Project Description: The session long project (SLP) consists of an investigation of a country: it can be either an industrialized country (other than the United States), or an advanced developing country (like China); please do not choose a developing country (like

Iraq). The relationship between the country’s health and demographics will be addressed.

SLP #2: Investigate your selected country with respect to the health of its population:

1. Discuss the major health issues in your country?

2. Identify which health issues disproportionately effect certain groups based on their demographics (e.g. gender, race, age,

employment status, location).

ASSIGNMENT EXPECTATIONS: Please read before completing assignments.

Assignment should be approximately 2-3 pages in length (double-spaced).
Please use major sections corresponding to the major points of the assignment, and where appropriate use sub-sections (with headings).
Remember to write in a Scientific manner (try to avoid using the first person except when describing a relevant personal experience).
Quoted material should not exceed 10% of the total paper (since the focus of these assignments is on independent thinking and critical

analysis). Use your own words and build on the ideas of others.
When material is copied verbatim from external sources, it MUST be properly cited. This means that material copied verbatim must be

enclosed in quotes and the reference should be cited either within the text or with a footnote.
Use of peer-reviewed articles is strongly recommended. Websites as references should be minimal.
The following items will be assessed in particular:

1. PRECISION: Each of the questions of the assignment is specifically addressed in the paper.

2. CLARITY: The paper reads clearly (i.e., it is not confusing) and is well-structured.

3. BREADTH: The paper presents appropriate breadth covering the questions of the assignment.

4. DEPTH: The paper presents points that lead to a deeper understanding of the matters and/or issues being discussed and integrates

several points into coherent conclusions.

5. CRITICAL THINKING: You set aside your own personal biases and instead approach the subject matter using available scholarly

evidence. You consider the strengths and weaknesses of competing arguments/perspectives on this topic. Having read these scholarly

sources, you make a judgment as to the merit of the arguments presented therein.

6. REFERENCES: A reference list is provided at the end of your paper (APA formatting not required, but preferred).
Required Readings

Centers for Disease Control and Prevention (2011). Surveillance of Health Status in Minority Communities — Racial and Ethnic Approaches

to Community Health Across the U.S. (REACH U.S.) Risk Factor Survey, United States, 2009. Morbidity and Mortality Weekly Report (MMWR)

are crucial and complex, but are often neglected by those working in the health field. In developing countries, where the need for

medical services is acute and resources perpetually inadequate, the funds allocated for collection, transmission and analysis of data

always fall short of requirements. In general, where disease occurrence is highest, the numbers are least trustworthy (Basch, 1999).

Population Health
Before health can begin to be measured, it must be defined. It is likely that you have already given this some thought.

Experts over the years have given considerable thought to defining health –”a sound mind in a sound body” was one of the

earliest definitions recorded. According to the World Health Organization “Health is a state of complete mental, physical and

social well-being and not merely the absence of disease or infirmity.

The Joint Committee on Health Education Terminology (JCHET) defines health as “an integrated method of functioning which is

oriented toward maximizing the potential of which the individual is capable”.

Much of what you have just read and the following will be review for you. But as you review and recall, begin to think about applying

your knowledge to the international arena.

Today, we think “wellness”– a term much broader than “health”– and defined as an approach to personal health that

emphasizes individual responsibility for well-being through the practice of health promoting lifestyle behavior. High level wellness is

defined, sociologically, as bodily and emotional conditions that support or complement the pursuit and enjoyment of prized cultural

values.

David Bruhn (1970) conceptualized a “Health-Illness Continuum” to look at high level wellness. Illness is defined as any

condition that interferes with the pursuit and enjoyment of desired cultural values (e.g., working, going to school, taking care of the

family). He described good health as a static position that is the consequence of avoiding behaviors or circumstances producing

illness. While wellness is described as a constantly evolving process in which individuals actively arrange their lifestyles and

behavior.

The Levels of Wellness, as conceptualized by Herbert L. Dunn (1991) is presented below. One can move back and forth on the continuum,

except when death occurs.

Other Terminology
Health Education: is the “continuum of learning which enables people…to voluntarily make decisions, modify and change social

conditions in ways which are health enhancing” (JCHET). Health education has also been defined as any combination of learning

experiences designed to facilitate voluntary adaptations of behavior conducive to health.” (Green, Kreuter, Deeds & Partridge,

1980). Health education is one component of health promotion.

Health Promotion: is a broader term than health education and is defined by JCHET as the “aggregate of all purposeful activities

designed to improve personal and public health through a combination of strategies, including the competent implementation of

behavioral change strategies, health education, health protection measures, risk factor detection, health enhancement and health

maintenance.”

The United States Department of Health and Human Services defines health promotion as “any combination of health education and

related organizational, political and economic interventions designed to facilitate behavioral and environmental adaptations that will

improve or protect health.”

Models of Health
Models of health are of interest in that they influence not only how a health problem is perceived and addressed, but how resources are

allocated and how the recipient(s) is/are viewed.

The medical model focuses on illness and cure; the environmental model focuses on the interaction and adaptation of the individual to

the environment; and the holistic model focuses on optimal health with a balance of several components.

Dunn (1991) elaborates on the wellness dimensions of the holistic model:

Spiritual – the belief in some force that unites human beings. This force can include nature, science, religion, or a higher power. It

includes morals, values, and ethics. Optimal spirituality is the ability to discover, articulate, and act on your basic purpose in life

(Chapman, 1997).

Social – the ability to interact successfully with people and one’s personal environment. It is the ability to develop and maintain

intimacy with others and to have respect/tolerance for those with different opinions and beliefs.

Emotional – the ability to control stress and to express emotions appropriately and comfortably. It is the ability to recognize and

accept feeling, and to not be defeated by setbacks and failures.

Intellectual – the ability to learn and use information effectively for personal, family, and career development. It means striving for

continued growth and learning to deal with new challenges effectively.

Physical – the ability to carry out daily tasks, develop cardiovascular fitness, muscular fitness, maintain adequate nutrition and

proper weight, avoid abusing drugs/alcohol, and not use tobacco products.

What kind of Health Data Is Needed?

In our studies we will now move from population and census data in general to the specific of data needed to monitor, improve, and plan

for health for nations and for the world. Multiple variables influence the health of individuals and populations. A change in speed

limits can influence death and injury from automobile accidents. The amount of rainfall can affect nutrition by altering agricultural

production and it can influence subsequent rates of illness in endemic areas by affecting populations of malaria vector mosquitoes.

(Some people believe that global warming will lead to great epidemics of vector-borne diseases.) While such variables have indirect

effects on health, rainfall and speed limits do not qualify as health statistics in the conventional sense.

The basic categories of generally accepted health-related statistics are:

Data on population
The number of people and their attributes, such as age, gender, ethnic origin, urbanization, geographic distribution, and similar

fundamental characteristics.
Vital Statistics Live births; deaths (including fetal deaths) by gender, age and cause; marriages and divorces. (In some countries

migration (internal and external), adoptions, and similar categories are also considered as vital statistics.
Health Statistics Morbidity by type, severity, and outcome of illness or accident; data on notifiable diseases, on blindness,

incapacity; tumor registries, etc. (This category is not as clearly defined as the previous two and will vary from one jurisdiction to

another.)
Statistics Bearing upon Health Services Numbers and types of facilities and services available; the distribution, qualifications, and

functions of personnel; nature of the services and their utilization rates; hospital and health center operations; organization of

government and private health care systems; costs, payment mechanisms, and related information. (This large and diverse category is

often subdivided into subjects of special interest.)

Key Demographic and Health Surveillance Resources
World Health Organization (WHO)

WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership

on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options,

providing technical support to countries and monitoring and assessing health trends. The WHO website offers valuable information on a

myriad of health topics and worldwide health data and statistics.

World Health Statistics 2011 contains WHO’s annual compilation of health-related data for its 193 Member States, and includes a summary

of the progress made towards achieving the health-related Millennium Development Goals (MDGs) and associated targets.

The following in a summary of demographic and health trends, according to the 2011 Report:
Fewer children are dying. Annual global deaths of children under five years of age fell to 8.1 million in 2009 from 12.4 million in

1990.
Fewer children are underweight. The percentage of underweight children under five years old is estimated to have dropped from 25% in

1990 to 16% in 2010.
More women get skilled help during childbirth. The proportion of births attended by a skilled health worker has increased globally,

however, in the WHO Africa and South-East Asia regions fewer than 50% of all births were attended.
Fewer people are contracting HIV. New HIV infections have declined by 17% globally from 2001–2009.
Tuberculosis treatment is more successful. Existing cases of TB are declining, along with deaths among HIV-negative TB cases.
More people have safe drinking-water, but not enough have toilets. The world is on track to achieve the MDG target on access to safe

drinking-water but more needs to be done to achieve the sanitation target.
Click here to review Health-related Millennium Development Goals.

Click here to go to the WHO Home Page.

Morbidity and Mortality Weekly Report

The Morbidity and Mortality Weekly Report (MMWR) series is prepared by the Centers for Disease Control and Prevention (CDC). Often

called “the voice of CDC,” the MMWR series is the agency’s primary vehicle for scientific publication of timely, reliable,

authoritative, accurate, objective, and useful public health information and recommendations. MMWR readership predominantly consists of

physicians, nurses, public health practitioners, epidemiologists and other scientists, researchers, educators, and laboratorians.

The data in the weekly MMWR are provisional, based on weekly reports to CDC by state health departments. The MMWR is an excellent

resource to obtain epidemiologic information, health statistics, outbreak investigations, immunization recommendations, and U.S. and

worldwide surveillance studies.

Note that on the MMWR Home Page, you may be interested in subscribing for a free MMWR electronic or paper subscription.
Identify specific demographic health issues in countries