Child Mortality.

I had to initially skip child mortality because it is kind of hard to talk about. I can tell you all how important it is to get vaccinated or how we need more education but when it comes to literally talking about children dying because of preventable things it is kind of hard. 

From a lecture I had in one of my classes we learned that 6.6 Million children are dying every year. That number may not seem very large to some people but once you consider that it is just children under 5 it gets a little scarier. 

The top 6 causes of child mortality are

1. Neonatal causes 

2. Pneumonia

3. Diarrhea

4. Malaria

5. Measles

6. AIDS

Almost 40% of children die in the neonatal period (under 28 days old) which makes sense that neonatal causes would be the number 1 killer. These causes are usually hard to deal with but if there was more maternal health care, like what was already discussed then this would help with these issues. 

I also already spoke about Malaria and AIDS. The same issues that exist in adults also exist in children but the issue can be exacerbated because children have weaker immune systems. 

That leaves pneumonia, diarrhea, and measles. There is a vaccination for measles so you can refer to my last post about diseases to read more about the importance of those. To most Americans, pneumonia and diarrhea are not really life threatening issues. If our pneumonia gets really bad then we go to the hospital and we can usually be treated. Diarrhea isn't really a problem for us unless to persists for too long because we have effective ways of treating it. These diseases truly are life threatening to children in developing nations. These are two treatable diseases that are killing children all the time. To me, it is seriously depressing that half of the top 6 killers of children are easily preventable and not even an issue in developed countries. That is a sign to me that things need to change and they need to change now. 

Reduce Diseases

We are going a little out of order here and skipping to the 6th Millennium Development Goal. But I promise I will come back to Child Mortality.

The reduction of diseases is probably the most obvious one of the goals that relates to public health. The exact wording of the goal is "To Combat HIV/AIDS, Malaria, and Other Diseases". 

HIV/AIDS is one of the scariest diseases for people to think about. People often believe that having a positive test for HIV is a death sentence. That is not true.

Now there are some amazing drugs that can really help help slow down the progression of HIV into AIDS and it is believed by some people that if people follow their medication routines perfectly then the progression can be stopped all together. One of the most common drug cocktails that is used right now is called HEART. While these drugs are extremely helpful they can cost about $14,000 a year and if you are living in a developing country and making barely a dollar a day there is no way you can afford to get the treatment you need. If there were a more cost efficient way to combat HIV/AIDS then many more people would be able to survive.

Malaria is an extremely difficult disease to deal with because there is no vaccination and one of the most effective ways to prevent contracting Malaria is by taking a daily medication. I have had to take Malaria medicine twice and I can tell you just how hard it is to remember to take it every day. Especially if you have side effects like I did. Trying to get people to take a daily pill is impossible. The use of bed nets can seriously cut down on the spread of Malaria but if people do not even have real homes then how it a bed net going to help them?That was just a kind of depressing little bit there but Malaria is really hard and I personally can not think of a good way to deal with it. 

It is hard to discuss other diseases because there are so many. There are infectious diseases, chronic diseases, neglected tropical diseases, and diseases that come from parasites. Those are very broad groups that somewhat overlap but gives you a sense of how many diseases there really are. There are so many diseases that not all of them can get the exposure they require. This is an issue because if people don't know about a disease then how are they going to be able to combat this disease? But since it is such a broad topic I will just narrow in on one way to combat these diseases that I have already slightly touched on. 

Vaccinations.

Vaccinations are one of the simplest way to prevent the spread of disease. Smallpox has already been eradicated from the earth due to the vaccination and other diseases are on the way out. But these diseases can not be completely eradicated if vaccines are not being used. My main public health question is why vaccines are not being used every where all the time? I understand that there is a cost and some logistical issues but wouldn't to be easier to give vaccines always and everywhere.

Vaccinations are not really a suitable way to treat HIV/AIDS and Malaria but for most serious communicable diseases there are vaccines. These vaccines are a fairly simple way to really cut down on the world wide disease burden. 

Gender Equality.

The third Millennium Development Goal is to Promote Gender Equality and Empowering Women. The hardest part about gender equality is that the least healthy and poor countries often have the most gender inequality. I am not saying that gender inequality leads to poor health but it can often be a factor in prohibiting the improvement of health. 

For example, the average life expectancy in Afghanistan is about 50 years. That is in comparison with the US which has an average life expectancy of 78 years and Monaco which has the highest life expectancy of 89 years. The low life expectancy in Afghanistan probably has something to do with the war currently happening there but it also has to do with gender inequality.  Women do not have very many rights in that society and will probably not get the health care they need because of it. I believe that gender equality is important in every society but sometimes people focus on unimportant parts of gender inequality. Once everyone in the world has the same basic rights then we can start getting more nit-picky about more philosophical rights.

If women live in a society where they have similar rights to men then they have more opportunity but they need to be empowered. One way that progress is being made on empowering women are micro loans. There are a few different companies that are giving micro loans for women in developing countries that they can use to create their own small businesses. It has been proven that when women earn income they are more likely to use that income to benefit their children. This mean of empowering women helps to strengthen families and can lead to healthier communities.

Another one of the Millennium Development Goals is to improve Maternal Health. Maternal Health is something that is often overlooked in our society. Many people do not know how prevalent maternal deaths are in today's world.

Maternal Health relates to all health problems that a woman might experience while she is pregnant, during delivery, and postpartum. The main reason for lack of maternal health is a lack of access. The World Health Organization (WHO) suggests that women have at least 4 visits with a doctor during pregnancy. In most under developed countries around the world women are not getting any prenatal care. This lack of care leads to so many complications. With this lack of care it means that the probability of death for both the mother and child are high.

This problem is huge but some simple fixes. If skilled birth attendants were trained and lived in villages where women were giving birth, the death rates would drop substantially. The skilled birth attendant could help with routine births and know when to get the woman to a doctor if she is having complications. The training of these attendants would be time intensive but the overall benefit would pay for itself.

Gender inequality and maternal health go hand in hand. Women around the world are not getting the respect and help that they need. If gender inequality can be eliminated and maternal mortality can be decreased then there would be a huge impact on overall health. Women are a key part of society and if women are healthy then they are able to strengthen their families, communities, and the overall public health.

Education.

Achieving universal primary education is in my mind, one of the most important Millennium Development Goals. I believe that education is truly one of the best ways that we can change the world. If people are educated they be more able to have good jobs and to help their community. Education is really the best way to promote change.

Source

Education is also a way to promote good health. The more education someone receives the higher the likelihood that they will be better equipped to take care of themselves. They also know more about how disease spreads and will be able to help stop that spread. 

Education is also helpful in family planning. People that are less educated tend to have more children. Those children are then more likely to be less educated creating a horrible cycle of uneducated people who also tend to be poor. The more educated a woman is the more likely she is to be in control of her fertility cycles and to know to use some form of contraception.

People often assume that education can be increased simply by building schools. Infrastructure is obviously necessary but it is not the only part. How do you get teachers there? And even more importantly, how are you supposed to pay your teachers if your students are too poor to pay for school? It would be ideal if once the schools were built there would be no more additional costs and all students could just attend for free. It would be even better if parents could get financial help if their children attend school.  But as you know, the world is not ideal.  Teachers need to be paid, parents don't have the money to send their children to school, schools don't have the supplies they need, and children don't have a way to get to school. The list could go on and on. There are so many problems with getting universal education that do not have simple fixes.

Overall, education is a key part of public health. Without education, promoting health is nearly impossible. So while it may not seem like education is related to health, it is a key part of making sure people have the ability to have good health. 

Poverty and Hunger.

Poverty and hunger are two of the biggest issues plaguing the world today. These two issues effect literally every community on the earth. No one is immune to having poverty and hunger in their societies. That is truly terrifying if you think about it. The fact that even in affluent places like Salt Lake City, where I live, there are still billboards that advertise that 1 in 5 children are at risk for hunger. That is seriously concerning to me. 

It is generally understood what poverty is but there are some specific scientific ways to describe poverty. In the United States a family of 4 is considered to be below the poverty line if the total household income is under $23,550 per year. The poverty line for a single person is earning less than $11,490. Globally it has been established that if a person earns less than $1.25 per day then they are in poverty. That means that if the US followed global poverty standards anyone that made more than $456.25 was not in poverty. I think this is a good indicator of how great a disparity there is between the developed and developing countries. 

It should also be stated that most developing nations do not have the resources to assist those living in their country that are needy. If you are only making $400 per year then survival is going to be extremely difficult especially if you are not getting any financial support from your government. If you are barely surviving on your income then how are you going to be able to have good health. If you live in poverty then making any sort of strides towards better health is nearly impossible. Most people can only afford to even think about their health when they are sick and even then, they do not have the resources they need to get healthcare. 

Hunger is obviously a huge public health concern. If you do not have enough to eat or you are not getting the proper nutrition from the food you are eating then it is guaranteed that you will not be healthy. It is estimated that around 850 million people are suffering from hunger or under nutrition. That is about 1 in 8 people globally.  This hunger can stem from poverty but it can also come from conflicts like war, natural disasters, or famine.

People that live in poverty or are hungry are highly likely to be unhealthy. If you can not afford basic necessities the likelihood that you will be worrying about your health is very low. Poor and hungry people do not have the physical resources to think about health and all the stress from being poor usually means they do not have the mental resources to think about their health either. Health is heavily impacted by people's economic class.

Global Health Issues.

So I told you in my last post that my ideal role in public health is to be involved in global health. I think that most people know that health around the world is not all that great but I don't think that everyone knows why it is so poor and what the actual issues are. I will be honest and say that until a little while ago I wasn't very aware of what exactly the issues are so I don't blame anyone for not knowing. 

I think the best way to start looking at what issues are really contributing to poor global health is to look at the Millennium Development Goals.

The Millennium Development Goals were set by the United Nations in 2000. These goals were set with the idea that they would be achieved by 2015. We have a long way to go with the goals but good progress has been made. 

1. Eradicate Extreme Poverty and Hunger

2. Achieve Universal Primary Education

3. To Promote Gender Equality and Empowering Women

4. To Reduce Child Mortality Rates

5. To Improve Maternal Health

6. To Combat HIV/AIDS, Malaria, and Other Diseases

7. To Ensure Environmental Sustainability

8.To Develop a Global Partnership for Development

Not all of these goals are explicitly related to health but I think that all of them can be applied to general health outcomes. I also think that they address the biggest health issues currently plaguing the earth. I will go into more depth on each of the goals later but I think that they provide a good framework from which to start examining global health issues.

In addition to these issues that are being worked on by the Millennium Development Goals there are issue like sanitation, war, disasters, access to healthcare, population, and corrupt governments that can lead to poor health. These issues are all so complicated that there is really no simple solution.  Many people believe that more money is the best and only solution but that just is not true. You can throw money at problems all day long but unless there is a good infrastructure in place to receive and distribute the funds then no significant progress will be made.

My role in public health.

Now that we have established what public health is, let me tell you a little bit about what I hope to do in public health. 

I have been extremely blessed to be able to do a fair amount of traveling through out my life, and some of those places have been in extreme poverty. Seeing that poverty and seeing how horrible the health of those people are made me want to do something about it. Most of the things I wanted to do were not very plausible and would have left me living in the poverty I was trying to help. But luckily for me, Public Health is a credible field that I can make a career out of and help people.

Once I graduate with my undergrad and hopefully go onto get my Masters in Public Health I want to work in international health promotion. My ideal career would be to be a program manager for a health focused non-profit. I LOVE traveling and would be perfectly happy with traveling often but I am not sure that I want to live internationally. But if that is what I need to do to help progress my career and to do that most good then I am definitely willing to do it.

Let me explain a little bit more about precisely what I want to do. I will use my two biggest interests as examples. I am very passionate about vaccines and how helpful they are in preventing infectious diseases. I would be thrilled if I could work for an organization that worked doing immunizations in developing countries. I am also extremely interested in Maternal Mortality. I know of many programs that I would be amazing to work for that help find ways to prevent maternal mortality and promote women's health.

I hope that helps explain a little more about what exactly I want to do and where I see my career going. Public Health is such a broad field that sometimes it is hard to know exactly what people mean when they refer to public health as a career.