The goal of this assignment is to familiarize yourself with the most important determinants of health in your country in order to understand what drives health and to identify potential areas of intervention and disease reduction.
The goal of this assignment is to familiarize yourself with the most important determinants of health in your country in order to understand what drives health and to identify potential areas of intervention and disease reduction. The assignment is structured into four sections. In Section 1 to 3 you will be asked to collect information on determinants of health using the literature as well as the Global Burden of Disease study. In Section 4, you will be asked to elaborate in priority areas to focus mitigation efforts on.
Instructions
The Global Burden of Disease (GBD) study attributes mortality and morbidity to 87 risk factors, including behavioral, environmental, and metabolic risk factors. For part of this exercise, you will be using the GBD compare tool to analyze the relevant risk factors in your country of choice. As the GBD risk factor list is not exhaustive, and does not include all possible determinants of health, we also ask you to do additional research on determinates of health in your country. For example, risk factors currently not included in the GBD study include education, political stability, access to care, etc. You will also be asked to provide data on these additional risk factors and discuss their relevance.
Finally, we will ask you to discuss the role of determinants of health in your county and provide a short write-up. What are major focus areas for public health intervention? What are data gaps and limitations of data on determinants of health?
Please label all figures included in your responses, including a brief descriptive title. Please include references/citations for each response below; these do not count towards your word limit.
Guiding questions are:
Section 1: During this week’s lectures (videos) we learned about (social) determinants of health, sometimes also referred to as risk factors. Determinants that were specifically highlighted in the video were: income, education, nutrition, health care and access to water, sanitation and housing. What is the situation with regards to these risk factors in your country? How have they changed over time and compare to other countries in the region or globally? (5 points, 150-250 points, 1-2 figures)
Tip: Check out WorldBank (https://data.worldbank.org/indicator/Links to an external site.) and UNICEFdata warehouse (https://data.unicef.org/dv_index/Links to an external site.)
Section 2A: The GBD provides an overview over 87 individual risk factors, that are clustered into metabolic, behavioral and environmental risk factors. The GBD provides these risk factors on four different levels, with level 1 being the coarsest level (e.g., environmental risk factors). Higher levels of risk factors provide an increasing level of detail. For instance, level 2 of environmental risk factors provides information about air pollution, water and sanitation, occupational risk factors, temperature, and other environmental risk factors. When zooming into level 4 of “air pollution”, we see information on ambient and household particulate matter pollution as well as ozone. What information does GBD compare provide for your country? What risk factors contribute the highest burden of disease? Look at different levels and choose 1 to 2 figures that demonstrate the risk factor profile in your country. (Note: You are free to choose a risk factor level that you think provides most meaningful results.)(2 points, 50-150 words, 1-2 figures)
Tip: Go to the ‘Risk by cause’ tab in GBD compare and switch to ‘advanced settings’. Then choose your country from the drop-down menu. You can move the lever in order to choose a level or you can click on a risk to get to the next level.
Section 2B: How have risk factors and the risk attributable burden changed over the last three decades?Have they decreased or increased? Please consider all demographic and epidemiological drivers. This means evaluate whether population aging, or high fertility has intensified or offset the impact of risk factors. You can use the line or pattern display in GBD compare to answer this question and choose the appropriate metric you want to look at (tip: all age vs. age-standardized rates tell a different story). Include appropriate graphics in your answer and provide a brief narrative (2 points, 50-100 words, 1+ figures).
Tip: Go to the line setting and choose the ‘Risk’ tab (stay in advanced settings) and choose your country. Now you have the option to choose a cause, a risk, a measure, and age group including all ages and age-standardized, as well as a sex and a unit. For this section, I suggest looking at all causes, DALYs or deaths, both sexes and rates. Compare the risk-attributable burden for all ages versus age-standardized rates to better understand the role of demography.
Section 3: Are there additional risk factors that are relevant in your country but were not discussed during the lectures (and in Section 1) and are not part of GBD?If so, please list them and provide some additional information why you think these determinants of health are important! Possible determinants of health could be war and conflict, discrimination, domestic violence etc. If you can’t name any, please outline your approach to finding information (1 point, 50-100 words, 0+ figures)
Section 4: Based on what you have learned during this module and the information you have compiled for questions 1 to 3, what do you think are priority risk factors your country should focus on and aim to mitigate?Please provide a rationale for your suggestions! Factors to consider are, for instance, the burden of disease these determinants are causing, the cost and/or opportunity cost of mitigation, the ease of implementation etc. In addition to these hard considerations, ethical reasons and equity might also be driving forces behind your recommendation. Please provide a brief narrative (250 to 500 words). (5 points) – list all refrences and also use the files below to answer the questions needed
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