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Objective 1 – Describe and explain global patterns of health, morbidity and mortality: health in world affairs.

Experts’ Tips

• As in all parts of the specification the knowledge of this section can be tested in short, low scoring questions (2 – 4 marks). Command words could include ‘define’, ‘outline the distribution of’, ‘describe the distribution of’.

• This section can also be used to test skills such as map/graph description

• You must learn how to describe a global distribution. Simple lists of the location of individual areas will not score highly; do though, name locations as examples. Distributions should be described in terms of continental areas, latitude, and development. Look for overall patterns as well as anomalies.

What you need to know:

• Health. This can be measured by crude death rates and infant mortality rates. You must be able to describe a general global pattern as well as be able to describe a world map.

• Morbidity. This refers to disease and the reporting of disease. It can be measured in Disability Adjusted Life Years (DALYs), the number of years of life lost due illness.

• Mortality can be measured by crude death rate, infant mortality or case-mortality rate (C-MR: the number of people dying of a disease divided by the number of people who have that disease).

Health in world affairs relates to the global programmes, mainly through the work of the World Health Organisation, that are designed to improve health and reduce or eradicate disease.

Questions:

1. Define the term ‘morbidity [2 marks]

2. Outline the differences between the concepts of ‘morbidity’ and ‘mortality’ [4 marks]

3. Describe the global distribution of cumulative cases of influenza (H1N1) in 2009 [4 marks]

 

Objective 2 – Provide a detailed analysis of one infectious disease (eg malaria, HIV / Aids), its global distribution and its impact on health economic development and lifestyle.

Experts’ Tips

• As above you may be asked to describe a global distribution from a map or table.

• It is useful to understand the causes of your chosen disease and how it is transmitted. There will be no direct questions on this, but it helps in your understanding.

• Questions could be asked about the impact on each of health, economic development and lifestyle individually.

• Longer questions could be asked about all three together.

What you need to know:

For your chosen disease you must be able to

• Describe areas of high, medium and low morbidity at a global scale.

• Describe in detail how it impacts on health (reduced life expectancy, increased death rate and infant mortality, incidence of secondary infections.

• Describe how it impacts on economic development e.g. Malaria causes an average loss of 1.3% of annual economic growth in some countries. It traps communities in a downward spiral of poverty, disproportionately affecting poor people who cannot afford treatment or have limited access to healthcare.

• Describe the impact on lifestyle e.g. people who suffer from HIV/AIDS live in fear of the social stigma that it brings.

• Although not stated, it is useful to know how the disease is managed, because this too impacts upon health, economic development and lifestyle.

Questions:

4. Describe the pattern shown in Figure 2 [4 marks]

5. For one infectious disease that you have studied, describe its impact on the health, economic development and lifestyle of areas affected by that disease. [15 marks]

 

Objective 3 – Provide a detailed analysis of one ‘disease of affluence’ (eg coronary disease , cancer), its global distribution and its impact on health, economic

Experts’ Tips

• As above you may be asked to describe a global distribution from a map or table.

• It is useful to understand the causes of your chosen disease and how it is transmitted. There will be no direct questions on this, but it helps in your understanding.

• Questions could be asked about the impact on each of health, economic development and lifestyle individually.

• Longer questions could be asked about all three together.development and lifestyle.

What you need to know:

• Describe areas of high, medium and low morbidity at a global scale.

• Describe in detail how it impacts on health (reduced life expectancy, increased death rate, and incidence of secondary infections). DALYs could be used here.

• Describe how it impacts on economic development. E.g. Coronary Heart Disease is responsible for 10% of DALYs lost in low and middle income countries and 18% in high income countries.

• Describe the impact on lifestyle. E.g. people who suffer from Coronary Heart Disease have to change their lives radically if they wish to survive. This can include reducing stress factors, such as work; reduction in exercise or even becoming housebound.

Although not stated, it is useful to know how the disease is managed, because this too impacts upon health, economic development and lifestyle.

Questions:

6. Describe the global distribution of one ‘disease of affluence’. [6 marks]

7. Using an example of one ‘disease of affluence’ you have studied assess its impact on the economic development of a country. [6 marks]

 

Objective 4 – Understand the issues relating to food and health – malnutrition, periodic famine, obesity. Contrasting health care approaches in countries at different stages of developments.

Experts’ Tips

• Once again this is an opportunity for the Expert to ask skill questions. These could be based on the interpretation of maps, table, graphs or short pieces of text.

• Have contrasting case studies of the causes, effects and management of at least 2 forms of malnutrition.

• Have a case study of the causes, effects and management of at least one area that suffers periodic famine.

• Have case studies of health care approaches for at least two countries at different stages of development. Know the differences between them.

What you need to know:

• A definition of malnutrition:
– Malnutrition is the condition that results from taking an unbalanced diet in which certain nutrients are lacking, in excess (too high an intake), or in the wrong proportions. A number of different nutrition disorders may arise, depending on which nutrients are under or overabundant in the diet.

• The effects of malnutrition:
– The World Health Organization cites malnutrition as the gravest single threat to the world’s public health. Improving nutrition is widely regarded as the most effective form of aid.
– According to the United Nations mortality due to malnutrition accounted for 58% of the total mortality in 2006: ‘In the world, approximately 62 million people, all causes of death combined, die each year. One in twelve people worldwide is malnourished.] In 2006, more than 36 million died of hunger or diseases due to deficiencies in micronutrients’.
– According to the World Health Organization, malnutrition is by far the biggest contributor to child mortality, present in half of all cases. Underweight births and inter-uterine growth restrictions cause 2.2 million child deaths a year. Poor or non-existent breastfeeding causes another 1.4 million. Other deficiencies, such as lack of vitamin A or zinc, for example, account for 1 million. Malnutrition in the first two years is irreversible. Malnourished children grow up with worse health and lower educational achievements. Their own children also tend to be smaller.
– Malnutrition was previously seen as something that exacerbates the problems of diseases as measles, pneumonia and diarrhea. But malnutrition actually causes diseases as well, and can be fatal in its own right.

• Types of malnutrition, examples include:
– Lack of protein leads to Kashiorkor
– Lack of vitamin B1 leads to Beri Beri
– Lack of Vitamin D leads to rickets.
– Excess of cholesterol leads to cardiovascular disease.

• Periodic famine: This refers to any place that suffers, on a regular basis, from a severe shortage of food. This leads to starvation, malnutrition and death.

• An example of a famine-struck area is the Southern Sudan. The 1988 and 1998 famines make them periodic. The causes include climate change (physical) and civil war and human rights abuse (human). This would be a good case study to have.

• Obesity definition: it is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems.

• Obesity increases the risk of many physical and mental conditions, including: diabetes type 2, high blood pressure, high blood cholesterol.

• Contrasting health care approaches could include:
– Emergent: e.g. India. Low government spending (<2% of GDP) with basic provision. Big differences between rural and urban areas.
– National Health Service: e.g. the UK. Free at source, paid for by taxation. Prescriptions and some dentistry and ophthalmology paid for.
– Socialised: e.g. Cuba. 100% funded by the government.

Questions:

8. Define the term ‘malnutrition’. [2 marks]

9. Outline the ways in which periodic famine can affect the health of a region. [7 marks]

10. Discuss issues associated with the contrasting approaches to health care that operate in at least two countries. [15 marks]

 

Objective 5 – Explain health matters in a globalising world economy – TNCs and pharmaceutical research, production and distribution, tabacco transnationals.

Experts’ Tips

• You must have a general understanding of the terms globalisation, and transnational corporation as well as being able to apply that knowledge to pharmaceutical and tobacco TNCs.

• Questions are likely to be of the short or long structured type.

• Case studies are essential.pharmaceutical research, production and distribution; tobacco transnationals.

What you need to know:

• A globalising world economy can be defined as one in which there is a growing interdependence and interconnectedness of the modern world through increased flows of goods, services, capital, people and information.

• Transnational corporations are those corporations which operate in more than one country or nation at a time. They have become some of the most powerful economic and political entities in the world today.

• Transnational pharmaceutical companies often have their research and development facilities in the home country but production elsewhere. Distribution depends on the drug in question:
– The expensive branded and patented drugs are marketed in MEDCs
– Generic drugs are much cheaper. These often form essential drugs and are used widely in LEDCs where they are used to treat many preventable conditions that might otherwise prove fatal.

Questions:

11. Discuss health issues relating to tobacco transnational corporations. [15 marks]

12. Describe and suggest reasons for the distribution of Pfizer’s research facilities as shown in figure 3. [7 marks]

 

Objective 6 – Describe and explain the regional variations in health and morbidity in the UK.

Experts’ Tips

• You could be asked to describe these variations as shown on a map, graph or table. It is useful to know the names and locations of the Government Regions to help in any description.

• This could form part of a longer structured question or an essay question.

What you need to know:

• Determining whether a population is healthy is very difficult. The UK government asks questions about general health in their census. This is a form of self-reporting, and can be very misleading, particularly about what might define ‘good health. E.g. Pakistani and Bangladeshi men and women in England and Wales reported the highest rates of ‘not good’ health in the 2001 census. However Bangladeshi men were three times as likely to visit their GP than men in the general population. Chinese men and women had the lowest rates of reporting poor health, but their visits to a GP were also very low.

• Morbidity in the UK refers to the presence of certain diseases within the population. This can be reported as cases per one hundred thousand of the population or by DALYs.

Choose at least two diseases and be able to describe their morbidity patterns in the UK.

Questions:

13. Describe the distribution of long term illness in Scotland [3 marks]

14. Describe and explain the regional variations in morbidity in the UK [5 marks]

 

Objective 7 – What are the factors affecting regional variations in health and morbidity – age structure, income and occupation type, education, environment and pollution.

Experts’ Tips

• Remember, this is a section about regional variations.

• Research whether there is a link between general good health and each of the named factors above. What are those links and how does each one affect ‘good health.’

• It would be useful have two diseases that affect the UK e.g. cardio vascular disease (CVD) and diabetes. For each one research whether there is a link between each of the named factors above, and the incidence of that disease.

What you need to know:

• How each of the factors given in the specification affects both good health and the incidence of a selection of diseases. E.g.
– In areas dominated by an older population, the general health might be reported as being low. There will be a higher than average morbidity of diseases such as CVD.
– Areas where the income is below average may well have people suffering from diseases related to poor diets.
– Areas of high pollution levels may have a higher than average reporting of lung diseases such as bronchitis.

Questions:

15. Assess the importance of the effect of age structure (this could be income and occupation type, education, environment and pollution) on the regional variation of health and morbidity in the UK. [7 marks]

16. Assess the importance of factors such as age structure, income and occupation type, education, environment and pollution have on the regional variations in health and morbidity in the UK. [15 marks]

 

Objective 8 : Age, gender, wealth and their influence on access to facilities for exercise, health care and good nutrition.

Experts’ Tips

• This is very similar to section 8 only this time differences are not limited to regions. This time it is ‘factors (age, gender and wealth) that affect peoples’ access to facilities for exercise, health care and good nutrition.

• Have a case study of an area dominated by an older population and find out which of the facilities are available and their ease of access. Then do the same for an area dominated by younger people.

• Take two contrasting areas (one that is relatively wealthy and one that is much less well off) and repeat the above.

• Gender is slightly different to the above. There are few places where there is a great gender imbalance. In this case you could be asked whether there are communities where cultural issues could have an effect on whether either males or females have the same access to the named facilities.

What you need to know:

• How does age, gender and wealth make it easy or difficult to access facilities (private/local authority/NHS) that provide:
– exercise (gyms, swimming pools, Wii facilities etc)
– health care (clinics, GPs, hospitals, health visitors and district nurses etc)
– Good nutrition (meals on wheels, organic/processed foods etc).

Question:

17. Comment on how age and wealth influences access to facilities for exercise and heath care. [15 marks]

 

Objective 9 – Provide a detailed case study on the implications of the above for the provision of health care systems.

Experts’ Tips

• Do exactly what the specification states. It would be better to use an example close to you, that you are familiar with.

• Research the topic using the Office for national Statistics web site.

What you need to know:

• How does age, gender and wealth make it easy or difficult to access facilities (private/local authority/NHS) that provide:
– exercise (gyms, swimming pools, Wii facilities etc)
– health care (clinics, GPs, hospitals, health visitors and district nurses etc)
– Good nutrition (meals on wheels, organic/processed foods etc).

Question:

18. Using a local case study, describe the implications of, and explain how access to, facilities for exercise, health care and good nutrition impact on the provision for health care in that area. [15 marks]

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