Global Health

Part III: The Burden of Disease
 

Chapter 6  - Culture and Health 
Culture is a set of standards shared by a society that are generally followed by members leading to acceptable behaviors and beliefs that are learned and shared. Aspects of culture that vary across diverse societies include social groups, communication, religion, gender roles, art, politics and law, and the economy. It is important to assess the relationship between culture and health in societies because cultural practices have a huge influence on physical and mental health. 
For example, listening to health care providers, implementing maternal leave, and promoting male circumcision are practices influenced by culture that promote health. On the other hand, practices such as feeding sugar water to infants, are harmful to health. Culture also plays a big role in people's perceptions of illnesses and their causes. Keep in mind that "illness" differs from "disease." Illness is a manifestation of personal and cultural reactions to discomfort or disease. People who live in low-income countries with traditional cultural practices tend to regard illnesses such as "normal" because of its high prevalence. Low-income earning people in traditional societies are likely to see witchcraft or other supernatural phenomena as possible causes of illnesses, while people in higher-income, westernized cultures usually follow a more medical approach. When an infant is ill in a low-income setting, the parents are most likely to seek help from traditional healers rather than a medical doctor. Global health policy attempts to address different health behaviors and looks for ways to change and improve them. There are numerous models and/or theories that provide a general framework on how to encourage changes in behavior: the ecological perspective, the health belief model, the stages of change model, and the diffusion of innovations model. These models incorporate several approaches to behavior change, such as community mobilization, mass media, social marketing, and health education.

 

Chapter 7 - The Environment and Health

Our environment is the “external physical, chemical, and microbiological exposures and processes that impinge upon individuals and groups and are beyond the immediate control of individuals.” Although the relationship between environment and health is a very broad topic, this chapter focuses on three important risk factors of the burden of environmentally-influenced diseases and summarizes their costs and consequences while proposing cost-effective solutions.

The WHO defines environmental health as “those aspects of human health, including quality of life, that are determined by physical, chemical, biological, social, and psychosocial factors in the environment." Environmental health also refers to "the theory and practice of assessing, correcting, controlling, and preventing those factors in the environment that can potentially affect adversely the health of present and future generations.” The impact of environmental factors touches the household, the community, the region, and the global community. Currently, the risks of environmental impacts on health are greatest in Africa and Asia. The environmental burden of disease of developing countries results from environmental conditions that include unsafe water, hygiene, and excreta disposal; urban air pollution, indoor air pollution (from household use of solid fuels); chemical and radiologic pollution; and chemical and radiologic terrorism. 
 

Link to developing countries
Cost-effective solutions to improve environmental health do not only include implementing technological innovations, but also promoting healthy behaviors. 

 

Questions & Ethics
What approaches can we take in low-income African countries to help enhance access to better water supplies to the destitute? 
What constraints are keeping poor people in middle-income countries from investing their own resources in improved low-cost sanitation? How do we overcome those constraints?