This course provides an overview of the physical and mental health of human populations in both the poor and more affluent nations of the world. The course is divided into three sections. The first third of the course consists of an examination of morbidity and mortality among different social groups throughout the world. It includes an extensive review of data from the United Nations and other sources that document large disparities in illness and death within countries as well as massive differentials in health between the developing and developed worlds. We will also review data showing historical changes in patterns of disease that reveal that while acute diseases continue to ravage the developing world, chronic diseases have become the major causes of disability and death in developed nations.
The second third of the course focuses on the health of specific subgroups, including children, women, the elderly, native populations, minority groups, and immigrants. Social characteristics that are associated with socioeconomic status are also associated with health levels. Although population health levels are influenced by such factors as nutrition, education, and political stability, health care systems are also important.
The final third of the course focuses on health care delivery and different national health care systems. In many of the poorest nations, and in those that have experienced serious political upheavals, health care systems have collapsed or have too few resources to provide adequate care to their entire population. As part of our discussion of differential access to health care we will examine the basic principles that define equity in health care.
A core focus of the course will be on the consequences of aging populations and improved medical technology on in the health care systems of the world. Aging populations, high rates of medical inflation, and soaring hospital costs raise serious challenges to governments and raise important public policy concerns. We will compare and contrast health care systems with more universal coverage, such as those of the European nations, to those with a more market based approach, such as that of the United States. In addition, we will examine the process and consequences of implementation of health reform in the U.S. and other nations. Future fiscal crises will require all nations to ration increasingly expensive health care services. This rationing raises serious questions of equity related to the treatment of the poor, minorities, immigrants, and native populations.