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ECONOMICS HEALTH HEALTH ECONOMICS PHARMACOECONOMICS

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HEALTH

comes from the English word

heal

HEALTH (WHO)
POSITIVE DEFINITION :

The state of complete mental, physical, and social well being, and does not merely the absence of illness or infirmity

HEALTH (WHO)
NEGATIVE DEFINITION :

Total absence of diseases or illness in ones body

6 BIOLOGICAL ASPECTS OF HEALTH

SOCIETY

ENVIRONMENT
Physical Mental

Emotional
Spiritual

Social Sexual

BIOLOGICAL

Physical health

Mental health

Emotional Health

Social Health

Spiritual Health

Sexual Health

Health is

a general condition of the body and mind; the presence or absence of illness, injuries or impairments

NOTE:
An individual who does not experience any symptoms of disease may not necessarily be healthy. Absence of symptoms does not necessary connote healthfulness

Health care sector has a

task to insure health services to people

OBJECTIVE OF HEALTH
To promote the health welfare as well as the health services to everybody

OBJECTIVES HEALTH
SOCIETY
ENVIRONMENT
Physical Mental

Emotional
Spiritual

Social Sexual

BIOLOGICAL

Major Determinants of Health 1. Genetic and biological factors

2. Lifestyle factors

3. Environmental factors
4. The extent and nature of health services

Underlying socioeconomic, demographic, and cultural factors Individual

Determinants of Health: Major Effects and Intervention Points

Proximate Factors Health Care Services Health Outcomes Mortality Morbidity Nutritional Status Disability

Underlying Age, gender

Education

Health benefits, Attitudes Household Income/wealth Age-gender composition Social network Community

Economic, Demographic, and Occupation Cultural Factors

Socio-

Environmental Contamination
Nutrient Dietary intake

Ecological climate Markets & prices Transportation size, structure, and distribution Social structure and organization

Fertility
Injury

How is health objectively measured?

There are a number of ways of measuring health

1. Health measures
Measures of the health status of people: a. Vital statistics height and weight b. Dental health status decayed, missing and filled teeth, index c. Average height of population proxy for nutritional status d. Percentage of low birth weight babies

2. Health behavior indicators

a. Peoples behavior Examples: number of people smoking, drinking alcohol, using drugs, eating a healthy diet, practicing safe sex or planned fertility b. Specific behavior Examples: percentage of children immunized against childhood illness, percentage of women screened for cervical and breast cancer

3. Environmental indicators
a. Measurement of physical environment Example: air and water quality

b. Social environment
Example: housing type and density 4. Socio-economic indicators

a. Wealth (3 components)
Examples: life expectancy, educational attainment, and income

b. GNP a measure of countrys wealth

c. Peoples health related beliefs and attitudes

Top 10 Leading Diseasess (mortality)

Disease of the heart Disease of the vascular system Pneumonia Malignant neoplasm TB, all forms Accident
Chronic obstructive pulmonary & allied conditions Other diseases of the respiratory system Diabetes Mellitus Diarrheal disease

Top 10 leading Diseases (morbidity)

Diarrhea Pneumonia Bronchitis Influenza TB, respiratory Hypertension Malaria Chicken pox Diseases of the heart Measles

A. Social and Health

Social Class Classification
1. Higher managerial and professional

e.g. company directors, bank managers, senior civil servants

2. Lower managerial and professional e.g. Nurses, soldiers, pharmacist 3. Intermediate

e.g. Secretaries, clerks

4. Small employers and own account workers e.g. publicans, play group leaders, farmers, taxi drivers 5. Lower supervisory, craft and related occupation

e.g. Printers, plumbers, butchers, train drivers

6. Semi-routine occupations e.g. Waiters, road sweepers, cleaners, couriers 7. Never worked and long term unemployment

B. Income and Health

Ways in which low income can affect health 1. Physiological Examples: inadequate or unfit housing, lack of food, lack of fuel 2. Psychological Examples: stress and lack of social support 3. Behavioral Examples: smoking or drinking alcohol; giving of children sweets

C. Housing and Health - housing quality and its lack of availability can damage health

- unknown number of families share unsuitable or inadequate accommodations

- problems of homelessness respiratory illness depression

high rates of infections

difficulties in gaining access to health services

D. Employment and Health

- work is important to consider as a social determinant of health - it determines income level - it affects self-esteem - the type of employment may itself affect health Examples: mining exposure to hazardous substance or stress publicans high risk of developing cirrhosis

E. Gender and Health

- Genders refers to the social categorization of people as men or women, and the social meaning and beliefs about sexual differences - men are encouraged to be aggressive and risk-taking both at work in their leisure time higher rates of accidents and alcoholism - women are socialized to be passive, dependent and sick - women working increased stress and ill health

F. Health of Ethnic Minorities

- black and ethnic minority experience more ill health, chronic and mental ill (sickle cell anemia, thalassaemia and Tay-sachs disease) - little information of health, low income, poor working conditions, unemployment and poor housing shared by those in lower social classes

Health Outcomes They can be 1. Distinct figures

Examples: life expectancy (length in years, nutritional status (weight for age or height )
2. Ratios Examples: mortality rates, morbidity rates, incidence and prevalence

Examples of Health Outcomes

1. Fertility Rate measures the

reproductive capacity of groups

Crude Birth Rate = Total number of live births

(CRB) midyear population x 1000

2. Mortality Rate measures risk of dying within a specific group or dying from a cause Crude Death Rate (CDR) = number of deaths, all causes x 1000 midyear population Cause Specific Death Rate (CSDR) = number of deaths from specific cause
x F

midyear population

2. Mortality Rate measures risk of dying within a specific group or dying from a cause

Infant Mortality Rate (IFR)

= infant mortality rate <1 year age x 1000 Total number of live births

3. Morbidity Rate measures the frequency of illnesses within specific population Prevalence Rate (PR)
= Number of new and old cases within a period x 100 midyear population

Incidence Rate (IR)

= Number of new cases XF Population at risk

Health outcome before the health program

Compare

Health outcome after the health program

Health Program

Proximate factors and health programs developed

Proximate factors Health Care Service Utilization Environmental Contamination Nutrient Dietary Intake Fertility Injury Health Programs Developed OPLAN Bakuna with Jollibee, OPLAN Alis Disease Anti-pollution Campaign, Worker Health and Safety Program Barangay Day Care Centers, Vitamin A Campaign Responsible Parenthood Information Drive Dont Drink and Drive

Example
A: Individual Level
Occupation as a >>> Exposure to mining >>> increased coal miner contaminants incidence of workers lung

disease
(Occupation as underlying determinant) (Environmental contamination as proximate determinant) (Health Status/ outcome)

Example
B. Household Level
Low household Income >>> Poor nutritional >>>> Poor nutritional intake status (low weight, height) (Health status/ Outcome)

(Income/Wealth as underlying determinant)

(Nutritional intake as proximate determinant)

Example
C. Community Level
Poor transportation >>> Poor health care >>> More deaths in transportation network (Transportation as underlying (Healthcare service utilization as a (Health Status/ Outcome) service utilization the area

determinant)

proximate factor

Relationship Of health and Economic

Improvement in Health status

More resources allocated for health

Improvement in worker productivity

?
Contributes to better economy

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