I need the following questions answered:
500 words per question
Question 1
-How is 'innovation' important for the success of a healthcare system?
Question 2
- How will decreasing rates of communicable diseases and increasing rates of non-communicable diseases impact national health systems?
Global Health and Disease Carleen H. Stoskopf and James A. Johnson ▸ Introduction In the development and management of a coun- try’s healthcare system, an essential component is an understanding of the environment or national con- text in terms of (1) the social and cultural beliefs and behaviors; (2) the physical environment, such as expo- sures to environmental hazards, levels of sanitation, and food and water supply safety; (3) the political cli- mate, including legal issues that impact the provision of health care; (4) the design for financing health care and the distribution of health resources; (5) economic development, including poverty levels, distribution of wealth, types of industry, and agriculture; (6) other social structures, such as the education and judicial systems; and finally, (7) the types of diseases that are present in the population (morbidity) and rates of mortality, the disease burden. Assessment of the pop- ulation’s health needs in light of the national profile should drive how medical resources are distributed and health services are provided. Healthcare systems are called on to do disease prevention, primary treat- ment, secondary treatment, and tertiary treatment. Integration of the healthcare system with the public health system is essential for effective intervention in the cycles of disease that plague many populations. Public health systems can provide a variety of nonmedical services, such as sanitation improve- ments, environmental hazard control, vector con- trol, health promotion, community interventions to improve health and well-being, and setting health policy for the financing and distribution of health services. The public health systems are also responsi- ble for the surveillance of disease in populations. The activity of disease surveillance is vitally important to healthcare systems that are often called on to decide how few and precious resources are to be deployed. Understanding the disease profile of a population and the burden of disease that exists in that popula- tion is essential to planning and implementation of health programs. For example, in the case of malaria, healthcare providers must rapidly identify and treat specific types of malaria, as well as asymptomatic cases, to prevent further transmission. The public health system must work to eliminate vectors through destruction of breeding sites and use of safe and effec- tive pesticides. Equally important is the role of health educators who work with the community to change behavior by encouraging use of bed nets at night and emptying local water receptacles. Simultaneously, researchers must continue the search for safe and cost-effective new treatments, for methods to quickly identify asymptomatic individuals, and for a new vac- cine. No campaign to eliminate or substantially reduce malaria will be successful without all of these compo- nents; therefore, it is incumbent on healthcare systems to understand the populations they serve and to work with their communities through public health efforts and other social institutions to effect change. BOX 2-1 identifies the 10 essential public health functions. 21 CHAPTER 2 C o p y r i g h t 2 0 1 8 . J o n e s & B a r t l e t t L e a r n i n g . A l l r i g h t s r e s e r v e d . M a y n o t b e r e p r o d u c e d i n a n y f o r m w i t h o u t p e r m i s s i o n f r o m t h e p u b l i s h e r , e x c e p t f a i r u s e s p e r m i t t e d u n d e r U . S . o r a p p l i c a b l e c o p y r i g h t l a w . EBSCO Publishing : eBook Academic Collection (EBSCOhost) - printed on 1/28/2023 12:53 PM via WAKE FOREST UNIVERSITY AN: 1229396 ; James A. Johnson, Carleen Stoskopf, Leiyu Shi.; Comparative Health Systems Account: s8853755.main.ehost case fatality rate, that is, the rate of death among those who have the disease reported per 1,000 or 100,000 people with the disease. For example, 720 out of 1,000 men with prostate cancer that has spread to other areas of the body will die within 5 years. Mortality rates are often reported based on age groups or other demographic variables.1 A list of commonly used health indicators can be found in TABLE 2-1.2 The burden of disease is expressed by statis- tics that attempt to determine the impact of disease on a population through measuring disability and healthy-life years lost. The World Health Organiza- tion (WHO) initiated the Global Burden of Disease study in 1992 that continues to the present. The study selected disability-adjusted life years for its measure- ment.3,4 Other measures include quality-adjusted life years, health expectancies, and healthy life years.1 Implicit in these measures is the idea that one can apply cost-benefit analyses in terms of the cost to a population to prevent and treat diseases versus the cost that population pays for years lived with disabil- ity and/or early mortality from those same diseases. Healthcare providers who avail themselves of these types of measures as applied to their populations can make better decisions in appropriating scarce resources. National health policymakers can use the economic data applied to loss of healthy life years to understand better the impact of diseases upon their nation’s population and therefore its produc- tivity as measured in gross domestic product (GDP). An understanding of the burden of disease results in better decision making in terms of allocation of resources for specific programs for prevention, treat- ment, eradication, and control of specific diseases that severely impact their populations and ultimately the economic viability of the country. A good exam- ple of this is the burden that malaria places on popu- lations where it is endemic. The collection of health statistics is difficult and complicated, even in countries with well-developed health systems like the United States. Collection of these statistics requires standardized definitions of diseases, consistent standards for diagnosis of these diseases, and a well-defined population at risk for these diseases. For developing countries struggling to provide the most basic healthcare needs of their communities, the collection of useful statistics can be a daunting but nevertheless vital task. TABLE 2-2 illustrates the burden of disease, both communica- ble and noncommunicable, for the countries pre- sented in this book, allowing a comparison across counties. BOX 2-1 Ten Essential Public Health Functions Monitor health statuses to identify and solve community health problems . Diagnose and investigate health problems and health hazards in the community . Inform, education, and empower people about health issues . Mobilize community partnerships to identify and solve health problems . Develop policies and plans that support individual and community health efforts . Enforce laws and regulations that protect health and ensure safety . Link people to needed personal health services and assure the provision of health care when otherwise unavailable . Assure a competent public and personal healthcare workforce . Evaluate effectiveness, accessibility, and quality of personal and population-based services . Research for new insights and innovative solutions to health problems . Reproduced from Centers for Disease Control and Prevention. The public health system and the 10 essential public health services. http://www.cdc.gov/nphpsp/essentialServices.html. March 2014. No healthcare system can be successful without a close working relationship with the public health system. In an ideal world, they would blend seamlessly. ▸ Burden of Disease Disease is measured in many ways. In public health, the term prevalence is used to measure the number of individuals with a disease in a specific population at a discrete point in time. Incidence is the number of new cases of a disease in a population over a specified period of time.1 A vast amount of data are available on the incidence and prevalence of diseases (morbidity data) by country, states, regions, and cities and by population demographics, such as age, gender, and race/ethnicity. Disease severity is commonly measured by disease-specific mortality for that disease. Disease-specific mortality is the number of deaths due to a given disease per time, usually expressed per 1,000 or 100,000 people per year. An example is the mortality from prostate cancer (25 per 100,000 in 2000 in Germany). To communicate the magnitude of a disease in different populations, it can also be reported as a 22 Chapter 2 Global Health and Disease EBSCOhost - printed on 1/28/2023 12:53 PM via WAKE FOREST UNIVERSITY. All use subject to https://www.ebsco.com/terms-of-use of approximately 60 million deaths worldwide each year, over half are the result of chronic disease. Car- diovascular disease is now the leading cause of death in the world and is the number one cause of death in all regions except sub-Saharan Africa, where the com- bination of HIV/AIDS and malaria are the culprits. Communicable, or infectious, diseases are caused by a pathogen or infectious agent spread from person to person or from animal to person, whereas noncommu- nicable diseases are in many ways the opposite, as they do not spread from person to person by an infectious agent. Chronic diseases also tend to last a long time ▸ Noncommunicable / Chronic Diseases As we enter the second decade of the 21st century, we are also facing a growing prevalence of noncommunica- ble chronic disease. As shown in EXHIBIT 2-1, this trend is expected to be even more dramatic in coming years. Diseases such as heart disease, stroke, cancer, chronic respiratory disease, mental illness, and diabetes have reached epidemic status in low- and middle-income countries, as well as in high-income countries.5 In fact, TABLE 2-1 Commonly Used Population Health Indicators Indicator* Definition** Crude birth rate Number of live births per 1,000 people in a population during a specific period of time Crude death rate per 100,000 people Number of deaths per 100,000 people in a population during a specific period of time Specific death rate per 100,000 people (age, gender, cause) Deaths by age, gender, or per 100,000 people in a population during a specific period of time Infant mortality rate per 1,000 live births Deaths under one year of age per 1,000 live births in a population Neonatal mortality rate per 1,000 live births Deaths < 28 days of age per 1,000 live births in a population maternal mortality rate per 100,000 women deaths from maternal causes per 100,000 women of childbearing age proportionate mortality percentage of deaths that can be attributed to a particular disease, calculated out of all deaths within that population incidence rate new cases for a condition per 1,000 or 100,000 people in a population during a specific period of time prevalence (point in time) number of cases of a condition at a specific point in time per 100,000 people in a population disease-specific mortality rate number of deaths from a specific condition in a defined population group per 1,000 or 100,000 people during a specified period of time case fatality rate number of deaths among those with a specific condition per 1,000 people suffering from that condition * all indicators are per year. ** all definitions are per a defined population. data from basch pf. textbook of international health. 2nd ed. new york: oxford university press; 1999, pp. 80, 81; world health organization. who global health observatory data. https://www.cia .gov/library/publications/resources/the-world-factbook/cia. accessed june 8, 2016. 23noncommunicable / chronic diseases ebscohost - printed on 1/28/2023 12:53 pm via wake forest university. all use subject to https://www.ebsco.com/terms-of-use table 2-2 major causes of death per 100,000 population, 2016, in selected countries country all causes of death communicable diseases noncommunicable diseases injuries australia 345 14 303 28 bangladesh 847 235 549 64 botswana 1,255 555 612 88 brazil 687 93 514 80 canada 372 23 318 31 china 668 41 576 50 dr congo 1,782 920 724 137 france 369 21 313 35 germany 410 22 365 23 ghana 1,222 476 670 76 india 1,051 253 682 116 ireland 397 22 344 32 israel 363 31 311 21 japan 319 34 244 41 jordan 746 53 640 54 mexico 589 57 468 63 nigeria 1,685 866 674 146 peru 533 121 453 58 korea 389 34 302 53 russia 967 74 790 103 turkey 638 44 555 39 united kingdom 409 29 359 22 united states 488 31 28="" days="" of="" age="" per="" 1,000="" live="" births="" in="" a="" population="" maternal="" mortality="" rate="" per="" 100,000="" women="" deaths="" from="" maternal="" causes="" per="" 100,000="" women="" of="" childbearing="" age="" proportionate="" mortality="" percentage="" of="" deaths="" that="" can="" be="" attributed="" to="" a="" particular="" disease,="" calculated="" out="" of="" all="" deaths="" within="" that="" population="" incidence="" rate="" new="" cases="" for="" a="" condition="" per="" 1,000="" or="" 100,000="" people="" in="" a="" population="" during="" a="" specific="" period="" of="" time="" prevalence="" (point="" in="" time)="" number="" of="" cases="" of="" a="" condition="" at="" a="" specific="" point="" in="" time="" per="" 100,000="" people="" in="" a="" population="" disease-specific="" mortality="" rate="" number="" of="" deaths="" from="" a="" specific="" condition="" in="" a="" defined="" population="" group="" per="" 1,000="" or="" 100,000="" people="" during="" a="" specified="" period="" of="" time="" case="" fatality="" rate="" number="" of="" deaths="" among="" those="" with="" a="" specific="" condition="" per="" 1,000="" people="" suffering="" from="" that="" condition="" *="" all="" indicators="" are="" per="" year.="" **="" all="" definitions="" are="" per="" a="" defined="" population.="" data="" from="" basch="" pf.="" textbook="" of="" international="" health.="" 2nd="" ed.="" new="" york:="" oxford="" university="" press;="" 1999,="" pp.="" 80,="" 81;="" world="" health="" organization.="" who="" global="" health="" observatory="" data.="" https://www.cia="" .gov/library/publications/resources/the-world-factbook/cia.="" accessed="" june="" 8,="" 2016.="" 23noncommunicable="" chronic="" diseases="" ebscohost="" -="" printed="" on="" 1/28/2023="" 12:53="" pm="" via="" wake="" forest="" university.="" all="" use="" subject="" to="" https://www.ebsco.com/terms-of-use="" table="" 2-2="" major="" causes="" of="" death="" per="" 100,000="" population,="" 2016,="" in="" selected="" countries="" country="" all="" causes="" of="" death="" communicable="" diseases="" noncommunicable="" diseases="" injuries="" australia="" 345="" 14="" 303="" 28="" bangladesh="" 847="" 235="" 549="" 64="" botswana="" 1,255="" 555="" 612="" 88="" brazil="" 687="" 93="" 514="" 80="" canada="" 372="" 23="" 318="" 31="" china="" 668="" 41="" 576="" 50="" dr="" congo="" 1,782="" 920="" 724="" 137="" france="" 369="" 21="" 313="" 35="" germany="" 410="" 22="" 365="" 23="" ghana="" 1,222="" 476="" 670="" 76="" india="" 1,051="" 253="" 682="" 116="" ireland="" 397="" 22="" 344="" 32="" israel="" 363="" 31="" 311="" 21="" japan="" 319="" 34="" 244="" 41="" jordan="" 746="" 53="" 640="" 54="" mexico="" 589="" 57="" 468="" 63="" nigeria="" 1,685="" 866="" 674="" 146="" peru="" 533="" 121="" 453="" 58="" korea="" 389="" 34="" 302="" 53="" russia="" 967="" 74="" 790="" 103="" turkey="" 638="" 44="" 555="" 39="" united="" kingdom="" 409="" 29="" 359="" 22="" united="" states="" 488="">