Intl health ch 3 Discuss the relationship between health, education, and development. 1) Explain the three ways health and education are linked. Provide an example of each. 2). Why is the education of women so important to a countries health? Please provide some examples. 3) Explain how health and the economy are linked. Provide examples. 4) Explain how health costs and poverty affect health. Provide examples. 5) What is health equity, inequality and disparities, how are they different and why are t hey important in understanding health outcomes globally? 6) What are some important access and health coverage issues to consider? Provide one example and explain why it might be important globally as well as domestically. 7) What are some of your main take aways when looking at health disparities data on pages 61-64, and cost expenditures data on pages 65-67? 8) Explain the economic and health links for guinea worm infections in Sub -Saharan Africa. How was the efforts to eradicate guinea worm successful? In economic terms what is the best why to determine the effectiveness of the program? Health and education are linked in three major ways:intergenerational links, meaning that the health and education of parents influence the health and education of their children; malnutrition and disease affect cognitive development and school performance; education enables people to better prevent and manage illness (1). Even in the US today it is much less common to find first generation college students. Additionally, parents of poor health often keep children at home to help as caretakers. Ill or malnourished children have decreased school performance due to lack of concentration or cognitive development. These under-educated people also lack knowledge of basic health issues and how, when, and where to receive treatment for them, even in such simple things as childhood vaccinations. Women’s education is critical to the health of their family. Women are usually the water gatherers and food preparers in a family. Much disease can be prevent with attention to water quality and appropriate food storage. Some studies show a huge decrease in child mortality for women with just a primary education over no education. Apart from education, health has an important influence on the economy of individuals and the country. Healthy people can work more productively and for more years, enabling more income for their family as well as more production for their company and thereby community. An example was given in Indonesian rubber workers in which their productivity increased 20% after deworming (1)! The cost of illness is devastating to many families. From my personal experience in developing countries, a cow or goat is often sold to pay for medical bills, decreasing the available food production or future income-generating offspring. Further, travel to a healthcare facility involves multiple family members who then cannont tend the household or work, rather must stay near the hospital and in many cases provide food and basic care for the patient. This often pushes people well below the poverty line. Health equity is the achievement of health and the capability to achieve food health in the context of social justice, structures and allocation of resources. Health inequality is the “differences in health status or in the distribution of health determinants between different population groups.” (1) Health disparities are differences in health attributed to social or economic disadvantage. Equity often refers to fairness, while equality refers to outcomes, or the application of equity. These are important ways to talk about the multifactorial nature of health care in various groups or individuals as well as systems. Differences in location, income, gender, ethnicity among other factors create vast differences in healthcare access and coverage. A female living in a poor area far from a hospital in a male-dominated society faces a lack of empowerment to seek healthcare, lack of resources to pay for care and a physical inability to travel vast distances to find care. We probably envisioned a rural setting in a developing nation as we read this example, but it could just as easily be an inner-city woman of a marginalized ethnicity in the US. Money can’t buy happiness, but it certainly appears to buy health! From education, vaccinations, family planning, and birth attendance, higher income lead to much improved outcomes. Money, education, and social power often go hand-in-glove, especially for different ethnicities within a region. Concerning health expenditures, there is some correlation with expenditures and life expectancy, but not as direct as expected. Educational campaigns and low-cost/high benefit programs like vaccinations may do much more than higher cost expenditures on more chronic disease states. The guinea worm eradication program involved policy and economic buy-in from many countries to launch the program. The cost-benefit of the program has been fantastic though, with the increased productivity of the population who no longer suffer from the disease. Knock-on effects of this include higher levels of education for the children as they can attend school (before they missed due to personal infection or from taking on household duties of affected adults). Buy-in from local leaders to educate the population and track and monitor cases was the critical step. The eradication has been very successful, but there has been a significant reservoir noted in the domestic dog population who continue to release larvae in the water. Campaigns are ongoing in some regions to educate people to tether infected dogs out of the water sources, and reduce overpopulation. The CDC/Carter Center initiative is now offering an incentive in Chad of $20 and stout chains with locks to keep infected dogs chained until worms are removed (2). References 1. Skolnik, R. Global Health 101. Burlington, MA : APHA Press, 2016. 9781284050547. 2. A, Carrozza. Canine Guinea Worm Infection Sparks Global Concern. American Veterinarian. [Online] June 27, 2018. https://www.americanveterinarian.com/news/canine-guinea-worm-infection-sparksglobal-concern. Objectives P 50 almost all highlighted, 1st sentence in each paragraph of ways health and education linked-education most imp. 3 opinions of quality of health equity-make own from the 3. Bulleted lists of access, distribution, social capital etc. Skilled attendant birth percentage equity vs income. Equity and gender-female is dangerous to health Power, education, income and ethnicity. Themes from figure on health expenditures Video 5 The program in Mexico includes conditional cash for raising healthier, better educated kids. This helps break a generational cycle of poverty by providing supplemental income so the children can go to school instead of working. It is a change in the source of income from child labor to the supplement which increases with higher education. Nutrition education and healthcare visits are required and the children experience better learning outcomes as their health improves. Females are “worth” more money than boys to encourage this often under-valued and under-educated group to be educated. This, in turn, will lead to potentially fewer, but healthier children in the next generation as not as many children will be needed to work for the family and hope that some survive to adulthood. This certainly is helping this batch of children in the present, but there are still concerns about their future with the lack of jobs available, even for more educated laborers. Video 6 Unicef is raising awareness about kids in conflict zones and refugees and their lack of access to education. As we look forward to a snow day and the excuse to escape a day of school, many children in conflict zones are dodging landmines to go to school, or setting up schools in caves to be sheltered from bomb threats. The UN estimates that 4 million school-age refugees are not enrolled in school. These displaced peoples are in an interminable cycle of poverty and poor health that will be worsened by the next generation’s lack of education. Only 2% of relief aid goes to education. Thinking beyond the current, immediately apparent needs of shelter and food are critical after the first week of a crisis to avoid a downward spiral that may take generations to reverse.