Introduction to Global Health Promotion

Rick S. Zimmerman, Ralph J. DiClemente, Jon K. Andrus, Everold N. Hosein

• Publisher: Jossey-Bass
• Year: 2016
• ISBN:
  9781118897836
• Edition: 1
• Topic: Medicine
• Subtopic: Public Health, Administration & Care

Introduction to Global Health Promotion addresses a breadth and depth of public health topics that students and emerging professionals in the field must understand as the world's burden of disease changes with non-communicable diseases on the rise in low- and middle-income countries as their middle class populations grow. Now more than ever, we need to provide health advocacy and intervention to prevent, predict, and address emerging global health issues. This new text from the Society for Public Health Education (SOPHE) prepares readers with thorough and thoughtful chapters on global health promotion theories, best practices, and perspectives on the future of the field, from the individual to the global level. The world's biggest health care challenges—including HIV, malaria, heart disease, smoking, and violence, among others—are explored in detail in Introduction to Global Health Promotion. The state of the science, including the latest empirical data, is distilled into 19 chapters that update readers on the complex issues surrounding a variety of illnesses and conditions, and disease epidemics and individual, social, institutional, and governmental barriers to preventing them. Expert authors bring to the fore human rights issues, new uses of technology, and practical application of theory. These perspectives, along with the book's multidisciplinary approach, serve to create a well-rounded understanding of global health today. Learn more from the Editors of Introduction to Global Health Promotion here.

Chapter 1
The State of Global Health

Richard Skolnik

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Learning Objectives

By the end of this chapter, the reader should be able to:

• Explain the concepts of “DALYs” and “burden of disease”
• Outline the leading causes of morbidity and mortality globally
• Discuss the main risk factors for the leading causes of morbidity and mortality
• Explain how the leading causes of morbidity and mortality and their risk factors vary by country income group, age, and sex
• Review broadly how health communication relates to the burden of disease and its risk factors

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The state of global health has changed dramatically over the past two decades. Life expectancy has increased globally and in all regions (World Bank, 2015a). The number of under-five children dying every year has fallen from about 11.6 million in 1990 to about 6.3 million in 2013 (UNICEF, 2014, p. 4). The number of women dying maternal deaths decreased from 1990 to 2010 from about 359,000 to 255,000 (Lozano et al., 2012, p. 2122). Even in the face of HIV, the share of total deaths due to communicable diseases has fallen from 1990 to 2010, and the share from noncommunicable diseases has risen. Today, communicable diseases are the predominant cause of death only in sub-Saharan Africa (IHME, 2015).

The most important risk factors for death and disability have also shifted. Twenty years ago, childhood underweight, indoor air pollution from cooking in unventilated spaces with biofuels, and the lack of access to safe drinking water or sanitation were the leading risk factors globally for death and disability. These risk factors remain significant to the lives of poor people in low- and middle-income countries. Today, however, the most important risk factors globally relate to “behavioral risks.” These include a diet abundant in salt and saturated fats but lacking in fresh fruits and vegetables; sedentary lifestyle; hypertension; diabetes; and tobacco and alcohol use. There are now more people in the world who are obese than who are undernourished (Lim et al., 2012, p. 2246).

There has also been a change in the composition of healthy life years lost. Twenty years ago, the majority of healthy life years lost was due to premature death. In the face of lower child death rates, lower death rates for some diseases, and greater longevity, however, the predominant cause of healthy life years lost has shifted from death to disability. People are living longer. However, they are also spending more years living with disability (Institute for Health Metrics and Evaluation [IHME], 2013, pp. 24–30).

The promotion of better health requires that we understand what people get sick and die from and why they get sick and die from these causes. It is also essential that we understand how these burdens have changed in the past and how they are likely to change in the future. In addition, morbidity and mortality vary by age, gender, location, income group, and country income level. Efforts to promote better health must take account of these differences.

The objective of this chapter is help the reader understand the most important causes of morbidity and mortality both globally and as they vary across regions, countries, and groups. It also aims to assist readers in understanding the underlying risk factors and determinants of these causes. The chapter seeks to answer the following questions:

• How long do people live and how many of those years are lived in good health?
• What are the most important causes of morbidity?
• What are the most important causes of mortality?
• What are the most important risk factors associated with these leading causes of morbidity and mortality?
• How do morbidity and mortality and their associated risk factors vary across regions, countries, and groups?
• How have the leading causes of morbidity and mortality changed over time?
• How do we project that the leading causes of morbidity and mortality will change in the future?

A Note on Data Sources and Definitions

Before one begins to examine these questions, it is important to understand the sources of the data for this chapter.

Since the early 1990s, an important foundation for work on global health has been studies of the burden of disease. One of the most recent and important such studies was published in 2012: Global Burden of Disease: Generating Evidence, Guiding Policy (Institute for Health Metrics and Evaluation [IHME], 2013). A series of related articles was also published in 2012 in the Lancet. The Institute of Health Metrics and Evaluation, the lead author of these studies, also has an extensive interactive website on the burden of disease. This chapter will refer to the main IHME Global Burden of Disease report, the Lancet series, and the interactive website as the “Global Burden of Disease Study, 2010” or “GBD.”

The GBD has coherent and consistent information on the global burden of disease, and it is used extensively in this chapter. Additional data, pr...

Table of contents

• Cover
• Title Page
• Copyright
• Table of Contents
• Dedication
• Preface
• Acknowledgments
• The Editors
• SOPHE
• The Contributors
• Chapter 1: The State of Global Health
• Chapter 2: Global Health Promotion: The State of the Science
• Chapter 3: Global Health Promotion and the Social Determinants of Health
• Chapter 4: Models of Health Behavior Change: International Applications
• Chapter 5: Two Health Communication Approaches: Communication for Behavioral Impact (COMBI) and Entertainment Education
• Chapter 6: Global Health Promotion in the Context of Human Rights
• Chapter 7: eHEALTH and Global Health Promotion
• Chapter 8: Reducing Maternal and Infant Mortality: Meeting a Global Challenge
• Chapter 9: Malaria Prevention and Control
• Chapter 10: Global Immunization Initiatives from a Health Promotion Perspective
• Chapter 11: The Evolving Global HIV Pandemic: Epidemiology, Prevention, and Future Priorities
• Chapter 12: Community-Based Risk Communication in Epidemics and Emerging Disease Settings
• Chapter 13: Noncommunicable Diseases (NCDs): Moving Toward Health Promotion
• Chapter 14: Women's Cancers
• Chapter 15: Health Promotion in Families and Communities: An Integrated Approach from Latin America and the Caribbean
• Chapter 16: Oral Health Promotion
• Chapter 17: Adaptation and Implementation of Public Health Innovations in Developing Countries
• Chapter 18: Health Promotion in the Global Setting: The Role of International Organizations and Governments
• Chapter 19: The Future of Global Health Promotion
• Author Index
• Subject Index
• End User License Agreement