GLOBAL HEALTH CARE
ISSUES AND POLICIES
Carol Holtz, PhD, RN
Professor of Nursing
WellStar School of Nursing
Kennesaw State University
Kennesaw, Georgia
JONES AND BARTLETT PUBLISHERS
Sudbury, MassachusettsIntroduction xiii Acknowledgments xxv Contributors xxvii
Section I Global Healthcare Policy, Methods, and Delivery
Chapter 1 Global Health in Developed Societies: Examples in the United States,
United Kingdom, Sweden, and Israel 1
Carol Holtz United States 1 Sweden 21 United Kingdom 24 Israel 29 References 34
Chapter 2 Developing Countries: Mexico, China, and South Africa 39 Carol Holtz Mexico 39 China 50 South Africa 59 References 68 in
iv CONTENTS
Chapter 3 Global Perspectives on Economics and Health Care 73 Marsha Burke, Govind Hariharan, Robert A. Lipson,
and Caroline Aultman
Introduction 73 Profiles of Five Healthcare Systems 74 Comparative Analysis of Healthcare Systems 84 Healthcare Productivity and Costs 87 Key Components of an Ideal Healthcare System 94
Acknowledgments 99
References 99
Chapter 4 Global Perspectives on Politics and Public Health Policy 103 Alexandra Toma, Michele Zebich-Knos, Richard B. Davis,
and Enrique Paz
Introduction 103 The United States Perspective 104
The Bolivian Perspective 113 A Multilateral Perspective 121
Conclusion 137 References 138
Chapter 5 Global Health Research Methods 143 Timothy A. Akers and Mary Anne Alabanza Akers
Planning for Global Health Research: The 10/90 Debate 144
Accessing Data: Secondary Data 146 Collecting the Data: Primary Data 150
Geographical Information Systems (G1S) in Global Health Research 153 Conclusion 154 References 154
Chapter 6 International Research Ethics 157 Jonathan B. VanGeest and Deborah S. Cummins
Research Ethics 157
The Use of Human Subjects in Research 158
Research Ethics in Today's Global Context 160
A Closer Look: Clinical Trials in the Prevention o/MTCT of HIV 160
Section II
Basic Principles 164 Applications: Another Look at Clinical Trials in the Prevention ofMTCT
of HIV 169 Protecting Human Subjects Globally: A Need for Oversight
andMonitoring 170 Conclusion ' 174 Case Studies 174 References 176 Appendix 6-A: Selected Web-Based Resources on Research Ethics 179
Special Global Healthcare Issues
Chapter 7 Infectious Diseases from a Global Perspective 181 Timothy A. Akers, Barbara J. Blake, and Robert A. Hanson
Overview 181
Historically 182
People and Environment: Epidemiology and Regional Impact 183
Cholera 183
Dengue Fever (Arbovirus) 184 Malaria (Plasmodiums: falciparum, malariae, ovale, vivax) 184
Avian (Bird) Flu (H5N1) 185 West Nile Virus (Arbovirus) 186
SARS (Severe Acute Respiratory Syndrome) 186
Ebola (Hemorrhagic Fever) 187 Hepatitis A, B, and C 188
Syphilis (Treponema pallidum) 190 Tuberculosis (Mycobacterium tuberculosis) 190 Human Immunodeficiency Virus (HIV) I Acquired Immunodeficiency
Syndrome (AIDS) 191
Interdisciplinary and Systemic Impact on Infectious Diseases 194
Prevention Intervention Strategies 195 Surveillance, Research, and Evaluation: Three Sides of the Same Coin 195 References 196
vi CONTENTS
Chapter 8 Global Use of Complementary and Alternative Medicine (CAM)
and Treatments 199
Ping Hu Johnson
Introduction 199
CAM Defined: Complementary and Alternative or Traditional? 199 CAM in the United States 200 CAM in the World 203 Major Forms of CAM ,.. .204
Research and Technology 217
Legal and Ethical Issues 219 Influences of Politics, Economics, Culture, and Religion 225 Developing and Developed Societies 228 Case Study Examples 229
References 230
Chapter 9 Global Perspectives on Selected Chronic Cardiovascular Diseases 235
Bowman O. Davis, Jr.
Introduction 235 Demographic and Socioeconomic Transition 236
The Underlying Role of Poverty 247 The Chronic Disease Burden 248 The Cardiovascular Disease Burden 250
Cardiovascular Disease Risk Factors 252 Conclusions 261 References 265
Chapter 10 Global Perspectives on Diabetes and Respiratory and Orthopedic
Chronic Diseases 267
Janice Long, Betsy Rodriguez, and Carol Holtz
Introduction: The Global Burden of Chronic (Noncommunicable)
Diseases 267
Musculoskeletal Disorders 269
Diabetes 273
Preventing Limb Amputations: A Diabetes Intervention Case Study Involving Working Across Borders in Latin America (Five Andean Countries: Bolivia, Ecuador, Peru, Colombia and Venezuela) 282 References 294
Chapter 11 Overview of Cancer for Allied Healthcare Professionals:
A Public Health Perspective 299
Linda G. Alley, Temeika L. Fairley, Cheryll Cardinez, and Paran Pordell
Introduction 299 Key Cancer and Public Health Concepts and Definitions 300 Cancer Prevention 309 Early Detection, Screening, and Education 315 Cancer Care Considerations 323 Noteworthy Compilations of Cancer Information 333 Conclusions 333
References 334
Chapter 12 Global Perspectives on Violence, Injury, and Occupational
Healthcare 343 Carol Holtz Violence 343 Injury 352 Occupational Health 357 References 365
Chapter 13 Global Perspectives on Nutrition 369
Carol Holtz, Kathy Plitnick, and Marvin Friedman
Introduction 369 Types of Nutritional Challenges 371 Food Safety and Security 379
Nutrition and Poverty 380 Nutrition Emergencies 381 Nutritional Challenges in Vulnerable Populations 383 Nutrition Case Studies 386 References 393
viii C O N T E N T S
Chapter 14 Global Perspectives on Mental Health 397 Mary A n n Camann
Overview 397 Global Perspective—The Results of Research and Technology 397 Legal and Ethical Issues 399 Regional Mental Health Issues and Outcomes 403 Summary 414 References 416
Chapter 15 Global Perspectives on Environmental Health 419 Marvin Friedman
Global Issues—Lessons in Environmental Health 419 Principles of Environmental Health 422 Principles of Toxicology 425 Legal and Ethical Issues 427 What Is the Environment? 428 Sustainable Development 434 References 435
Section -illi? Lifespan Health Issues
Chapter 16 Global Health in Reproduction and Infants 437 Carol Holtz and Suzanne Grisdale
Background 437 Reproductive Rights 439 Adolescent Reproductive Health 440 Fertility 443 Infertility 444 Family Planning and Contraception 445 Abortion 447 Maternal Mortality and Morbidity 450 Accessing Reproductive Health Care 451 A Comparison of Customs and Practices of Pregnancy, Delivery,
Infant Health 461 Sexually Transmitted Diseases (STDs) 467 Violence Against Women 469
Male Reproductive Health 471
Conclusion 472
References 472
Chapter 17 Global Health of Children 477 Kathie Aduddell
Introduction •.-• 4 7 7 Background and Historical Perspective 478 Childhood Mortality and Morbidity Statistics: Measuring Health in Children . .480
What Are the Health Problems for Children? 481
Larger Ramifications of Children's Health Problems 484 Approaches to Child Health Around the World 487
Future Challenges 490
References 493
Chapter 18 Global Health of the Older Adult 495 David B. Mitchell
Introduction 495 Mortality and Morbidity Statistics 498 Research and Technology 507
Legal and Ethical Issues 509
Influences of Politics, Economics, Culture, and Religion 511 Case Study Examples 515 Conclusion 518 Acknowledgments 518 References 518
Appendix I8-A: 20 Questions about Global Aging 522 Answers 523
CONTENTS
Worldwide Issues and Trends by Specific Country
Chapter 19 Establishing Medical and Nursing Education Programs in the Country
of Georgia 527
Judith L. Wold, H. Kenneth Walker, and Natia Partskhladze
Introduction 527
The Georgian Healthcare System 531
Healthcare Reform 536 Access to Information 536 Nursing 536 Women and Children 544
Medical Education 545
Business Education 545 Healthcare Management „ 545 Scholarly Activities and Biomedical Research 546
Emergency Medical Care and Other Initiatives 546
Discussion 547 References 549
Chapter 20 A Unique Perspective on Health Care in Panama 551 Larry Purnell
Overview 551 Education 559 Communication 561
Spirituality and Religion 564 Research and Demonstration Projects 565 Healthcare Practices 568 Traditional Practitioners and Herbal Medicine 577
Case Study 578
Critical Thinking Questions 580
Bibliography and References 581
Chapter 21 Health and Environmental Design: The Relationship Between Health
and Place in a Philippine Urban Setting 583
Introduction 583
Health and Place 585 Early Environmental Design Health Interventions 585
Current Environmental Design Approaches to Health 586
The Environment and Health 589
Urbanization in Asia 590 Baguio City: A City Founded on Health and Healing 591
A Case Study of Health and Place: Street Vendors in Downtown Baguio 591 An Environmental Design Proposal to Address Health in Baguio City's
Central Business District 597 Conclusion ." 598 References 598
Chapter 22 Building Cultural Competence: A Nursing Practicum in Oaxaca,
Mexico 601
David Bennett and Carol Holtz
Need for Cultural Competence 601
Impact of Study Abroad and Immersion Experiences on Cultural
Competence 602 Language Acquisition and Increased Fluency 602 Experiential Learning 603 Problem-Based Learning 603 Achieving Praxis 604 Development of the Study-Abroad Practicum 604 Implementation of the Nursing Practicum in Oaxaca 608 Student Outcomes 611 Lessons Learned 612 Conclusion 613
. References 614
