HCR4001
Social, political, and environmental issues in International Healthcare
Assessment: Essay
Table of Contents
Introduction_50
This assignment is all about identifying the social, economic, and political issues experienced by the international healthcare sector. While carrying out this assignment, three tasks are to be performed, where some major concepts such as CHD (Coronary Health Diseases), its diagnosis, management, aetiology, risk factors, effects of economic, political, and social issues on a developed nation, and a developing nation, and a reflective account are to be explored. For instance, occupational stress increases the risks related to CHD, where occupation stress refers to a harmful physiological and psychological reaction, which occurs when a person’s workability with needs followed by own resources cannot adapt to the work-related requirements (1, p.1). Hence, the developed nation is the France and the developing nation is Brazil in order to move forward in this assignment.
Body
Task A: Outlining the key risk factors for CHD and the key features of CHD
Overview of CHD with its symptoms and some numbers of global prevalence_200
NCDs (Non-Communicable Diseases), also known as chronic diseases, are not transferred from one person to another; however there are four types of NCDs such as cardiovascular diseases, diabetes, chronic respiratory diseases, and cancers. Thus, CHD belongs to NCDs, for instance, CHD refers to a type of heart disease, which develops whenever the arteries of an individual’s heart fails to deliver enough oxygen-rich blood to the heart. CHD is the leading reason of death in the US. Its symptoms vary from person to person even if the person has the similar type of CHD. However, since many people are asymptomatic, they do not know they have CHD until they experience chest pain, sudden cardiac arrest, or heart attack. Its symptoms include discomfort or chest pain, shortness of breath, light-headedness, weakness, nausea, discomfort or pain in the shoulder or arm. Prevalent cases regarding total CHD nearly doubled from 271mn, 95% uncertainty interval [UI] that is 257 to 285mn in 1990 to approx. 523mn in 2019, and the no. of CHD deaths increased readily from 12.1mn in 1990 to 18.6mn to 2019.
How CHD is diagnosed_200
Certain intelligent systems utilizing techniques such as artificial neural networks, fuzzy logic, and ensemble-based method are developed to diagnose the CHD from a structured Electronic Health Record or EHR (2, p.288). A number of tests are utilized to diagnose CHD, for instance, ECG (Electrocardiogram), blood tests, MRI scans, X-Rays, exercise stress tests, echocardiogram, coronary angiography, and radionuclide tests. CHD is often diagnosed after a risk assessment along with further tests is performed. If a General Practitioner finds a person might be at risk of CHD, the GP may do a risk assessment for heart attack, stroke or cardiovascular disease. The GP asks about that person’s medical with family history, checks his/her Blood Pressure, and conducts a blood test for assessing his/her cholesterol level. A list of criteria based on which CHD is diagnosed a high level of blood pressure, unhealthy level of blood cholesterol, LDL (Low-Density Lipoprotein) cholesterol is considered as bad one as it causes plaque build-up in arteries, however HDL (High-Density Lipoprotein), is good as a higher level provides some protection against heart diseases, diabetes mellitus, and high obesity. Furthermore, genetic factors play some role in heart disease, high blood pressure, and other associated conditions. Age can be a criteria as risks go up as a person ages, race and ethnicity matter as heart disease is found to be the leading cause of death for the people belonging to the most ethnic and racial groups across the US, along with American Indians, White people, Alaska Natives, and African Americans.
Aetiology of CHD_200
Chronic diseases of lifestyle seem to be a group of disease, which share similar risk factors as a result of exposures over many decades, to high blood cholesterol, obesity, diabetes, unhealthy diet, possibly stress, lack of exercise, tobacco addiction, high BP, and diabetes. The aetiology of CHD includes age, growing older can increase an individual’s risk of narrowed, damaged, weakened or thickened heart muscles, sex, men are found to generally to be at risk of CHD, family history, a history of high blood pressure and insulin increases the probability of experiencing CHD, smoking, nicotine tightens a person’s blood vessels, heart attacks are common in a smoker, and, high BP, high or uncontrolled BP results in thickening and hardening of arteries resulted in narrowing the vessels via which blood flows. In addition, aetiology includes obesity, excess gained weight worsens other risk factors leading to CHD, blood cholesterol, high level of cholesterol in blood increases the risks of forming plaque and atherosclerosis, diabetes, it increases risks of CHD, both the conditions share same risk factors such as high BP and obesity, stress, unrelieved stress can damage arteries and further worsen other risk factors for CHD, physical inactivity, lack of physical activities is associated with different forms of CHD, and poor dental health, if a person’s gums and teeth are not healthy, then germs may enter the bloodstream and the travel to his/her heart causing endocarditic. The risk factors include mean concentration of cholesterol, systolic blood pressure, diabetes, smoking, overweight, physical activity, and obesity, along with all standard treatments for heart failure and CHD (3, p.3). Baldness could also serve as an early predictive marker for CHD, where MBP (Male-Pattern Baldness) is considered as a moderately increased risk for CHD (4, p.6).
Disease Management_200
Treatment of CHD often indulges lifestyle changes, and whenever necessary, specific medical procedures and drugs. Treatment directs the patient making a commitment towards the following health lifestyle chances, which could go a long away to promote a healthier artery
When an individual gets addicted to smoking, “Quit Smoking is essential”, high blood cholesterol level is the circumstance, when healthy diet is the immediate call, feeling unhealthy, fatigued, stressed, tired, and short of breath is the circumstance, when physical activity is needed. Obesity is the call, when loss of weight is needed, and high Blood pressure with depression, unbalanced personal and professional life is the circumstance, when working on stress becomes mandatory.
Different drugs can also be used to treat CHD, along with:
Health concepts with definitions
Diseases and health cannot be defined merely with respect to mental, anatomical or physiological attributes, although their actual value seems to be the ability of an individual for functioning in such a manner that is acceptable to her/him, and to the group the individual belongs to. As per the WHO (World Health Organization), health refers to a state of complete mental, social, and physical well-being, however, not merely the absence of infirmity or disease (5, p.2). It seems to be challenging for discovering a specific formula to define “health”, which is broad enough for encompassing the requirements of every person. However, the WHO’s definition of health has been criticized as an ideal, which is inspirational instead of specific, for instance, it does not indicate how the health could be measured or from whose perspective, the measurement could occur. Health could be defined as a condition of well-being, being free of any infirmity or disease and a universal or basic human right. There are two approaches of defining health; negative definition reflects that health seems to be free of any symptoms of illness, however positive definition states that health is being physically well-being. However, personal and complex nature of health’s definition was an approach, and another approach was to define health as per its functions and biomedicine. The conditions include a range of economic, educational, environmental, and social factors, which recognize a health as a good health. A person if not found to be in a state of good or normal health or in a weak, unsound or morbid condition has bad health. Chronic disease is known as NCDs (Non Communicable Diseases), which cannot be transferred from an individual to other individuals, for instance, cancers, diabetes, CVD, chronic respiratory disease, and CHD. Unhealthy life (poor lifestyle) leads to CHD, which can be stated that a person having bad health is prone to CHD. CHD is a chronic disease, as it also does not transfer from one to another. Progression of CHD is neither predictable nor linear. The unpredictable nature of CHD progression is explained by a rapid increase of stenoisis because of thrombosis that occurs as complications regarding atherogenic process. Types of CHD include cardiovascular, obstructive artery, and non-obstructive artery such as stroke and heart attacks.
Task B: Selection of one developed country with one developing country
Diagnosis
In France, there seems to be significant effects imposed by economic situation on the diagnosis of CHD. For instance, in France, the economic burden of CAD (Coronary Artery Disease) was approx 3.65bn pound in 2009 as compared to 5.08mn pound in 2014 (6, p.11). Health seems to be a major sector of most of the economies along with a core area of social policy and GDP plays an important role in maintaining a good public health across the nation. The current economic issue experienced by France is its inability to succeed in moderating, medically speaking health expenditure. Due to lack of effectiveness in managing health expenditure, access to healthcare services lacks publicly funded packages, which restricts diagnosis of CHD effectively. There is lack of containment of healthcare expenditure, support for technology and innovation, and protecting the jobs in the pharmaceutical industry, which overall fail to respond to the principal public health issue, specifically chronic disease like CHD.
Prevalence
As per the WHO 2018, deaths due to CHD in France have reached 61,854 or 13.64% of the total deaths, for instance, approx 120K heart attacks occur in France annually, and 10% of them die within an hour. The most challenging political issue, France has been going through in its healthcare sector, is the lack of a balance between the roles played by minister’s representatives and various national agencies of public health. This issue affects the prevalence, which results in increasing the number of CHD cases in France. In addition, in 2018, France as a developed nation had spent only 11.2 percent of its GDP on its healthcare sector, which reflects that healthcare expenditure due to less shared GDP suffers; as a result, prevalence seems to be increasing in numbers across France even though having a higher aggregate level of services along with higher consumer’s satisfaction.
Disease Management
Significant improvements in the surgical techniques with intensive care, more adults as compared to children, have currently been living with a CHD (7, p.2). In France, treatment of CHD as compared to other nations seems to be of a higher level, which contributes in keeping the heart diseases’ rate lower. Availability of treatment is of satisfactorily level and efficacy of treatment offers an optimum level of satisfaction. France, instead of having a diet high in fat-saturated, yet has a significant lower number of deaths from CHD. Proactive approach is applied by France healthcare sector in order to treat CHD. Socioeconomic, regional, and educational status of France affects the rate of treatment of CHD, for instance, socioeconomic and regional variations affect behavioural pattern in general, and might thus lead to a cluster of risk factors such as smoking, drinking alcohol, and many others. However, these consumptions in France are negatively associated with educational level and socioeconomic status as compared to Northern Ireland. Furthermore, France and other regions are found to be having a high consumption of vegetables and fruit, rich sources of folate, which explains the French paradox contributing in ease and reliable treatment.
Discussing the risk factors and causes of CHD
CDVs are found to be the major cause of death among the NCDs in Brazil, and these people have a high economic effect on their overall health systems (8, p.1). Risk factors of CHD encountering in Brazil reflect that male gender, obesity, smoking, and systolic blood pressure are the major risk factors among the Brazilian population leading them to experience CHD. Causes leading Brazilian experiencing the respective disease reveal that the high prevalence regarding hypertension, along with the increasing prevalence of diabetes (mellitus), a rising prevalence regarding habits of unhealthy eating, obesity, overweight, and lack of physical activity are the major causes. The reason behind these facts is poverty in Brazil, they even have low literacy level, however a higher rate of population growth, poor health facilities, lack of effective transport infrastructure, low level of per capita income being insufficient for generating savings for the economic growth, and dependence over commodity and agriculture exports. For instance the proportion of Brazilian people living in poverty with earning less than 2USD per day gets fallen from 20.3% in 2001 to 6.8% in 2012. Social-inequalities in Brazil lead the Brazilian people experiencing health inequality, which is one of the reasons of a higher CHD rate in Brazil.
Some numbers on the CHD prevalence
The CHD prevalence reveals that approximately 45.7mn people across Brazil get affected by four different conditions of heart, which is around 32% of the Brazilian adult population. This has been measured in 2015. In addition, the four heart conditions include HF (Heart failure), MI (Myocardial Infarction), HTN (Hypertension), and AF (Atrial fibrillation). In 2011, CHD accounts for around 31% of every single death in Brazil, however, 19% of overall spending on hospitalizations. The rate of obesity across Brazil has more than tripled in the last 40 years (9, p.2).
Discussing the causes and risk factors of CHD of developed countries
The causes of CHD in France include a few things only such as intake of alcohol, a higher level of psychological risk, lower social support, impatience level, a higher level of cholesterol (HDL), and recently adoption of high fat diet. However, the psychological risk is the major cause of CHD in France as compared to any other nations, specifically Northern Ireland. France is found to be at lower risks for CHD, although, a few risk factors such as hypertension, Fibrinogen, and dyslipidemia lead France to experience CHD, however significantly very low. The reason behind this fact could be the French Paradox, which reflects that consumption of a highly saturated fat in their diet could be a reason, however, it yet does not contribute that much in France CHD rate as compared to other nation’s CHD rate. Their culture could be a reason since health seems to be a cultural concept as culture can frame and shape how individuals perceive the overall world and their experiences. Thus, the patients and healthcare providers of France could view health positively and illness negatively, their perspective of perceiving health and illness make keep them away of CHD.
Some numbers on the CHD prevalence
The overall rate of prenatal detection for CHD is found to be 71.5% in the southern region of the respective country, which was measured in 2005 (10, p.8). In addition, the detection rate for the selected disease seems to globally be satisfactory in the southern region of France. 6.5% of French people suffered from cardiovascular diseases, which was measured in 2013. However, obesity has come up as a public health issue in France, for instance 10% of the overall population are found to be obese. However, in 2013, 2.7% among the French population had been accounted for CHD.
Comparing the two nations
While comparing the two nations such as Brazil and France, it has been found that in terms of CHD, there seems to be a huge difference in-between these two countries. For instance, France has the lowest rate of CHD however Brazil comes among those nations, who have the highest rate of CHD. In addition, risk factors and causes of CHD in France seem to be negligible because even though having a fatty saturated diet, the French people are least prone to CHD; on the other hand, Brazilian people are prone to this disease because of having a large number of causes and risk factors. The main cause of CHD in France is the psychological risk, which the French people possesses, however there are various major reasons in Brazilian people leading them to experience this disease, diabetes, poor diet, lack of physical activities, high blood pressure, high HDL, and even lack of economic stability as well. French people have different perceptions regarding illness and health; however Brazilian people see health with negative perspective due to health and social inequalities in Brazil.
Discussing the diagnosis and treatment issues of CHD
CHD has found to be a leading cause of mortality and morbidity across the world (11, p.1). However, in terms of diagnosing and treating the issues of CHD, it is identified that France experiences only two issues such as there is a less shared GDP towards healthcare expenditure and there is a lack of balance between the minister representative’s responsibility and national agencies regarding healthcare. The issue of inefficient healthcare expenditure is specific to France because the French Government spends only a few percentage to their overall GDP, however similar to Canada and Germany, but lesser than the US. In addition, there is a key element of the French insurance system is solidarity, which means the more ill an individual becomes, the less, the insurance firms pay. On other side, Brazil have a lot of issues to present, which restrict the diagnosis and treatment of CHD, for instance, poverty, low per capita GDP, inequalities, low education level, overdependence on commodity with agriculture, and many others. Socioeconomic factors in Brazil plays an important role in distributing, severity, and managing the CHD, which makes the white people benefitted from the healthcare policy, however black lives suffer. The burden seems to be greater in the south and southeast regions of Brazil, having a higher mortality rate in a low-income population group.
iii. Discussing the strengths and limitations of Global Strategies_300
Identifying and describing at least one global strategy from WHO
Treatment strategy for CHD includes PCI (Percutaneous Coronary Intervention), medicine therapy, and CABG (Coronary Artery Bypass Graft) (12, p.4). However, the WHO is an agency of the UN, which focuses over global health issues. The strategy to be focused here and introduced by the WHO is the introduction of Development Aid. It is a financial aid provided by the governments along with other agencies for supporting the social, political, economic, and environmental development of the developing nations. “Cooperation” is used by the WHO for expressing the idea, which partnership needs to exist between recipient and donor instead of the traditional situation within which the relationship is dominated by the wealth including specialized knowledge regarding one side. The goals of this strategy are “for improving the lives of this planet’s poorest people, improving access to healthcare with education, reinforcing nations’ capacity for running their own affairs, and building infrastructure, and partnership between donor and recipient could be stronger”. The WHO, the governments, and other agencies have been constantly working on achieving the respective goals, for which they have started various initiatives and different approaches, for instance providing grants with loans to the developing nations, supplying equipment, experts, and training, and many others. The WHO, various countries’ Governments, national agencies, NGOs, private sectors, and not-for profits firms are involved. They expect the outcomes to be a diverse growth and development across the world. Poverty, inequality and other social issues could be removed from the world.
Discussing the strengths and limitations of the strategy
The strength of the respective strategy is its accountability, which strengthen the interventions in the healthcare system along with other sectors brought by the WHO. This strength opens up various opportunity spaces for diminishing the corruption and improving the governance outcomes such as efficient use, equity, and responsiveness. Strategy’s strength involves the decision-making power, which seems to be delegated, and a means for preventing the misuse or abuse of any power. However, limitation of this strategy reflects that various nations are involved, thus lack of effective communication could be a limitation to this strategy. In addition, one-way transmission of information could be encountered from the aspect based on answerability that associates with transparency.
Task C: Writing a reflective account_400
Stating the reflective model
The selected reflective model is Gibb’s reflective model. This model has six stages, which provide a guiding question for fostering a more accomplished reflection (13, p.357). This model is suitable enough to this context because comparison between two nations indulges various stages such as my feeling, my observation skills, evaluation, and analysis as well. Thus, while comparing the two nations, it was needed to apply my feelings and thoughts regarding those two countries’ data.
Describing the model
The Gibb’s reflective cycle has been utilized because this model incorporates knowledge, thoughts, feelings, and actions in a single learning cycle (14, p.63). It is one of the most popular cyclical models regarding reflection leading a learner through six varied stages for exploring an experience such as description, feelings, evaluation, analysis, conclusion, and, action plan. Central to this model seems to be the assumption that a trainee and professional could learn from their negative and positive clinical experience through reflecting over them along with that such feedback could benefit their performance in specific situations (15, p.2).
Use of model
Description: The overall experience directs me to contribute towards the global issues faced by different countries by making best efforts to act sensibly about them. This situation makes me responsible to think about making this world as the best planet to live from every person’s perspective irrespective of their race, ethnicity, culture, and status.
Feeling: While carrying out this study, I thought that Brazilian people need to suffer a lot, which made me think about the inequality issues being present in other developing nations. Thus, I felt that respecting the cultural diversity with human rights could work for Brazil, and my thoughts reflect that education could be a key to success in Brazil.
Evaluation: The best part of this situation is to the extent and amount of knowledge I could have grasped, which could help me to bring changes in myself as well, thus I could also contribute in making this world better. However, the current scenario of Brazil made me sad, upset, and low, which boosted me to travel to Brazil to grasp practical and evidence-based data.
Analysis: I could make a sense of urgency, which directs me that there is an urgency call sought by the world as intensity of negativity and lacks in the forms of inequality, corruption, bribery, and many others is increasing.
Conclusion: After analysing this study, I learnt that there is a world beyond me as well and I am a part of that world, and I need to play an active role in improving it.
Action-plan:
| Objective | Activities | Resources | Time-bound |
| To gain knowledge about the responsibilities of a global citizen | Building own understanding regarding the world events
Taking learning into the real world Getting involved in my national, global, and local communities |
Empowerment
Help of teachers Opportunities Petitions, tweets, or emails to the world leaders Rallies Government |
Within 6-12 months |
Including what a responsible global citizen means
A responsible global citizenship seems to be informed compassion within actions, for instance making their best efforts for understanding global issues, for acting sensitivity about those, and for changing themselves and the world for better. Global citizenship and proper education could assist the youth of today’s world with the struggles for the identity (16, p.389). This citizen is important because youth could be potential enough for solving the problems, making decisions, thinking critically, communicating ideas effectively, and working well with others. Implications direct a global citizen to be aware of this wider world and must have a sense of their own roles as a global responsible citizen. Its effects on people’s health would be positive enough because they would encourage the people living a healthy and fit lifestyle and leading a quality life. Health inequalities could be mitigated by a responsible citizen because they would take an active role and responsibility in their respective community and make every healthcare service accessible to every person living in that community.
Conclusion
After analysing the overall scenario, it can be concluded that a health system consists of every single person with actions, who has a primary purpose of improving the health. The WHO’s health is such system, which includes every activity having purpose for promoting, restoring or maintaining health. A responsible citizen can change the shape and thinking of this world, which is sought by the Brazilian people and the community as there is a huge inequality issues.
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