EQ4: How can the impacts of health risk be managed?

Aims: To investigate the social, economic and environmental impacts of health risk

In investigating the varying impacts of infection and disease on people and communities and the resultant short and long term economic burdens on society, consider:

•The impact on families of one member having a chronic (long term disease) or a disability

–Social

-Economic

-MEDC/NIC/LEDC differences

•The impact on communities of the same disease but in a large number of people e.g HIV/AIDS

Key terms

• Health system – ALL of the activities whose primary purpose is to promote, restore and maintain good health– Funded in a variety of ways across the globe

• Taxation• Stat social insurance schemes• Employers’ contributions to workers’ insurance

schemes• Private health insurance schemes• Direct payments from patients• NGOs and other sources of aid

Key terms

• SHORT term – a limited period of time – days or weeks

• LONG term – more extensive timeframe – months, years even decades

Impact of Increasing Life Expectancy (i.e. improving health!)

• More people at risk of degenerative non-communicable diseases (chronic) – expensive drugs, expensive operations, expensive LONG TERM care

• Over 80s cost more in terms of long term care

Major cost to healthcare and welfare

“Much has been accomplished in the last 30 years: if children were still dying at 1978 rates, there would have been 16.2 million child deaths globally in 2006 instead of the actual 9.5 million. Yet, progress in health has been deeply and unacceptably unequal, with many disadvantaged populations increasingly lagging behind or even losing ground.

Meanwhile, the nature of health problems is changing dramatically. Urbanization, globalization and other factors speed the worldwide transmission of communicable diseases, and increase the burden of chronic disorders. Climate change and food insecurity will have major implications for health in the years ahead thereby creating enormous challenges for an effective and equitable response.

In the face of all this, business as usual for health systems is not a viable option. Many systems seem to be drifting from one short-term priority to another, increasingly fragmented and without a strong sense of preparedness for what lies ahead.”From WHO report 2008

Read the section “Responding to the challenges of a changing world “ from pxii-xiii of the report and summarise the challenges it describes.

Health Divide

• Within and between countries

• Think about your UK and China examples

Health Divide – between countries

Health Divide – between countries

1.4 and 1.6 from WHO world health report 2008

Health Divide – Within Countries

For most countries and for most indicators, infection and disease impact the most as income decreases.

Health Divide – Within CountriesHIGHER INCOME = ability to pay + greater educational prospects leading to greater understanding of health prevention measures

From: WHO world health report 2008

Read WHO 2008 case studies taken from the WHO World Health report 2008 – you will make use of these throughout this enquiry question

Income has a major impact on housing quality.

Studies in UK and USA have examined aspects of housing impacting on health including:

• Lack of indoor toilet

• Sharing of basic domestic facilities

• Overcrowding

• NOx and CO emissions

• Damp

• Low temperatures in main rooms

See next slide

SCIE research briefing 19: What is the impact of environmental housing conditions on the health and well-being of children?

Published December 2005Key messages•More than one million children live in housing in England that it considered sub-standard or unfit to live in •On the whole, the research indicates that there is an association between homes with visible damp or mould and the prevalence of asthma or respiratory problems among children •Dampness and mould has also been found to be associated with exacerbated symptoms among children with asthma or wheezing illness •Poor quality housing can have an adverse effect on children's psychological well-being •Parents and children both complain of the social stigma of living in bad housing •Overcrowding and cooking with gas may cause respiratory infections in preterm infants •Interventions such as installing or improving heating systems has been found to be effective in alleviating the potentially adverse effects of damp on the health on children

Social Care Institute for Excellence: http://www.scie.org.uk/publications/briefings/briefing19/index.asp

Level of Health Impacts on Countries in terms of:

• Labour Supply • Labour productivity• Savings and Investments• Education

Consider the differing impacts in MEDCs vs. LEDCs

E.g. HIV/AIDS

Short Term Impacts

• Short term health care is Curative and Palliative (alleviating symptoms)

• Impacts– Interruption to schooling leads to…..– Cost of hospitalisation and immediate drug

care – cost to who…?Reduction of household wages for periods of illness leads to….

– Temporary loss of personnel leads to….– Lost short term productivity leads to….

Swine flu absenteeism could cost small firms €90m - SFA19.10.2009Almost 60pc of small firms have no business contingency plan in place in the event of a Swine flu epidemic, according to a new survey from the Small Firms Association (SFA), which has also warned that absenteeism rates resulting from such an epidemic could end up costing small businesses €90m. http://www.businessandleadership.com/owner-manager/news/article/16722/owner-manager/swine-flu-could-cost-firms-eur90m

For most small firms, the threat of interrupted cashflow will be one of the biggest concerns. According to think tank Oxford Economics, the swine flu pandemic could cost the UK more than £40 billion in lost trade.You also need to consider the impact a pandemic might have on your stock levels. “Think about your peak selling season – if it’s Christmas, make sure you’re well prepared regarding inventory, stock and suppliers,” warns Price. “If delivery is affected, and there’s a dip in cashflow, how will you manage?”http://www.icaew.com/index.cfm/route/167402/icaew_ga/en/Technical_and_Business_Topics/Guides_and_publications/Small_Business_Update/Articles_Strategy

Long term impacts• 3 long term aims of health care? Read PA page

371• Impacts:

– Reduces skills and qualifications of significant proportion of population – reducing national income

– COSTS of long term disability and care – ageing populations

• “A report published in May by The King's Fund predicts the costs of mental health services in England will spiral from £22.5 billion today, to £47 billion in 2026, largely as result of the country's growing population, but also because of the rising prevalence of dementia.” 2008

Long term impacts• Joint research by the Confederation of British

Industry and Axa shows that in 2006, the cost of staff absence to the UK economy rose to £13.4bn, with over 40% of overall time lost attributable to longer periods of absence - 20 days or more.

• In Wales, £90 million is spent each year on incapacity benefits to individuals suffering with back pain, with costs of the health care at some £150 million. Sickness absence due to back pain costs the economy in Wales £85 million.

Long Term Impacts

• Long term skills shortage due to disability and death from HIV/AIDS etc

• Death of a household member increases the probability of depression, alcoholism etc

• Increase in dependency ratio as economically active decrease in number

• Health problems reduce national savings and investment