front 1 health system responsiveness (ie. what does a health system need to be responsive?) | back 1 1) data 2) descriptive statistics 3) measurement tools and surveillance systems |
front 2 descriptive statistics | back 2 mean, median, range, standard deviation of data set, etc. - prevalence of conditions / risk factors - incidence of new cases - outcomes |
front 3 infant mortality rate | back 3 number of deaths of infants (<12 months) per 1,000 live births, measured annually |
front 4 life expectancy at birth | back 4 average number of years a new baby can expect to live if current mortality trends continue |
front 5 neonatal mortality rate | back 5 number of deaths of neonates (<28 days) per 1,000 live births, measured annually |
front 6 neonate mortality rate statistics | back 6 ~4 per 1,000 in high-income countries ~40 per 1,000 LMICs |
front 7 under-5 mortality rate (child mortality rate) | back 7 number of deaths of children under 5 per 1,000 live births, measured annually |
front 8 under-5 mortality rate (child mortality rate) statistics | back 8 ~3-5 per 1,000 in high-income countries ~200 per 1,000 LMICs captures deaths among children aged 0-59 months |
front 9 maternal mortality ratio | back 9 measure of the risk of death associated with childbirth number of women who die each year as a result of pregnancy, labor, delivery, or within 42 days after delivery, per 100,000 women who deliver a live child |
front 10 2023 maternal mortality ratio data | back 10 CA - 4/100,000 MA - 8.4/100,000 LA - 58.1/100,000 |
front 11 global MMR | back 11 declined from 341 to 211 / 100,000 deaths between 2000 & 2017 |
front 12 which region has the largest percent reduction of MMR of any region (59%) | back 12 South Asia also - SSA (39%) was large |
front 13 which region has the highest MMR in the world? (2017) | back 13 South Sudan 1,150 / 100,000 |
front 14 why is MMR measured per 100,000 but neonatal morality and under-5 mortality are measured per 1,000? | back 14 it's relatively rare compared to child mortality / neonatal mortality rates produces a more meaningful, less fractional number |
front 15 fertility rate | back 15 number of births per woman |
front 16 global average fertility rate | back 16 ~2.3 |
front 17 highest fertility rate? (2024) | back 17 Niger 6.6 |
front 18 lowest fertility rate? (2024) | back 18 Hong Kong 0.8 |
front 19 morbidity | back 19 sickness |
front 20 mortality | back 20 death |
front 21 mortality rate | back 21 annual number of deaths per 100,000 population |
front 22 disability | back 22 long-term or short-term reduction in functional capacity |
front 23 prevalence | back 23 number of people with condition X at any given time cross-sectional in nature |
front 24 incidence rate | back 24 number of new cases over time per a given population that's at risk |
front 25 disability-adjusted life year (DALY) | back 25 a measure of losses due to illness, disabilities, and premature death - accounts for loss due to death and disability - requires data about prevalence and incidence Mortality + Morbidity |
front 26 goal of health policy | back 26 avert DALYs in the most cost-effective way |
front 27 health-adjusted life expectancy (HALE) | back 27 the number of years one can expect to live in good health |
front 28 risk factor | back 28 an entity (characteristic, environment, behavior, etc.) that is known to be associated with a health issue |
front 29 health professionals seek to ______ risk factors | back 29 minimize |
front 30 _______ is the lead risk factor for death and disability in high-income countries | back 30 Smoking |
front 31 malnutrition | back 31 a leading risk factor worldwide (too much, not enough, not the right kind of nutrition) |
front 32 categories covered in global burden of disease study (GBD project) | back 32 - infections and perinatal and maternal conditions - NCDs - injuries and accidents (grouped into 8 global regions - established market economies) |
front 33 findings: global burden of disease study | back 33 - high premature mortality in impoverished regions - lack of good data - NCDs and injuries play a major role (infectious diseases also critical component) - inequities among regions are enormous - findings can be very different for mortality versus for DALYs |
front 34 epidemiologic transition "ages" | back 34 1) age of pestilence and famine 2) age of receding pandemics 3) age of degenerative and manmade diseases 4) age of delayed chronic diseases |
front 35 limitations of the epidemiologic transition model | back 35 1) diseases do not occur in a stepwise fashion (in contrast to what the model states) 2) disease burden is diverse in all countries 3) health systems in all countries are needed that can address a variety of health issues 4) treatment often is prevention, so healthcare systems need to be able to provide treatment |
front 36 cost-effectiveness | back 36 1) formula proposed in '77 by Weinstein and Stason 2) for intervention to be cost-effective, its cost should be no more than 3x the per capita health costs 3) limited impoverished countries to interventions $5-15 per patient per year |
front 37 limitations of cost-effectiveness | back 37 1) cheap interventions fail to address the actual burden of disease, out-of-pocket costs, & other costs the patient experiences (also - doesn't address other factors that negatively impact health) 2) fixed costs in cost-effectiveness models that are planned for 5-10 years out fail to account for cost changes 3) too little money allocated for health in impoverished countries; failing to provide healthcare is a moral issue |
front 38 the epidemiologists's bathtub | back 38 prevalence = water in bathtub water leaking out = death recovery = water evaporating from tub incidence = faucet putting water into the tub |
front 39 '90 burden of disease (measured in DALYs) | back 39 1) diarrhea and common infectious diseases (557.39 million) 2) neonatal disorders (277.79 million) 3) cardiovascular diseases (266.82 million) (4. cancers, 5. other NCDs) |
front 40 '00 burden of disease | back 40 1) diarrhea and common infectious diseases (418.8 million) 2) cardiovascular diseases(300.06 million) 3) neonatal disorders (253.16 million) (4. cancers , 5. HIV/AIDS and TB) |
front 41 '10 burden of disease | back 41 1) cardiovascular diseases (329.07 million) 2) diarrhea and common infectious diseases (295.21 million) 3) neonatal disorders (219.25 million) (4. cancers , 5. HIV/AIDS and TB) |
front 42 2019 burden of disease | back 42 1) cardiovascular disease (393.11 million) 2) cancers (251.39 million) 3) neonatal disorders (185.89 million) (4. other NCDs, & 5. respiratory infections & TB) |
front 43 on the decline over time ('90 - '19), global burden of disease | back 43 - neonatal disorders - respiratory infections and TB - enteric infections - malaria & neglected tropical diseases - HIV/AIDS and STIs - other infectious diseases - nutritional deficiencies - maternal disorders |
front 44 on the rise over time ('90 - '19), global burden of disease | back 44 - cardiovascular disease - cancers - musculoskeletal disorders - diabetes and kidney disease - mental disorders - respiratory diseases - neurological disorders - digestive diseases - skin diseases - substance use disorders - conflict and terrorism |
front 45 staying about the same, global burden of disease | back 45 - unintentional injuries - transport injuries - self-harm - interpersonal violence - natural disasters |
front 46 burden of disease | back 46 quantity of diseases and conditions and their impact on a population - assessing this = attempting to build systems of care to achieve targets in SDGs |
front 47 Global Burden of Disease project ('90) | back 47 quantifies the impact of diseases worldwide on a regular basis |
front 48 epidemiological transition | back 48 observed shift in the types of diseases that affect populations as economic conditions improve - used disease burden to help countries of differing economic strata to assign health priorities |
front 49 Disease Control Priorities (DCP) project | back 49 burden of disease in impoverished countries impede economic development -- need to address this prioritize interventions with greatest impact on burden of disease impoverished communities (uses cost-effectiveness analyses to help policymakers set priorities in national health systems) |
front 50 health system responsiveness x burden of disease | back 50 the health of a population must be measured and understood if the health system is to appropriately respond |
front 51 reasons to quantify the burden of disease | back 51 planning, policymaking, design of delivery systems, and program evaluation |
front 52 disease | back 52 refers to conditions, illnesses, and injuries |
front 53 burden | back 53 refers to the impact of disease on a population |
front 54 disease surveillance | back 54 measurement of conditions |
front 55 why insufficient data to estimate burden of disease early on? | back 55 1) never reach medical care (get sick and die at home) 2) facilities don't have adequate diagnostic capabilities (causes of illnesses remain unknown) 3) record keepers in short supply (insufficient data to estimate BOD) |
front 56 '92, World Bank commissions WHO to quantify global burden of disease | back 56 published a series of papers in the Lancet |
front 57 sequelae | back 57 consequences of diseases - GBD sought to characterize this |
front 58 leading causes of death (wealthy versus impoverished countries) - 2021 | back 58 wealthiest quartile 1) cardiovascular disease 2) cancer 3) chronic respiratory diseases impoverished quartile 1) cardiovascular disease 2) respiratory infections and TB 3) maternal and neonatal |
front 59 age of pestilence and famine | back 59 - high mortality rate in population - caused by infectious diseases and starvation low life expectancies |
front 60 age of receding pandemics | back 60 reductions in mortality (esp. young children and infants) life expectancy increase w/ improved access to food, clean water, and infrastructure |
front 61 age of degenerative and manmade diseases | back 61 total fertility rate declines as infant mortality continues to fall major causes of death = NCDs (cancer, diabetes) |
front 62 age of delayed chronic diseases | back 62 reductions in mortality, old age, and primary prevention of chronic diseases (promotion of exercise and healthy diets) |
front 63 three dependent inputs for prioritization (GBD project) | back 63 1) understanding types of diseases and overall burden within a country 2) design of health system to respond to need of population 3) ability of govt to set priorities, ability to use instruments at their disposal *choosing interventions that could be supported within the confines of their health budgets* |