IntroductiontoglobalhealthbyKathrynH.Jacobsenz-lib.org2.pdf

GLOBAL
HEALTH

THIRD EDITION

INTRODUCTION TO

Kathryn H. Jacobsen, MPH, PhD
George Mason University

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Names: Jacobsen, Kathryn H., author.
Title: Introduction to global health / Kathryn H. Jacobsen.
Description: Third edition. | Burlington, MA: Jones & Bartlett Learning, [2019] | Includes bibliographical references and index.
Identifiers: LCCN 2017044502 | ISBN 9781284123890 (paperback: alk. paper)
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3.8 Governance and Politics . . . . . . . . . . . . . . . . . . . . .61

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63

Chapter 4 Environmental Determinants
of Health . . . . . . . . . . . . . . . . . . . 65

4.1 Environmental Health and the SDGs . . . . . . . . .65

4.2 Water, Sanitation, and Hygiene . . . . . . . . . . . . . .67

4.3 Energy and Air Quality . . . . . . . . . . . . . . . . . . . . . . .75

4.4 Occupational and Industrial Health . . . . . . . . . .81

4.5 Urbanization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84

4.6 Sustainability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88

4.7 Climate Change and Health . . . . . . . . . . . . . . . . .92

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .94

Chapter 5 Health and Humans Rights . . . 98
5.1 Health and Human Rights . . . . . . . . . . . . . . . . . . .98

5.2 Access to Basic Human Needs . . . . . . . . . . . . . 101

5.3 Access to Health Services . . . . . . . . . . . . . . . . . . 103

5.4 Access to Medicines . . . . . . . . . . . . . . . . . . . . . . . 106

5.5 Health and Natural Disasters . . . . . . . . . . . . . . . 108

5.6 Conflict and War . . . . . . . . . . . . . . . . . . . . . . . . . . . 112

5.7 Bioterrorism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115

5.8 Health in Prisons . . . . . . . . . . . . . . . . . . . . . . . . . . 118

5.9 People with Disabilities . . . . . . . . . . . . . . . . . . . . 119

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

Chapter 6 Global Health Financing . . . . . 126
6.1 Personal and Public Health . . . . . . . . . . . . . . . . 126

6.2 Health Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129

6.3 Paying for Personal Health . . . . . . . . . . . . . . . . . 131

6.4 Health Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . 133

6.5 Paying for Global Health Interventions . . . . . 135

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii

New to This Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . viii

About the Author . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x

Chapter 1 Global Health Transitions . . . . . . 1
1.1 Defining Global Health . . . . . . . . . . . . . . . . . . . . . . . 1

1.2 Health Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . 3

1.3 Prevention Science . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

1.4 Health Transitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

1.5 World Regions and Featured Countries . . . . . .12

1.6 Global Health Security . . . . . . . . . . . . . . . . . . . . . . .17

1.7 Globalization and Health: Shared Futures . . . .18

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Chapter 2 Global Health Priorities . . . . . . 21
2.1 Global Health Achievements . . . . . . . . . . . . . . . .21

2.2 Prioritization Strategies . . . . . . . . . . . . . . . . . . . . . .23

2.3 Health Metrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

2.4 Millennium Development Goals . . . . . . . . . . . . .34

2.5 Sustainable Development Goals . . . . . . . . . . . . .36

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41

Chapter 3 Socioeconomic Determinants
of Health . . . . . . . . . . . . . . . . . . . 42

3.1 Health Disparities and the SDGs . . . . . . . . . . . . .42

3.2 Economics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44

3.3 Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51

3.4 Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54

3.5 Employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55

3.6 Minority Populations . . . . . . . . . . . . . . . . . . . . . . . .57

3.7 Migrant and Refugee Health . . . . . . . . . . . . . . . . .59

Contents

iv Contents

9.4 Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203

9.5 Other Respiratory Infections . . . . . . . . . . . . . . . 206

9.6 Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208

9.7 Immunization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210

9.8 Vaccine-Preventable Infections . . . . . . . . . . . . 212

9.9 Viral Hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215

9.10 Meningitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218

Chapter 10 Malaria and Neglected
Tropical Diseases . . . . . . . . . . 224

10.1 Malaria, NTDs, and Global Health . . . . . . . . . 224

10.2 Parasites: Protozoa and Helminths . . . . . . . . 227

10.3 Malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228

10.4 Malaria Interventions . . . . . . . . . . . . . . . . . . . . . 229

10.5 Dengue and Other Arboviruses . . . . . . . . . . 233

10.6 Chagas Disease and Trypanosomiasis . . . . . 236

10.7 Leishmaniasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237

10.8 Schistosomiasis . . . . . . . . . . . . . . . . . . . . . . . . . . 237

10.9 Lymphatic Filariasis . . . . . . . . . . . . . . . . . . . . . . . 238

10.10 Onchocerciasis . . . . . . . . . . . . . . . . . . . . . . . . . . 239

10.11 Leprosy, Buruli Ulcer, and Trachoma . . . . . 240

10.12 Rabies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241

10.13 Soil-Transmitted Helminths . . . . . . . . . . . . . 242

10.14 Other Neglected Tropical Diseases . . . . . . 244

10.15 Eradication. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247

10.16 Emerging Infectious Diseases . . . . . . . . . . . 250

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252

Chapter 11 Reproductive Health . . . . . . 257
11.1 Reproductive Health and Global Health . . 257

11.2 The Fertility Transition . . . . . . . . . . . . . . . . . . . . 259

11.3 Population Planning. . . . . . . . . . . . . . . . . . . . . . 263

11.4 Family Planning . . . . . . . . . . . . . . . . . . . . . . . . . . 264

11.5 Infertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 268

11.6 Healthy Pregnancy . . . . . . . . . . . . . . . . . . . . . . . 269

11.7 Maternal Mortality and Disability . . . . . . . . . 272

11.8 Neonatal Health . . . . . . . . . . . . . . . . . . . . . . . . . . 275

11.9 Gynecologic Health . . . . . . . . . . . . . . . . . . . . . . 279

6.6 Official Development Assistance . . . . . . . . . . . 136

6.7 Multilateral Aid . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139

6.8 Foundations and Corporate Donations . . . . 140

6.9 Personal Donations . . . . . . . . . . . . . . . . . . . . . . . . 142

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146

Chapter 7 Global Health
Implementation . . . . . . . . . . . 148

7.1 Global Health Interventions . . . . . . . . . . . . . . . 148

7.2 Local and National Governments . . . . . . . . . . 150

7.3 International Cooperation . . . . . . . . . . . . . . . . . 151

7.4 The World Health Organization
and the United Nations . . . . . . . . . . . . . . . . . . . . .153

7.5 International Health Regulations . . . . . . . . . . . 156

7.6 Global Partnerships . . . . . . . . . . . . . . . . . . . . . . . . 158

7.7 The Nonprofit Sector . . . . . . . . . . . . . . . . . . . . . . 159

7.8 The Corporate Sector . . . . . . . . . . . . . . . . . . . . . . 161

7.9 Research and the Academic Sector . . . . . . . . 162

7.10 Measuring Impact . . . . . . . . . . . . . . . . . . . . . . . . 163

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165

Chapter 8 HIV/AIDS and Tuberculosis . . . 167
8.1 HIV/AIDS, TB, and Global Health . . . . . . . . . . . . 167

8.2 Viruses, Bacteria, and Fungi . . . . . . . . . . . . . . . . 168

8.3 HIV and AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170

8.4 HIV/AIDS Epidemiology . . . . . . . . . . . . . . . . . . . 173

8.5 HIV Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . 179

8.6 Other Sexually Transmitted Infections . . . . . . 183

8.7 Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184

8.8 TB Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . 185

8.9 Antimicrobial Resistance. . . . . . . . . . . . . . . . . . . 189

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192

Chapter 9 Diarrheal, Respiratory,
and Other Common
Infections . . . . . . . . . . . . . . . . . 195

9.1 Infectious Diseases and Global Health . . . . . 195

9.2 Diarrheal Diseases . . . . . . . . . . . . . . . . . . . . . . . . . 198

9.3 Diarrhea Interventions . . . . . . . . . . . . . . . . . . . . . 200

Contents v

14.4 Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . 346

14.5 Other Cardiovascular Diseases . . . . . . . . . . . . 348

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 349

Chapter 15 Other Noncommunicable
Diseases . . . . . . . . . . . . . . . . . 351

15.1 The Epidemiologic Transition
and Global Health . . . . . . . . . . . . . . . . . . . . . . . . .351

15.2 NCDs and Behavior Change . . . . . . . . . . . . . . 355

15.3 Chronic Respiratory Diseases . . . . . . . . . . . . . 358

15.4 Tobacco Control . . . . . . . . . . . . . . . . . . . . . . . . . . 360

15.5 Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363

15.6 Chronic Kidney Disease . . . . . . . . . . . . . . . . . . 366

15.7 Liver and Digestive Diseases . . . . . . . . . . . . . . 367

15.8 Neurological Dis s . . . . . . . . . . . . . . . . . . . 368

15.9 Genetic Blood Dis s . . . . . . . . . . . . . . . . . . 369

15.10 Musculoskeletal Dis s . . . . . . . . . . . . . . . 371

15.11 Sensory Dis s . . . . . . . . . . . . . . . . . . . . . . . 372

15.12 Skin Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . 374

15.13 Dental and Oral Health . . . . . . . . . . . . . . . . . . 374

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 375

Chapter 16 Mental Health . . . . . . . . . . . . 381
16.1 Mental Health and Global Health . . . . . . . . . 381

16.2 Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 382

16.3 Bipolar Dis . . . . . . . . . . . . . . . . . . . . . . . . . . 383

16.4 Depressive Dis s . . . . . . . . . . . . . . . . . . . . . 383

16.5 Anxiety Dis s . . . . . . . . . . . . . . . . . . . . . . . . . . 385

16.6 Alcohol and Drug Use Dis s . . . . . . . . . . 385

16.7 Other Mental Health Dis s . . . . . . . . . . . 387

16.8 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 388

16.9 Autism and Neurodevelopmental
Dis s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .390

16.10 Dementia and Neurocognitive Dis s 391

16.11 Mental Health Care . . . . . . . . . . . . . . . . . . . . . 391

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 392

Chapter 17 Injuries . . . . . . . . . . . . . . . . . . 396
17.1 Injuries and Global Health . . . . . . . . . . . . . . . . 396

11.10 Men’s Reproductive Health . . . . . . . . . . . . . . 279

11.11 Sexual Minority Health . . . . . . . . . . . . . . . . . . 280

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281

Chapter 12 Nutrition . . . . . . . . . . . . . . . . 285
12.1 Nutrition and Global Health . . . . . . . . . . . . . . 285

12.2 Macronutrients . . . . . . . . . . . . . . . . . . . . . . . . . . . 286

12.3 Protein-Energy Malnutrition . . . . . . . . . . . . . . 288

12.4 Food Security and Food Systems . . . . . . . . . 293

12.5 Micronutrients . . . . . . . . . . . . . . . . . . . . . . . . . . . 295

12.6 Iodine Deficiency Dis s . . . . . . . . . . . . . . 297

12.7 Vitamin A Deficiency . . . . . . . . . . . . . . . . . . . . . 297

12.8 Iron Deficiency Anemia . . . . . . . . . . . . . . . . . . 298

12.9 Other Micronutrient Deficiencies . . . . . . . . . 300

12.10 Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . 302

12.11 Overweight and Obesity . . . . . . . . . . . . . . . . 304

12.12 Food Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 308

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311

Chapter 13 Cancer . . . . . . . . . . . . . . . . . . . 315
13.1 Cancer and Global Health . . . . . . . . . . . . . . . . 315

13.2 Cancer Biology . . . . . . . . . . . . . . . . . . . . . . . . . . . 316

13.3 Cancer Epidemiology . . . . . . . . . . . . . . . . . . . . 316

13.4 Cancer Risk Factors and Prevention . . . . . . . 320

13.5 Cancer Screening and Diagnosis . . . . . . . . . 324

13.6 Cancer Treatment . . . . . . . . . . . . . . . . . . . . . . . . 326

13.7 Lung Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 328

13.8 Breast Cancer and Cervical Cancer . . . . . . . . 328

13.9 Prostate Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . 332

13.10 Liver Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . 332

13.11 Esophageal, Stomach, and
Colorectal Cancers . . . . . . . . . . . . . . . . . . . . . . .333

13.12 Other Cancers . . . . . . . . . . . . . . . . . . . . . . . . . . 334

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 335

Chapter 14 Cardiovascular Diseases . . . . 338
14.1 Cardiovascular Disease and Global Health 338

14.2 Ischemic Heart Disease . . . . . . . . . . . . . . . . . . . 342

14.3 Cerebrovascular Disease (Strokes) . . . . . . . . 344

vi Contents

Chapter 19 Promoting Healthy
Adulthood and Aging . . . . . . 425

19.1 Aging and Global Health . . . . . . . . . . . . . . . . . 425

19.2 Health Promotion in Early
and Middle Adulthood . . . . . . . . . . . . . . . . . . . .428

19.3 Health Promotion for Older Adults . . . . . . . . 430

19.4 Caring for Aging Populations . . . . . . . . . . . . . 431

19.5 Health Promotion Across
the Life Span . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .434

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 434

Chapter 20 Global Health Careers . . . . . . 436
20.1 Career Pathways in Global Health . . . . . . . . . 436

20.2 Global Health Education . . . . . . . . . . . . . . . . . 437

20.3 Experiential Learning
in Global Health . . . . . . . . . . . . . . . . . . . . . . . . . . .439

20.4 Global Health Matters . . . . . . . . . . . . . . . . . . . . 440

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 442

Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .443

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .468

17.2 Transport Injuries . . . . . . . . . . . . . . . . . . . . . . . . . 400

17.3 Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 402

17.4 Drowning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 403

17.5 Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 404

17.6 Other Unintentional Injuries . . . . . . . . . . . . . . 405

17.7 Intentional Injuries . . . . . . . . . . . . . . . . . . . . . . . 405

17.8 Interpersonal Violence . . . . . . . . . . . . . . . . . . . 406

17.9 Gender-Based Violence . . . . . . . . . . . . . . . . . . . 407

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 408

Chapter 18 Promoting Neonatal,
Infant, Child, and
Adolescent Health . . . . . . . . . 410

18.1 Progress in Child Survival . . . . . . . . . . . . . . . . . 410

18.2 Improving Neonatal Survival . . . . . . . . . . . . . 415

18.3 Promoting Infant and Child Health . . . . . . . 417

18.4 Promoting Early Childhood Development 419

18.5 Children with Special Needs . . . . . . . . . . . . . . 419

18.6 Health Promotion for Older Children . . . . . 420

18.7 Health Promotion for Adolescents . . . . . . . . 421

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 423

vii

© Xinzheng. All Rights Reserved/Moment/Getty

across the income spectrum. For example, the
SDGs include targets for preventing new hep-
atitis B virus infections; reducing the number
of adults who die from cardiovascular diseases,
cancers, and other noncommunicable diseases
before their 70th birthdays; reducing the suicide
mortality rate; increasing access to treatment for
substance use dis s; and reducing deaths
from road traffic injuries and violence. These
conditions affect people in every country, and all
countries have the opportunity under the SDGs
to track their progress toward improving health
metrics related to these concerns.

This third edition of Introduction to
Global Health is a book for the SDG era. The
socioeconomic and environmental determi-
nants of health are presented in the context of
the SDGs. The shifting landscape for financ-
ing and implementing global health initiatives
is described in expanded chapters on payers
and players. Chapters on infectious diseases,
reproductive health, and nutrition are comple-
mented by new chapters on noncommunica-
ble diseases, mental health, and injuries. The
similarities and differences in the conditions
that cause illness and death in featured coun-
tries representing diverse world regions and
income levels are illustrated with estimates
from the Global Burden of Disease (GBD)
project, which now produces annually updated
profiles of health status in every country. (Dis-
closure: the author is a GBD collaborator.) The
global health agenda has expanded to cover all
of the world’s people, and this book provides
a positive, forward-looking perspective on the
numerous actions that are helping promote
the health, well-being, and security of people
across the lifespan and across the globe.

The first and second editions of Intro-duction to Global Health were written during the Millennium Development
Goals (MDG) era of global health. The MDGs
spelled out an ambitious plan for significantly
reducing global poverty between 2000 and
2015. They were wildly successful. The num-
ber of people living on less than $1 per day
dropped substantially during the first 15 years
of the 21st century. As a growing number of
global health partnerships set agendas for
change and financed action plans, significant
progress was made toward alleviating hun-
ger, preventing maternal and child mortality,
and controlling HIV/AIDS and malaria.

The next generation of global goals—the
Sustainable Development Goals (SDGs)—were
launched at the end of 2015. They spell out 17
goals for enhancing human flourishing by 2030,
including targets related to poverty reduction,
hunger, health, education, gender equality,
clean water and sanitation, affordable and clean
energy, decent work, infrastructure and tech-
nology development, human rights, sustainable
urbanization, responsible production and con-
sumption, climate and environment, peace, and
governance. The SDGs seek to promote pros-
perity while upholding human rights, protect-
ing the planet, and fostering peace and security.
All of the goals are interdependent, and all are
inextricably tied to health. Improvements in
any of the 17 areas will yield benefits for popula-
tion health, and improvements in public health
will enable other SDGs to be achieved.

Most of the MDGs were targeted at improv-
ing quality of life among the world’s poorest
people. The SDGs retain those aims but add a
lengthy list of objectives that apply to countries

Preface

viii

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Chapter 6 is a new chapter that describes
the health system models used in various
countries and explains the funding mecha-
nisms used to pay for global health activities.
Chapter 7 features the diversity of entities
involved in implementing and evaluating
global health interventions, including gov-
ernmental and intergovernmental agen-
cies, nonprofit organizations, and for-profit
corporations.

Chapters 8 through 17 present the health
conditions that account for the greatest burden
of disease globally. Each chapter begins with a
section that explains why the featured topic is
considered to be a global health issue, and each
chapter emphasizes the interventions that can
reduce the impact of adverse health conditions
on individuals and populations. Health met-
rics from the Global Burden of Disease (GBD)
collaboration are used to illustrate the popula-
tions affected by each condition.

Chapter 8 describes the global threats
posed by HIV/AIDS, tuberculosis, and anti-
microbial resistance. Chapter 9 discusses the
heavy toll that child mortality from diarrheal
diseases and pneumonia takes on low-in-
come countries and describes the tools that
are available to contain outbreaks of influ-
enza and other vaccine-preventable infections.
Chapter 10 describes the burden from malaria
and neglected tropical diseases in low-income
countries and the global threats associated
with emerging infectious diseases. Chapter 11
highlights a diversity of reproductive and sex-
ual health issues, including family planning,
infertility, pregnancy, maternal mortality, neo-
natal health, men’s health, and sexual minority

The third edition of Introduction to Global
Health has been significantly expanded to
include more comprehensive coverage of the
full spectrum of topics that now constitute part
of the global health agenda.

Chapter 1 presents a new model for iden-
tifying global health issues—one that incor-
porates populations, action, cooperation,
equity, and security—and it introduces the key
concepts of prevention science, health transi-
tions theory, globalization, and global health
security.

Chapter 2 introduces the new Sustainable
Development Goals (SDGs) that will guide
international development efforts through
2030 and describes the most commonly used
global health metrics.

Chapters 3 and 4 use the SDGs as a frame-
work for exploring the social and environmen-
tal determinants of health. Chapter 3 describes
the connections between health and econom-
ics, education, gender, employment, culture,
migration, and governance. Chapter 4 exam-
ines the links between health and water, san-
itation, energy, air quality, occupational and
industrial health, urbanization, sustainability,
and climate change.

Chapter 5 uses the SDGs and the
Universal Declaration of Human Rights to
highlight some of the major ethical issues
in global health, including questions about
the right to have access to healthcare ser-
vices and medicines, humanitarian respon-
sibilities after natural disasters and during
times of conflict, and the rights of people in
prison, people with disabilities, and other
special populations.

New to This Edition

New to This Edition ix

achieved under the MDGs and the opportu-
nities for continued progress under the SDGs.
Chapter 19 describes the emerging challenges
associated with aging populations and the
opportunities for promoting healthy adult-
hood and aging.

Chapter 20 is a new chapter that describes
the links between diverse educational and career
pathways and global health, and emphasizes the
opportunities for everyone to be involved in
making communities and the world a healthier
place for current and future generations.

More than 350 figures and tables high-
light key material, and nearly all of these are
new for the third edition. All of the statistics in
the book have been updated. Data from eight
of the world’s largest countries, which collec-
tively are home to half of the world’s people,
are used to illustrate the patterns of health
status in high-income, middle-income, and
low-income countries: Brazil, China, Ethiopia,
Germany, India, Iran, Nigeria, and the United
States. A new glossary provides definitions for
more than 780 key terms in global health.

health. Chapter 12 describes the nutrition
transition and the challenges associated with
undernutrition, overnutrition, and food safety.

A series of new chapters describe the oppor-
tunities for global health initiatives to address
the noncommunicable diseases (NCDs), men-
tal health dis s, and injuries that are among
the leading causes of death worldwide. Chapter
13 focuses on cancer, Chapter 14 focuses on
cardiovascular disease, and Chapter 15 focuses
on …