85598_FM_Merson.qxd:Achorn Int'l 7/20/11 1:01 AM Page i © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION GLOBAL HEALTH Diseases, Programs, Systems, and Policies THIRD EDITION Edited by Michael H. Merson, MD Wolfgang Joklik Professor of Global Health Director, Duke Global Health Institute Duke University Durham, North Carolina Robert E. Black, MD, MPH Edgar Berman Professor and Chair Department of International Health Director, Institute for International Programs Bloomberg School of Public Health Johns Hopkins University Baltimore, Maryland Anne J. Mills, MA, DHSA, PhD Professor of Health Economics and Policy Head, Faculty of Public Health and Policy London School of Hygiene & Tropical Medicine London, UK 85598_FM_Merson.qxd:Achorn Int'l 7/20/11 1:01 AM Page ii © Jones & Bartlett Learning, LLC. 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Copyright © 2012 by Jones & Bartlett Learning, LLC, an Ascend Learning Company All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the copyright owner. This publication is designed to provide accurate and authoritative information in regard to the Subject Matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional service. If legal advice or other expert assistance is required, the service of a competent professional person should be sought. Production Credits Publisher: Michael Brown Manufacturing and Inventory Control Editorial Assistant: Teresa Reilly Supervisor: Amy Bacus Editorial Assistant: Chloe Falivene Composition: Achorn International, Inc. Associate Production Editor: Kate Stein Cover Design: Scott Moden Associate Production Editor: Cindie Bryan Cover Image: © argus/ShutterStock, Inc. Associate Marketing Manager: Jody Sullivan Printing and Binding: Courier Kendallville Cover Printing: Courier Kendallville Some images in this book feature models. These models do not necessarily endorse, represent, or participate in the activities represented in the images. Library of Congress Cataloging-in-Publication Data Global health: diseases, programs, systems and policies / [edited by] Michael H. Merson, Robert E. Black, Anne J. Mills. — 3rd ed. p. ; cm. Rev. ed. of: International public health. 2nd ed. c2006. Includes bibliographical references and index. ISBN-13: 978-0-7637-8559-8 (hardcover) ISBN-10: 0-7637-8559-8 (hardcover) 1. World health. 2. Public health—International cooperation. I. Merson, Michael H. II. Black, Robert E. III. Mills, Anne J. IV. International public health. [DNLM: 1. Public Health. 2. World Health. 3. International Cooperation 4. Public Health Administration. WA 530.1 RA441.I578 2012 362.1–dc22 2011000579 6048 Printed in the United States of America 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 85598_FM_Merson.qxd:Achorn Int'l 7/20/11 1:01 AM Page iii © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION Contents About the Authors ix Acknowledgments ix Contributors xi Foreword William H. Foege xv Introduction Michael H. Merson, Robert E. Black, and Anne J. Mills xvii Chapter 1 Measures of Health and Disease in Populations Adnan A. Hyder, Prasanthi Puvanachandra, and Richard H. Morrow 1 Reasons for and Approaches to Measuring Health and Disease 2 Summary Measures of Population Health 12 Comparisons and Trends in Disease Burden 27 Burden of Disease Attributed to Risk Factors 36 Conclusion 39 Discussion Questions 39 References 40 Chapter 2 Culture, Behavior, and Health Susan C. Scrimshaw 43 Basic Concepts from Medical Anthropology 43 Theories of Health Behavior and Behavior Change 54 Common Features of Successful Health Communication and Health Promotion Programs 58 Methodologies for Understanding Culture and Behavior 59 Case Study: Use of a Focused Ethnographic Study to Assess the Acceptability of a Fortified Infant Cereal in Africa 62 Case Study: The Slim Disease—HIV/AIDS in Sub-Saharan Africa 64 Conclusion 66 Acknowledgments 67 Discussion Questions 67 References 68 Chapter 3 The Social Determinants of Health Michael P. Kelly and Emma Doohan 75 Introduction 75 The Social Determinants of Health 75 iii 85598_FM_Merson.qxd:Achorn Int'l 7/20/11 1:01 AM Page iv © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION iv GLOBAL HEALTH Type of Social Determinants 79 The Health Gradient 83 Measuring the Health Gradient 88 Implications of the Health Gradient for Policy Makers 92 Models and Explanations 93 Conclusion 104 Discussion Questions 104 References 105 Chapter 4 Reproductive Health M. Omar Rahman and Jane Menken 115 Demographic Trends and Fertility Determinants 116 Family Planning Programs 129 Impact of Reproductive Patterns on the Health of Children 145 Impact of Reproductive Patterns on the Health of Women 149 Conclusion 162 Discussion Questions 162 References 164 Chapter 5 Infectious Diseases Arthur L. Reingold and Aubree Gordon 177 Overview 177 Control of Infectious Diseases 178 Childhood Vaccine-Preventable Diseases: The Expanded Program on Immunization 180 Enteric Infections and Acute Respiratory Infections 187 Bacterial Meningitis 194 Mycobacterial Infections 198 Sexually Transmitted Infections and AIDS 203 Viral Hepatitis 209 Malaria and Other Arthropod-Borne Diseases 212 Helminthiasis 216 Zoonoses 220 Viral Hemorrhagic Fevers 223 Infectious Causes of Blindness 226 Emergence of New Infectious Disease Threats 228 Conclusion 230 Acknowledgments 230 Discussion Questions 231 References 232 Chapter 6 Nutrition Keith P. West, Jr., Christine P. Stewart, Benjamin Caballero, and Robert E. Black 243 Food Security 245 Population Spectrum of Nutritional Status 248 85598_FM_Merson.qxd:Achorn Int'l 7/20/11 1:01 AM Page v © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION CONTENTS v Undernutrition 251 Diet and Undernutrition 263 Micronutrient Deficiencies 271 Malnutrition Among Older Persons 304 The Nutrition Transition 304 Discussion Questions 307 References 308 Chapter 7 Chronic Diseases and Risks Derek Yach, George A. Mensah, Corinna Hawkes, JoAnne E. Epping-Jordan, and Krisela Steyn 345 Epidemiologic Trends: Disease Mortality and Burden 345 Common Chronic Conditions 350 Risk Factors 355 Economic Impacts and Health Inequalities 361 Determinants of Major Chronic Diseases 365 Policy Responses to the Growing Burden of Chronic Diseases 367 Preventing and Managing Chronic Diseases: What Needs to Be Done 376 The Limitations of Studies on Cost-Effectiveness for Chronic Disease Prevention 383 Management of Chronic Diseases by Healthcare Systems 383 Comprehensive Care Applied to Clinical Prevention 388 Comprehensive Care Applied to Adherence 390 Summary of Effective Health Care 391 Reorientation of Health Services to Address Chronic Disease 393 Discussion Questions 395 References 396 Chapter 8 Unintentional Injuries and Violence Robyn Norton, Adnan A. Hyder, and Alexander Butchart 407 Introduction 407 The Global Burden of Injuries and Violence 408 Risk Factors for Unintentional Injuries and Violence 416 Interventions to Prevent Unintentional Injuries and Violence 423 Advancing the Injury and Violence Prevention Agenda: Opportunities and Challenges 431 Conclusions 434 Discussion Questions 435 References 436 Chapter 9 Global Mental Health Vikram Patel, Alan J. Flisher, and Alex Cohen 445 Introduction 445 Historical Development of Public Mental Health 446 Culture and Classification 448 85598_FM_Merson.qxd:Achorn Int'l 7/20/11 1:01 AM Page vi © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION vi GLOBAL HEALTH The Burden of Mental Disorders 451 Interventions 459 Human Rights and Mental Illness 467 Global Mental Health: A Call to Action 468 Discussion Questions 470 References 471 Chapter 10 Environmental Health Tord Kjellstrom, Anthony J. McMichael, Kirk R. Smith, and Sudhvir Singh 481 Definition and Scope of Environment 481 Scale and Distribution of Environmental Risks to Health 482 Environment: Encompassing Both Hazard and Habitat 485 Environmental Health Research, Risk Assessment, and Monitoring 486 Assessment of Environmental Health Impacts and Risks 497 Some Special Considerations in Environmental Health Research 500 Determinants of Individual and Population Vulnerability 500 Pathways to the Future in an Unequal World 525 Conclusion 528 Discussion Questions 529 References 530 Chapter 11 Complex Emergencies Michael J. Toole and Ronald J. Waldman 539 Direct Public Health Impact of War 543 Indirect Public Health Impact of Civil Conflict 548 The Effects of Armed Conflict and Political