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Nowadays, health care plays a vital role in the whole world. Global health is an area of practice, research, and study that puts a priority on gaining equality in health care for all people around the globe and improving healthcare services. Globalization has increased the interdependence and interconnectedness of states and people, and such changes have affected the health care area. In particular, international society has started to discover and analyze different disorders and search for medicines. This practice has shaped some global healthcare standards and expectations for all people. Hence, global health is a highly crucial notion because it involves international community participants that desire to improve a health care service level and promote equal access to health services for all society members.
Historical Perspectives on Global Health Learning
In 1977, at the annual World Health Assembly meeting, agencies established the main goal for all world citizens gaining the health level that would provide them with the ability to have economically and socially a productive way of life by 2000 (Holtz, 2017). The aims were promoted by various health-related conferences around the world, involving the International Council of Nurses. In 1978, global healthcare problems became the main points of discussion at the International Conference on Primary Health Care conducted in Kazakhstan and sponsored by the World Health Organization (WHO) and UNICEF (Holtz, 2017). Its participants adopted a resolution that stated the main issues of the “Health for All” initiative (HFA) by 2000 and worldwide primary healthcare implementation. As a result, a concern about global health has increased, and it has led to the need to realize health issues on the global level. However, not all states enjoy technological benefits in the healthcare system, and more developed countries have taken the leading position in defining global healthcare perspectives. Health problems are present all over the world, but less developed states have ones that sound in a more exotic way. Ongoing health issues needing control in such regions involve polio, rubella, mumps, and measles, whereas current health concerns of more developed countries are hepatitis, new viral strains, and greater social and health-related problems, such as violence, warfare, and terrorism (Holtz, 2017). However, AIDS is the most prevalent problem globally.
All states promote the HFA 21 objectives, and due to it, they realize that they need to improve their economies and infrastructures. Hence, they look for technological expertise and funds from the most developed and wealthy countries. Since economic agreements between states have removed political and financial barriers, development and growth have been stimulated. Therefore, a global health problem that has been once perceived as distant is closer to people from all over the world, and the population group movement has increased, just as risks of exposure to different kinds of disorders and other health problems.
Nowadays, less-developed states experience high child and infant death rates, with respiratory and diarrheal disorders as the main contributing factors. Other main worldwide health challenges involve drugs, alcohol and tobacco abuse, environmental and occupational health hazards, leprosy, neonatal tetanus, drug-resistant tuberculosis (TB), malaria, and HIV (Holtz, 2017). Hence, due to these problems prevalence, the WHO made a commitment to renew all health care policies. It currently continues to develop new initiatives, putting emphasis on solidarity, equity, as well as community, family and individual responsibility for health. Being informed about global health is also highly crucial for nurses. They play an important role internationally, where economic and political boundaries mesh (Holtz, 2017). Nurses have been participants of global health phenomenon formation from the beginning, and their involvement has helped to form this notion.
Serious attempts were made on the global level to emphasize health as a policy issue, while raising awareness of the connection between health and foreign policy. For instance, in 2009, the UN General Assembly passed an official resolution, and individual states adopted their own mandates (Holtz, 2017). Global health diplomacy is a quite new notion that has two goals to improve international relations in struggling world areas and global health. The nursing discipline is perfectly placed to promote its members as actors in both global health diplomacy and human rights efforts. Moreover, the long history of delivering healthcare services to the global community can develop in one, where nurses take leading roles.
Healthcare Disparities Importance
Healthcare disparities represent differences in the access and delivery of health care services to population groups. In general, this notion relates to a higher mortality, disability, injury, or illness burden experienced by one population group relative to the other one. Health care disparities usually involve differences in healthcare quality, access, and coverage for people. While they are usually realized from the ethnical or race perspectives, they appear across many dimensions, involving sexual orientation, disability status, gender, location, age, and social status (The Kaiser Family Foundation, 2012, p. 3). Disparities in healthcare can limit a continued improvement in total care quality and population health, as well as result in unnecessary costs. For instance, the recent analysis states that thirty percent of medical costs directed at Asian Americans, Hispanics, and Blacks are excessive due to health inequalities and that the economy loses 309 million dollars annually due to indirect and direct disparity expenses (The Kaiser Family Foundation, 2012, p. 3). Within time the population turns highly heterogeneous, and it is projected that color people will account for over half of the population by 2050 with the largest growth among Hispanics.
At the same time, color people show disproportionally low income and uninsured levels in comparison to the general population size. Moreover, the growth of such communities and widening income gaps put emphasis on the importance of handling health care disparities. Therefore, addressing the latter is not only crucial from the social justice perspective, but also for improving the Americans’ health through achieving the overall quality of population health services and reducing expenses on health care (The Kaiser Family Foundation, 2012, p. 3). Moreover, as low-income individuals, American Indians/Alaska Natives, Blacks, and Hispanics tend to be uninsured relative to whites and people with higher incomes (The Kaiser Family Foundation, 2012, p. 3). At the same time, low-income and color people experience raised barriers to accessing care, face worse health care outcomes, and gain health care of poorer quality. Hence, the equality problem is huge.
Healthcare Regulatory Guidelines
Several policies affect healthcare on the global level. One of them is the Healthy People 2020 initiative, and its main purpose is to improve public health and empower U.S. national well-being through detecting global disorders and developing control, prevention and response strategies (Office of Disease Prevention and Health Promotion (ODPHP), n.d.). The main objectives of this policy have been still unfulfilled and involve “the increase of diagnostic testing ability in host states and regionally through the Global Disease Detection Regional Centers, raise of the public health professionals’ numbers trained by the Global Disease Detection programs around the world” (ODPHP, n.d.). However, this is not a single project.
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Another alternative is the UN Millennium Development Goals agreed upon by all UN member states. The UN Millennium Declaration was signed in 2000 and committed world leaders to fight with discrimination against women, environmental degradation, illiteracy, disease, hunger, and poverty (ODPHP, n.d.). There are eight goals, such as global partnership development, environmental sustainability promotion, malaria, HIV and other disease combat, maternal health improvement, child mortality reduction, women empowerment and gender equality promotion, and extreme hunger and poverty eradication (ODPHP, n.d.). This project represents efficient outcomes.
One more project is called the Global Polio Eradication Initiative. It issues regulatory guidelines under the control of the national government with five partners, such as the Bill & Melinda Gates Foundation, UNICEF, Rotary International, U.S. Centers for Disease Control and Prevention, and the WHO (ODPHP, n.d.). Their goal is to “finish the eradication and the containment of vaccine-related and Sabin polioviruses that no child ever suffers paralytic poliomyelitis” (ODPHP, n.d.). Nowadays, sixteen million people are walking, and without these regulations, they would have been paralyzed by the disorder. Moreover, 1.5 million of individuals are alive (ODPHP, n.d.). This initiative has helped states to achieve a great progress in protecting the global population from this disorder.
Another project is the President’s Malaria Initiative that was established in 2005 in order to decrease the malaria-related mortality rate by fifty percent around fifteen high-burdened states in sub-Saharan Africa through the rapid scale-up of proven and highly efficient malaria treatment and prevention tools (ODPHP, n.d.). Hence, all these projects are aimed to form a single position regarding the importance of global health and to improve health from the international perspective.
Moral Issues in Global Healthcare
The global initiatives creation in healthcare requires the review of moral and ethical values. Global health has to be guided by ethical principles, and political commitment and technical excellence have no value unless they have an ethically sound goal. Hence, there are different thought schools that can be applied to global initiatives justification (Holtz, 2017). The first one is humanitarianism, which means acting virtuously towards people that need help. It is the basic philosophy behind the U.S. government foreign aid policy. The next theory is utilitarianism, which means happiness maximization for people (Holtz, 2017). The main idea is the health improvement of people that live in society and in the best interest for all society members.
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Another moral issue is equality through gaining health capabilities fair distribution. Ensuring that all individuals in society have an equal and fair chance to gain good healthcare services is highly critical. At the same time, fulfilling obligations by healthcare providers plays a crucial role, just as ensuring that health care respects human rights and dignity of all society members. The next factor in the moral problem of equality is related to knowledge and institutions. The main point is the issue of access to new health medications, technology development, and research (Holtz, 2017). For instance, the HIV/AIDS antiretroviral drug development provided a new moral dilemma through putting emphasis on drug affordability differences among nations. Another equality issue relates to consensus and advocacy groups (Holtz, 2017). People that are usually empowered by strict political positions desire to have health policies provided for some groups in society, excluding others.
Healthcare Productivity and Economic Costs
With high amounts of money spent on the medical sphere, the USA approaches the flat curve unlike other states. The reason is additional expenses that produce less health outcomes. Economists can describe health care production through the use of the production function concept. The latter describes the relationship between outcomes and inputs and specifies the maximum amount of output that can be produced by a specific input combination for any provided production technology (Holtz, 2017). Outcomes can be a hospital-length stay, mortality rates, cancer detection, and other morbidity measures. Inputs can be tested expenditures and treatment procedures (Holtz, 2017). Through such approach, it is possible to analyze why the USA does not provide better results in any health outcome measures, even though it spends impressively more than other states. One of the most effective ways of identifying the benefits and costs across generations is the cost-effectiveness analysis (CEA) (Holtz, 2017). It measures costs per incremental or additional unit of health outcomes and applies the results to guide decisions on which procedure or test have to be used. Based on the comparison of healthcare costs in the U.S. and other states, it is possible to notice that in the former country primarily costs per bed day are 906.64, while the figure is 30.11 in Ukraine, 138.85 in Japan, 14.71 in India, and 140.09 in Canada. The primary cost per outpatient visit in the USA is 366.17, 9.16 in Ukraine, 54.85 in Japan, 3.96 in India, and 55.43 in Canada (Holtz, 2017, p. 135). Therefore, while Japan and Canada have similar unit costs, the USA has outpatient and inpatient expenses that are about seven times higher. Hence, the latter is at the phase where additional improvements in health are too challenging to gain, while such states as India and Ukraine can find it easier and less expensive to improve the health care system.
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Productivity in the USA is not brilliant because life expectance among women and men is 81.3 and 76.5 respectively, and it is lower than in Japan and Canada. Similarly, the infant mortality rate is higher than the one in other industrialized states despite the greater number of nurses and midwives (Holtz, 2017, p. 125). In 2013, expenses on healthcare in the US increased in comparison to Canada and Japan, and total spending grew by 5.3% in 2014. Similarly, spending on hospital care also grew by 4.1% in the same year (Holtz, 2017, p. 125).
Availability of Healthcare Providers
Nowadays, there is a crisis in the human resources area, and this main global health issue threatens health care system sustainability and quality throughout the world. Healthcare workers, particularly APNRs, RNs, and physicians find many chances for employment abroad, and it has led to the migration of workers moving from low-income states to higher-income ones. Healthcare employees migration has affected countries, from which they have migrated and provoked shortages in health service capacity, financial losses in worker education and training investment, decline in moral and commitment among remaining workers, loss of expert knowledge in academic centers, and the lack of role models for young students (Holtz, 2017). Hence, these states simply suffer from the brain drain. The USA has faced the problem of the lower number of nurses and physicians per capita in comparison to the average index provided by the Organization for Economic Cooperation and Development (OECD). In 2013, there were 10.8 nurses and 2.54 physicians per 1000 persons (Holtz, 2017, p. 125). Due to the rising prevalence of managed care organizations and the relative value fee adoption for physician reimbursement rates, the number of general practitioners has been growing, while the one of specific specialists like anesthesiologists has been reducing.
Overall, global healthcare plays a crucial role for all people around the world. The phenomenon of globalization has shaped new healthcare regulatory policies, goals, statements, and expectations. They are aimed at a healthcare disparities reduction, equal access to health promotion, and a healthcare service improvement. Global healthcare is based on the ethical vision and principles, which are promoted in many states in the world. Due to this phenomenon development, many effective programs and policies have managed to change health outcomes in many communities. Hence, global health is a vital issue that helps people to improve health care from the international perspective.
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