely poor
Non-indigenous are 36.5% poor, and 7.8% extremely poor