Childhood mortality: still a global priority

Mortality of children under-5 continues to be a global priority. In 2012, 6.6 million children under-5 died worldwide; more than half of these deaths are due to diseases that are preventable and treatable through simple, affordable interventions. In response to the United Nations’ Millennium Development Goal (MDGs) which called, through MDG4,to “reduceby two thirds the under-5 child mortality, between 1990 and 2015”, global organizations and many countries set targets and developed specific strategies to reduce child mortality and monitor progress.As a result, the number of deaths in children under-5 worldwide declined from 12.4 million in 1990 to 6.6 in 2012. Under-5 child mortality dropped in all regions of the world. However, two major challenges face the international community: The wide disparity in the risk of child death among countries, and the emerging role of neonatal death as a major component of child mortality. In order to continue the progress in reducing under-5 child mortality worldwide, current efforts must continue and new strategies need to be implemented to focus on preventing neonatal deaths as they start to represent a larger proportion of under-5 child deaths. In particular, further reduction in neonatal mortality will depend heavily on improving maternal health (MDG5).The world leaders continue to support the MDGs. In 2010, in a major push to accelerate progress on women’s and children’s health, a number of Heads of State and Government from developed and developing countries, along with the private sector, foundations, international organizations, civil society and research organizations, pledged over $40 billion in resources over the next five years

Parents' death and its implications for child survival

Reduction of child mortality is a global public health priority. Parents can play an important role in reducing child mortality. The inability of one or both parents to care for their children due to death, illness, divorce or separation increases the risk of death of their children. There is increasing evidence that the health, education, and  socioeconomic status of mothers and fathers have significant impact on the health and survival of their children. We conducted a literature review to explore the impact of the death of parents on the survival and wellbeing of their children and the mechanisms through which this impact is mediated. Studies have generally concluded that the death of a mother significantly increased the risk of death of her children, especially during the early years; the effect continues but is significantly reduced with increasing age through the age of 15 years. The effect of the loss of a father had less impact than the effect of losing a mother although it too had negative consequences for the survival prospect of the child. A mother’s health, education, socioeconomic status, fertility behavior, environmental health conditions, nutritional status and infant feeding, and the use of health services all play an important role in the level of risk of death of her children. Efforts to achieve the Millennium Development Goal No. 4 of reducing children’s under-5 mortality in developing countries by two thirds by 2015 should include promoting the health and education of women. Reduction of child mortality is a global public health priority. Parents can play an important role in reducing child mortality. The inability of one or both parents to care for their children due to death, illness, divorce or separation increases the risk of death of their children. There is increasing evidence that the health, education, and socioeconomic status of mothers and fathers have significant impact on the health and survival of their children.We conducted a literature review to explore the impact of the death of parents on the survival and wellbeing of their childrenand the mechanisms through which this impact is mediated. Studies have generally concluded that the death of a mother significantly increased the risk of death of her children, especially during the early years; the effect continues but is significantly reduced with increasing age through the age of 15 years. The effect of the loss of a father had less impact than the effect of losing a mother although it too had negative consequences for the survival prospect of the child. A mother's health, education, socioeconomic status, fertility behavior, environmental health conditions, nutritional status and infant feeding, and the use of health services all play an important role in the level of risk of death of her children. Efforts to achieve the Millennium Development Goal No. 4 of reducing children's under-5 mortality in developing countries by two thirds by 2015 should include promoting the health and education of women

Desigualdades na saúde: desafios, oportunidades e o que você pode fazer sobre isso: English

Racial disparities in health outcomes, access to health care, insurance coverage, and quality of care in the United States have existed for many years. The Development and implementation of effective strategies to reduce or eliminate health disparities are hindered by our inability to accurately assess the extent and types of health disparities due to the limited availability of race/ethnicity-specific information, the limited reliability of existing data and information, and the increasing diversity of the American population. Variations in racial and ethnic classification used to collect data hinders the ability to obtain reliable and accurate health-indicator rates and in some instances cause bias in estimating the race/ethnicity-specific health measures. In 1978, The Office of Management and Budget (OMB) issued "Directive 15" titled "Race and Ethnic Standards for Federal Statistics and Administrative Reporting" and provided a set of clear guidelines for classifying people by race and ethnicity. Access to health care, behavioral and psychosocial factors as well as cultural differences contribute to the racial and ethnic variations that exist in a person’s health. To help eliminate health disparities, we must ensure equal access to health care services as well as quality of care. Health care providers must become culturally competent and understand the differences that exist among the people they serve in order to eliminate disparities. Enhancement of data collection systems is essential for developing and implementing interventions targeted to deal with population-specific problems. Developing comprehensive and multi-level programs to eliminate healthcare disparities requires coordination and collaboration between the public (Local, state and federal health departments), private (Health Insurance companies, private health care providers), and professional (Physicians, nurses, pharmacists, laboratories, etc) sectors.  Disparidades raciais nos resultados de saúde, acesso a cuidados de saúde, cobertura de seguro e qualidade de atendimento nos Estados Unidos existem há muitos anos. O desenvolvimento e a implementação de estratégias efetivas para reduzir ou eliminar as disparidades de saúde são dificultadas pela nossa incapacidade de avaliar com precisão a extensão e os tipos de disparidades de saúde devido à disponibilidade limitada de informações específicas de raça / etnia, confiabilidade limitada dos dados e informações existentes. e a crescente diversidade da população americana. Variações na classificação racial e étnica usadas para coletar dados dificultam a obtenção de índices confiáveis e precisos de indicadores de saúde e, em alguns casos, causam viés na estimativa de medidas de saúde específicas de raça / etnia. Em 1978, o Escritório de Administração e Orçamento (OMB) publicou a "Diretriz 15" intitulada "Normas Raciais e Étnicas para Estatísticas Federais e Relatórios Administrativos" e forneceu um conjunto de diretrizes claras para classificar as pessoas por raça e etnia. O acesso a cuidados de saúde, factores comportamentais e psicossociais, bem como diferenças culturais, contribuem para as variações raciais e étnicas que existem na saúde de uma pessoa. Para ajudar a eliminar as disparidades de saúde, devemos garantir a igualdade de acesso aos serviços de saúde, bem como a qualidade do atendimento. Os prestadores de cuidados de saúde devem tornar-se culturalmente competentes e compreender as diferenças existentes entre as pessoas que servem para eliminar as disparidades. O aprimoramento dos sistemas de coleta de dados é essencial para desenvolver e implementar intervenções direcionadas para lidar com problemas específicos da população. O desenvolvimento de programas abrangentes e multiníveis para eliminar as disparidades na atenção à saúde exige coordenação e colaboração entre os setores público, privado e profissional (departamentos de saúde locais, estaduais e federais), privados (empresas de seguro-saúde, provedores privados de saúde) e profissionais (médicos e enfermeiros), farmacêuticos, laboratórios, etc)

Meeting the Emerging Public Health Needs of Persons With Blood Disorders

In its decades-long history, the Division of Blood Disorders (DBD) at CDC has evolved from a patient-focused, services-supporting entity at inception, to one of the world leaders in the practice of public health to improve the lives of people at risk for or affected by nonmalignant blood disorders. The DBD’s earliest public health activities consisted of working with care providers in a network of hemophilia treatment centers to provide AIDS risk reduction services to people with hemophilia. Because this infectious disease threat has been reduced over time as a result of the development of safer treatment products, the DBD—under the auspices of congressional appropriations guidance—has expanded its core activities to encompass blood disorders other than hemophilia, including hemoglobinopathies such as thalassemia and sickle cell disease, and Diamond Blackfan anemia. Simultaneously, in transitioning to a greater public health role, the DBD has expanded its network of partners to new consumer and professional organizations, as well as state and other federal health agencies. The DBD has also developed and maintains many surveillance and registry activities beyond the Universal Data Collection system aimed at providing a better understanding of the health status, health needs, and health-related quality of life of people with nonmalignant blood disorders. The DBD has integrated applicable components of the Essential Services of Public Health successfully to promote and advance the agenda of blood disorders in public health

THE EVOLVING ROLE OF PUBLIC HEALTH IN THE DELIVERY OF HEALTH CARE

Health care is conventionally regarded as the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Some examples of public health measures include ensuring a safe and healthy environment, clean water, safe workplaces; promotion of healthy behaviors such as hand washing and breast feeding; and, preventing infectious diseases such as delivery of vaccinations and distribution of condoms to control the spread of sexually transmitted diseases. How we define the quality of public health at any given time must be compatible with future generations enjoying health in an equivalent way. Public health practitioners must also integrate sustain ability in the definition of public health.Health care is conventionally regarded as the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Some examples of public health measures include ensuring a safe and healthy environment, clean water, safe workplaces; promotion of healthy behaviors such as hand washing and breast feeding; and, preventing infectious diseases such as delivery of vaccinations and distribution of condoms to control the spread of sexually transmitted diseases. How we define the quality of public health at any given time must be compatible with future generations enjoying health in an equivalent way. Public health practitioners must also integrate sustain ability in the definition of public health

THE EVOLVING ROLE OF PUBLIC HEALTH IN THE DELIVERY OF HEALTH CARE

Health care is conventionally regarded as the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Some examples of public health measures include ensuring a safe and healthy environment, clean water, safe workplaces; promotion of healthy behaviors such as hand washing and breast feeding; and, preventing infectious diseases such as delivery of vaccinations and distribution of condoms to control the spread of sexually transmitted diseases. How we define the quality of public health at any given time must be compatible with future generations enjoying health in an equivalent way. Public health practitioners must also integrate sustain ability in the definition of public health.Health care is conventionally regarded as the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Some examples of public health measures include ensuring a safe and healthy environment, clean water, safe workplaces; promotion of healthy behaviors such as hand washing and breast feeding; and, preventing infectious diseases such as delivery of vaccinations and distribution of condoms to control the spread of sexually transmitted diseases. How we define the quality of public health at any given time must be compatible with future generations enjoying health in an equivalent way. Public health practitioners must also integrate sustain ability in the definition of public health

Blood disorders among women: implications for preconception care.

The objectives of preconception care for women with blood disorders are to provide women and their partners with information on the implications of blood disorders for pregnancy; reproductive choices; and the management of potential or future pregnancies. Advances in hematology have led to improved diagnosis and treatment of blood disorders, thereby contributing to longevity and quality of life for women who are either affected by or are carriers of blood disorders. Women with blood disorders pose unique challenges: physiologic events such as pregnancy and menstruation influence the manifestations of blood disorders; blood disorders are a risk factor for adverse pregnancy outcomes; pregnancy imposes the risk of potential genetic transmission of the blood disorder to the offspring;and medications used for treatment of blood disorders pose additional challenges to conception and pregnancy. Hence, it is crucial that women of childbearing age with blood disorders be provided proper care for their conditions and be counseled before they become pregnant, in time to prevent complications to mothers and infants related to blood disorders. The purpose of this paper is to provide a brief overview of the current knowledge related to blood disorders in women of reproductive age, the interventions needed to manage these conditions, and the implications of these conditions and their management for the health of women and their infants

Burden of disease resulting from hemophilia in the U.S.

BACKGROUND: Hemophilia is a hereditary bleeding disorder. Its complications can result in substantial morbidity, but few efforts have been made to quantify the disease burden. PURPOSE: The objective of this analysis was to estimate the burden of disease due to hemophilia (A and B) in the U.S., using disability-adjusted life years (DALY). METHODS: The approach taken by the WHO in its Global Burden of Disease study was followed. Assumptions were drawn from published literature, and population estimates from the U.S. Census Bureau for the Year 2007 were used. Estimations of years of life lost resulting from mortality (YLL) and years of life lost resulting from morbidity (YLD) were done separately by gender, 5-year age intervals, and severity of disease (morbidity only) with their sum representing DALYs. Disability weights were derived from the quality-of-life tool EuroQol (EQ-5D). The stability of burden estimates was tested by performing sensitivity analyses, changing one assumption at a time. RESULTS: In the U.S. in 2007, hemophilia resulted in 110,095 DALYs, composed of 13,418 YLLs and 96,677 YLDs. Large differences between men/boys (107,346) and women/girls (2749) were observed, given that females are genetic carriers of the disorder and rarely present with disease. Sensitivity analyses revealed a relatively robust estimate with a maximum variation of 4.49%. CONCLUSIONS: This first estimate of hemophilia-related DALYs in the U.S. indicates that control of hemophilia can potentially result in a gain of 1 healthy year of life for every 2700 people in the population