Inequitable Burden of Disease on Reservations

 

Traditional medicine man, attempting to heal a sick tribesman. 

American Indian men and woman living on reservations today face great inequities when it comes to adverse health conditions. With more the 22 percent of all AI living on reservations this problem effects many people in an unjust manner and is something that needs be addressed.

Reap What You Sow

  Community gardens are publically owned and maintained plots of land that provide fresh, organic, and sustainable nourishment to urban communities.  The positive externalities associated with community gardens are vast and include improved diets, environmental education, and sustainability.  Community gardens are eclectic by nature, coming in an array of sizes, shapes, and biodiversity.  The usage of the lot depends mostly on size, but is also governed by some local restrictions. Community gardens have regulations in place to make sure that crops grown are done in a manner that is fair to fellow gardeners and plants in neighboring plots. Invasive or fast spreading species of crops are not allowed, which ensures environmental equity.  Additionally, gardeners may not use pesticides or products that are not approved by the Organic Materials Review Institute.

Tuberculosis

Tuberculosis (TB) is a communicable disease that is non-discriminant because it is airborne and can infect anyone.  It is most prominent in Sub-Saharan Africa, Asia, and Russia.  The populations that are usually infected are those who do not have insufficient funds and access to medical care.  Also it is more common that those who are infected live in densely populated areas so it is easily transferable.  Cure and medication is readily available but people do not have the funds to go throughout an entire treatment so the TB that they are already infected with evolves into TB type 2 which is incurable.  There are solutions and prevention that are available but it is very hard to detect because those infected do not even know that they are infected.

14 million people are living with TB

8.7 million people developed TB worldwide in 2011.

13 percent of people diagnosed with TB were living with HIV.

3.2 million people with HIV were screened for TB.

33.3 million people are living with HIV/AIDS.

Less than half of people identified as having TB and HIV started antiretrovirals.

1.4 million people died of TB - 430,000 were HIV-associated TB deaths. (Zaman, 2010) 
Visual representation of one million.

Community Health Workers: Two Snapshots from Work Around the World

The widely accepted World Health Organization’s (WHO) definition of community health workers states: “Community health workers should be members of the communities where they work, should be selected by the communities, should be answerable to the communities for their activities, should be supported by the health system but not necessarily a part of its organization, and have shorter training than professional workers” (WHO 1989).

Community health workers can be found all over the world, having administered basic health services to their communities for at least 50 years, and they all share the same goal which is to facilitate access to services and improve the quality and cultural competence of service delivery However, the strategies, techniques and approaches used by community health workers vary greatly from place to place. These reflect the unique and changing needs of regions and highlight how community health worker jobs represent both the specific individuals they serve and the challenges of the job.  This post will illustrate workers in two regions: Thailand and Uganda.

The American Healthcare Struggle

Healthcare systems play a significant role in the pursuit and promotion of global health. Including a spectrum of services, operating across a range of providers, and utilizing funding from both public and private sources, healthcare systems around the world are diverse to say the least. It would be easy to assume that the higher a nation's GDP, the higher their health status as a result of a higher quality of healthcare systems. But as safe and seemingly secure an assumption that is, you may be surprised to realize that indeed that it is not necessarily the case. Now, here in America, where we are inundated by the media outcry of how terrible the state of healthcare is within our country, that may not have come as a shock. However, when you break down the numbers and actually take a look at the statistics facing our nation in comparison to those of other high-income countries the results are embarrassing.

Figure 1:Health expenditure per capita (provided by OECD)

Global Forces of Urbanization: Slums and Urban Health

Favela in Curitiba, Brazi.

The global scale of slums is astounding. According to UN-HABITAT, one billion people currently reside in slums. That number may to grow to three billion by 2050.   People who live in slums lead less healthy lives than their more wealthy urban counterparts or even than rural folks in many places. (Friel et al, 2011, p. 862) The Global Research Network on Urban Health Equity (GRNUHE) researchers wrote, “there is something about urban living – urban physical and social environments and living conditions, and the ways of life they encourage – that cause these inequities in health.” (p. 863) But urban living is not the root cause of health inequities.

Global Health Education Through Art and Music

Advocating for public health issues has been undertaken in many ways. Music, art and dance are methods of expression that have been used for thousands of years to  express feelings on issues whether political, environmental, medical, or educational. These creative methods have been instrumental in raising  the  consciousness of communities all over the world. Artists like Juanes and Fela Kuti as well as organizations like Desert Soul use the tools of art and music to change the global health landscape and educate people.

Girl Rising airing on CNN June 16th!

Back in March we had a post on this blog about Girl Rising, a film highlighting the stories of 9 extraordinary girls from 9 countries around the world. This great film "showcases the strength of the human spirit and the power of education to change the world."

I encourage you all to check it out, and you'll have the chance on June 16th-  CNN will be airing it!

The Importance of Women’s Health

The Importance of Women’s Health

      By Elizabeth, Linh, Muj, and Zach (The Survivors)

Some preventive efforts supported by the World Health Organization (WHO) are currently being implemented in order to achieve two Millennium Development Goals: Improving Maternal Health and Promote Gender Equality and Empower Women.  One of the most valuable and important preventive care measures is providing contraception access and family planning services to all women. Not only is providing these services imperative to women’s health, but also important is establishing amongst women, their own autonomy and power to make reproductive health decisions.

Global Aspects of Alzheimer's Disease

Research suggests that both genetic and social risk factors contribute to the development of Alzheimer’s disease (AD). Although there is a demographic, socioeconomic, and cultural risk factors that all play a role in the disease process, there remain many important questions to be answered in order to understand the underlying causes of this disease. Age, family history, gender and education-level are some of the known risk factors, but cross-cultural studies have demonstrated stated later in the blog that show significant differences in the recognition and treatment of AD .  The global rises in morbidity and mortality due to this disease have led to increases in research that examine the presentation and progression of AD from an etiologic perspective. The findings from these studies can provide important insights into the underlying causes of this complex, and lethal disease.

Global Childhood Obesity

Global childhood obesity is a huge problem that society is dealing with worldwide. This is something that is very important to us as a whole. According to the World Health Organization, in 2010 there were over 42 million children under the age of 5 that were obese. This number is alarming and requires immediate action. 

Universal Healthcare for Oregonians!

Healthcare has been a constant issue and effort in America for over one hundred years. The first national healthcare effort dates all the way back to 1912 when Theodore Roosevelt was president. Two reasons why national healthcare did not happen in America is because Congress would not let it pass and the American Medical Association thought of it as “socialized medicine.”¹ It’s very hard to get such things passed on a national level so working towards it on a state level is still some progress and a huge step. Here in Oregon at least ten Oregonians die every week because they cannot afford health insurance. At least one thousand Oregonians per month face bankruptcy issues that are caused by healthcare. The American private healthcare insurance system and or companies create higher administrative costs than any single payer health program in the United States, or any other universal healthcare insurance plan in the industrialized world. How much of Americans’ premiums go towards the administrative costs of private health insurance? About forty percent of our premiums from health insurance go towards the administrative costs of private health insurance.

Investment in Technology for Global Health

On a recent 60 minutes, Bill Gates introduced some of the newest technological achievements that the Bill & Melinda Gates Foundation has been developing. One of these is a thermos that can maintain the proper conditions for a vaccine for up to fifty days despite the weather and transportation. Another advancement that was discovered during an innovation contest held by the foundation is a toilet which does not require plumbing for areas without restrooms or running water. It is clear that although these innovations cost money and take time to develop, the results are amazing and can change lives. 

Consumption of the Poor

The Consumption of the Poor is about the prevalence of tuberculosis late in the twentieth century. The chapter opens by challenging the claim that the high prevalence of tuberculosis in the late twentieth century was a “return” of the disease—this claim implies that tuberculosis prevalence had gone down over the years, an assertion the author of the chapter disagrees with. According to the chapter, not only was 1995/6 the deadliest year of TB deaths than any other year in history, but TB has also been around throughout the century, contrary to the belief in some discourse that it had abated or had been eradicated. According to the chapter, tuberculosis has continued to affect poor communities and communities of color in the United States, and poor people in the global South. Poverty, racism, and lack of social justice have all played a role in many incidences of TB, as has the HIV Aids pandemic. 

Good microbe, bad microbe.

In global health, sometimes our best friends and worst enemies are quite small. Microscopically small. Despite their modest size, microbes have served to shape the health and well-being of communities throughout history. As an epidemiologist and public health preparedness researcher, my work has often led me to focus on pathogens – those microorganisms that have the potential to cause disease in their host. The pathogens that tend to capture my attention are ones that are novel, that might be introduced or re-introduced into non-endemic regions, or that have outbreak or pandemic potential. In this post, I will provide an update on two novel viruses that have recently caused global concern, the influenza A (H7N9) virus circulating in China and the novel coronavirus that has emerged in the Middle East. But, before I do, I would like to interject some kind words for microbes, which often get a rap because of the rogue few that cause so much damage. As a recent New York Times article reminds us, the human body is mostly microbe – for every one human cell, there are approximately 10 microbes that take residence in our bodies and provide vital functions and health benefits in ways that we are just beginning to understand. Ok, now on to the bad guys…

Communicable Diseases

Communicable diseases are very interesting to me. It is also a very important topic that I think everyone should be aware of. Communicable diseases have accounted for about 40% of the disease burden in low and middle income countries (Skolnik, 2012). I thought I knew enough general information about communicable diseases, however there is always something new to learn.

What's wrong with our food system?

I came across this great TED talkby an 11-year-old, Brike Baehr.

11-year-old Birke Baejr presents his take on a major source of our food -- far-away and less-than-picturesque industrial farms. Keeping farms out of sight promotes a rosy, unreal picture of big-box agriculture, he argues, as he outlines the case to green and localize food production.

Urban Livestock

Another excellent article from NPR that I'd like to share with you! Eliza Barclay shares "African Cities Test the Limits of Living with Livestock" today, focusing on the health and economic benefits of keeping urban livestock.

Urban Food Centers of the Future!

I came across a great article today on NPR's website discussing the opportunities and challenges inherent in urban food centers, specifically vertical farms. While there have been increasing reports on vertical farming in the news of late, this piece by Michaeleen Doucleff speaks to the realities of food production using this method, focusing on the role of LEDs. Food for thought- enjoy!

Getting Involved in Global Health

When it comes to Global Health, this is a new topic for me that I'm exploring. I happen to be planning a trip abroad to volunteer in the Dominican Republic. I will be doing my traveling with International Student Volunteers (ISV).

The traveling consists of helping build homes, teaching English & health, after school programs, and more. Since the topic of global health is new to me, I wanted to do some exploring online. I was able to find information on Global Health Force. The focus on their program is to deliver medical services and supplies to understand areas around the world. I was able to read some posts on their site that is reflecting on trips that their program has previously made to the Dominican Republic. Here I was actually able to get a better understand of global health that is happening in this area. They actually have some of the same plans when going over seas to help with conquering global health. It was interesting when reading some of their reflections though because you were able to see that although they were well prepared to help with personal hygiene and more, when they went there, their plans changed. I was able to learn that going into these foreign countries, you actually find yourself getting more emerged in the culture.

I'm curious to know, has anyone else studied or volunteered abroad? What experiences have you had when you found yourself in another country? Seeing the experiences of others helps me with having something to look forward to and helps with knowing what to expect. It would also be nice to hear about what challenges I should expect.

Overall, when it comes to global health, this is still new to me but I'm interested in learning more. When it comes to volunteering abroad, this is something that I'm really looking forward to and the more I know the better. In addition to the International Student Volunteer program and the Global Health Force are there any other programs that help students explore the opportunities of volunteering and studying? At the moment while I'm still learning, these programs are interesting me in helping to learn more about global health.

Global Health Force posts

Thank you,
Angela Frazier