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Reflection Essay on individual goals Christiane Schaepe Public Health and Global Health Patterns Autumn 2010 Introduction The course objectives I put in the beginning of the course were: firstly to add on my body of knowledge a deeper understanding of public health by understanding the development of public health science, strategies, models, health indicators, health determining factors, public health issues. Secondly, to describe the contemporary global health situation, it’s relationship to globalization and to understand the global health patterns.
Thirdly to get an overview of the current research in the field of public health and to relate to ethical themes in public health. The learning objectives I stated in the beginning of the course, have some similarities with the goals presented in the syllabus of the Public Health and Global Patterns course. One motivation for doing this was out of practical reasons. I believed that the objectives presented in the syllabus would represent the course content, hence could easily be achieved. Moreover, the objectives I picked from the syllabus were the ones I found most important and interesting for my future profession as a public health expert.
In general there was no need for making adjustments in the objectives, because they were relevant during the course and are still worth to achieve. Each goal include several minor ones, which make each goal too broad with the benefit of hindsight. Consequently, each minor goal did not get the same attention. First goal As stated, I wanted to gain an deeper understanding on what public health is. Definitions on public health were already familiar to me before the course started. These definitions can somehow just give an broad understanding of what public health is.
Through studying the historical development on public health in chapter 2 in Beaglehole (1) and first chapter in Lindstrand et al (2), I understood better how broad the field is and what great achievements in the field of public health were done so far and that so much is left to archive. The course lectures opened my eyes for health issues like for example traffic injuries and accidents, drug abuse which I found surprisingly interesting and I might found a future field of working in, what I did not expected from the start of the course.
Before the course I know roughly the health indicators, but I did not had the correct definition in mind, which the diagnostic test also had shown. After this revealing results, I read them in Lindstrand et al (2) and even the lecture gave me more knowledge on them. I the beginning of the course I found it difficult to understand how they reflect the health reality of a population. That is why I like the indicator DALY (Disability adjusted live years),which was introduced to me during the course.
It describes “the losses of healthy years due to disability and premature deaths” (2) (p 109) Later on, I also understood the uncertainty with the health indicators: There is a problem with the quality and in some regions non-existence of data and not to mention the retrospective character of the data to describe, which I learned to have in mind when citing indicators. This knowledge will definitively benefit my profession because they are published by many organizations and commonly used to describe the need for public health action.
What gave me an concrete and “real life” understanding on the health determinants was the individual assignment. When studying domestic violence against women (DVAW) in rural Bangladesh, I understood how this issue is connected with the health determinants in a causal and sometimes reinforcing way. For example, poverty is a identified risk factor for DVAW on the one hand and on the other hand is poor health in women (as a consequence of DVAW) limiting the development of the country. Other determinants from the iterature reemerged as risk factors for DVAW in my literature review, like education, religion, drugs use, socioeconomic, marital status just to mention some. Determinants like gender (in the context of DVAW: gender inequalities), social and cultural environment do not only interplay with other determinants, they are both a barrier for change and crucial to tackle in the community for permanent norm change. I am convinced that what I learned by the literature review, can surely be transferred into an health issue, which is useful for the future. Second goal
This goal was not really met until the second intensive week, where lectures and discussions around globalization and global health patterns came up. In this phase I learned about the tremendous impact that globalization has on health. All societies are affected in some way, equally or differently. An example where all countries are affected equally is the increased average life expectancy and the decrease of the under five child mortality. Illustrations of this where given in the discussion and seminar lectures in the second course week and by introducing Hans Roslings lectures and “gabminder” to me.
Until recently I was unaware of these positive effects of globalization, maybe because media usually do not mention positive news. Unfortunately, the other face of globalization is the huge disparities between low, middle income countries and high income countries also shows that the interconnectedness has many negative consequences. By writing the group position paper on gender- based violence in a global context changed my perspective form the local (rural Bangladesh) to the global one.
The issue is globally distributed with wide-reaching prevalence differences, partly because of cultural differences in gender equalities. The flow of policies against gender based violence from international organizations to local legislation is only one example that illustrated for me globalization in this group assignment. Third goal Since the field of public health is wide, it was unrealistic to get an overview of current research in all aspects of the field.
However I gained insight into many fields like: community-based research in public health, substance abuse, global mental health, road traffic safety, sexual and reproductive rights, nutritional disorders in a global perspective, infectious diseases and many more. Honestly, I did not relate much of my studies to ethical themes as I stated in my objectives. The reason for this might be that in my opinion ethics have to have a concrete context, which means have to be reflected on in practice when ethical dilemma appear or when working with a project.
Even if there was a discussion in the lecture”Ethics in public health practice and research”about the ethical principles and I read chapter 13 in Beaglehole (1), I would have difficulties to recount them here. However, I believe that is not the point to know them by heard, rather to have ethical principles and considerations in mind when working with individuals, groups or communities. In conclusion the course add on my body of knowledge an introduction to the field of global public health.
The main sources of knowledge came from the obligatory course literature, from the articles provided, from the various types of lectures and from the individual and group assignment. Thanks to this variety of inputs my perspective of global public health is broadened. References 1. Beaglehole R, editor. Global Public Health : a new era. Oxford: Oxford University Press; 2004. 2. Lindstrand Ann BS, Rosling Hans, Rubenson Brigitta, Stenson Bo, Tylleskar Thorkild. Global Health An introductory textbook. 1 ed. Lund: Studentlitteratur; 2006.