Part -1: Population Health of the Former Soviet Union, India, and China

Nations or groups of nations can occasionally serve as natural experiments allowing us to see how certain factors that influence population health can change over time. For instance, available evidence suggests that Russia was much less healthy than the United States in 1900 but had mostly caught up in mortality outcomes by 1960, when progress languished. After the breakup of the Soviet Union in 1991 and the adoption of capitalist elements, mortality increased substantially in those nations and has not yet returned to the lower levels enjoyed previously (Walberg,et al, 1998). The vulnerable populations varied in different parts of the former Soviet Union as did the specific diseases responsible for the observed increase in mortality. The increase itself, however, is not in question. This suggests that a disease focus may not be the best way to address health in nations. This week, you examine the Russian experience and see how the dynamic is reflected in two other large eastern hemisphere nations, India and China.

This week, you examine the impact globalization and economic inequalities have on many issues in some high populace countries including health, poverty, human rights, and the environment. You also consider how larger populations display various health outcomes.

Learning Objectives

Students will:
- Analyze effects of globalization on health in Russia
- Analyze changes in quality of life and mortality in post-transition Russia
- Analyze health outcomes in India, Russia, and China over the last half century
- Analyze health outcomes in the Kerala community compared to the rest of India

Discussion: The Globalization of Health

Cell phones, video cameras, and other technologies are changing the way we live today. It is difficult to avoid the stories and images of poverty, human rights abuses, disasters, diseases, and other tragedies that plague people in rich and poor countries alike.

It is not just communications technology that is making the world a "smaller" place. Globalization is also exerting a powerful effect on the conditions in which people live and work, (i.e., the social determinants of health) and, thus, on health itself.

To prepare for this Discussion, review your Learning Resources. Search online for current stories/events related to population health.

Post a brief summaryon the effects of globalization on health in Russia. Discuss one change in quality of life in post-transition Russia. Also, explain one change in mortality in post-transition Russia. Provide examples for both. Expand on your insights utilizing the Learning Resources.

Assignment: The "Haves" and "Have Nots": Why Are There Disparities?

Earlier in the course, the different population health outcomes of two culturally and economically similar neighbors (the U.S. and Canada) were considered. This week, the focus shifts to the eastern hemisphere and an examination of health inequalities between and within nations with large, diverse populations.

Both India and China had similar health outcomes at the end of WWII. Unlike India, China's health improved tremendously over the next 30 years. When it did not have a focus on economic growth, China's health achievements surpassed India. Since the economic reforms 30 years ago, health progress in China has not been growing as much. Today, India is booming and is home to some of the richest people in the world, but it is also home to more food insecurities than anywhere else in the world.

To prepare for this Assignment, review your Learning Resources this week. Consider how certain large populations within a single political entity can still display disparate health outcomes. Think about how areas such as Kerala can have remarkably different health outcomes than the countries they are in. What makes those areas different from the rest of the country?

The Assignment (3-4 pages):

- Describe two health outcomes for which India and China have had different experiences in the last half century.
- Explain the reasons for the disparities noted.
- Describe the experience for those outcomes in Kerala and suggest reasons for why they are similar or different from the rest of India.
- Expand on your insights utilizing the Learning Resources.
Use APA formatting for your Assignment and to cite your resources.

Part -2: Health Status in Low-Income Countries

What must be done to intervene and ensure that history does not repeat itself for future populations? This week, you examine the impact of the historical roots of social disparities on health of populations in Africa and Latin America. As you go through this week's Learning Resources, think about what we can learn from history. This week, you consider developing a policy in a country you selected and think about various issues in practicing population health.

Learning Objectives
Students will:
- Analyze the impact of determinants on health outcomes for countries
- Analyze public issues in health literacy and cultural awareness
- Identify the relationship between health inequality and life expectancy in selected countries
- Identify efforts to reduce health inequities
- Analyze policy development and country support

Final Project

For your Final Project, share some of your ideas on how you can use the knowledge and insights gained in this course to promote positive social change in a community/country and the world. It is advisable to select a community/country other than the one where you live.

To prepare for the Final Project, review all the week's Learning Resources and consider possible issues you might encounter when implementing a policy.

Note: In grading your required Final Project, your Instructor uses a Final Project Rubric located in the Course Informationarea. Review this rubric prior to completing your assignment.

Final Project (7-10 pages), not including the cover and the references:
In developing a policy in the country you selected, consider the following:
- Explain the rationale for selecting the country.
- Describe the social determinants of health in the country that you would need to address. Explain why you need to address these determinants.
- Explain the possible public issues you might encounter in health literacy and cultural awareness in this country.
- Describe the relationship between health inequality/inequities and life expectancy for the population in your selected country.
- Describe two current efforts in this country (you selected) to reduce health inequities.
- Explain how you might develop a health policy so that it gets the support of the country you selected. Note: Take into account the culture of the country.
Use APA formatting for your Final Project and to cite your resources. Expand on your insights utilizing the Learning Resources.

Part -3: Discussion: Is Wealthier Healthier?

African nations tend not to have lower health outcomes, experiencing epidemics of infectious and non-communicable diseases across the continent. There is substantial health inequality among and within many nations in Africa. Similar disparities in health also exist in Latin America. Cuba, Costa Rica, and Chile have health outcomes comparable to the United States, while Haiti's health outcomes are comparable to the less healthy parts of Africa.

A variety of arguments can be made for the reasons why there is great health inequity in these regions. Some relate to the different colonial histories since health is transmitted inter-generationally. Colonization, neoliberal globalization, including free market, free trade, and the unrestricted flow of capital with little government influence, has resulted in large wealth inequalities. Some countries have cut their government spending on health programs, which has led to devastating health outcomes.

For this Discussion, examine countries and their health problems.

To prepare for this Discussion, review Week 10 and Week 11 Learning Resources. Select two countries with different per-capita income levels such that one could be classified as a "high income" nation and the other would not be classified in the same income category. Note: You may use The World Bank website in your Learning Resources to identify countries and their income levels.

Attachment:- Discussions.zip