Vital Statistics is the department of government registries responsible for the registration of important events such as birth, death, marriage, stillbirth and domestic partnership which occur in the country. Family events are key elements of genealogy and family history research and information from these statistics inform research, policies and other governmental decisions. Our lives as individuals are composed of events that occurred at different times such as birth, marriage and death. Vital Statistics Agencies are responsible for administering and enforcing The Vital Statistics Act, The Marriage Act, The Change of Name Act and processing disinterment under The Public Health Act. These Agencies register vital events and provide documents as proof of those events. The accessibility of the records held by these agencies are governed by legislations protecting privacy and these records are often held in perpetuity.

Historically, important events such as, baptisms, marriages and burials have been recorded in Church Records and Indexes. Subsequently, in the late 1800s and early 1900s, governments of various countries introduced the civil registration of births, marriages and deaths. The aim of vital statistics is to ensure the accuracy of information, trace the records relating those events, preserve the memory of the events and, if possible, obtain copies of these records. According to World Health Organization (WHO), a well-functioning civil registration and vital statistics (CRVS) system has the mandate to register all births and deaths, issue birth and death certificates, and subsequently compile and disseminate vital statistics, including cause of death information. It may also record marriages and divorces. Examples of vital statistics include:

• Birth
• Death
• Marriage
• Domestic Partnership
• Seperation and Divorce
• Genealogy
• Name Change
• Sex Change

Sources of vital statistics include:

• Hospitals
• Adoption facilities and Orphanages
• Parish Registers
• Church Records and Indexes
• Civil Registrations
• Databases
• Cemeteries and Wills
• Virtual Exhibitions

What is Malnutrition? Malnutrition is a term that almost everyone is familiar with because it’s a topic often taught in high school, alongside “balanced diet”

Malnutrition is a preventable medical condition characterized by lack of proper nutrition due to not having enough to eat, not eating enough of the right things, or the body being unable to use the food that is eaten. Individuals are malnourished if their diet does not provide them with adequate calories and protein for maintenance and growth, or they cannot fully utilize the food they eat due to illness. Also, people can become malnourished from consuming food with insufficient, excessive or imbalanced nutrients. Several different nutrition disorders may develop, depending on which nutrients are lacking or consumed in excess. Other words that can be used to describe malnutrition include undernourishment, malnourishment, poor diet, inadequate diet and unhealthy diet, lack of food.

Children are the most visible victims of malnutrition- geographically; over 70% of malnourished children live in Asia, 26% in Africa and 4% in Latin America and the Caribbean. In many cases, these children were born by malnourished mothers, resulting in low birth weight- a risk factor for neonatal deaths and a major cause of learning disabilities, mental retardation and poor health. In these developing parts of the world, malnutrition is responsible for over 300,000 deaths per year in children younger than 5 years, contributing to over half of all deaths in children worldwide. Impacts of malnutrition include low mood, and reduced energy, muscle wasting, low sex drive and fertility issues, reduced mobility, decrease in white blood cells and corresponding immunity, increased risk of falls, infections and hospital admission, longer healing times for wounds, longer recover times from infections and reduced independence.

Malnutrition is caused by a lack of essential nutrients and results in poorer health. In developing countries malnutrition is widespread and the major cause is poverty and a corresponding lack of food to eat. In developed counties, it is caused by poor diet and eating habits, mental health problems, digestive disorders and alcoholism. Severely malnourished children typically experience slow behavioral development including mental retardation. Even after treatment, malnutrition may have long-term effects in children, causing impaired mental function and digestive problems permanently. On the other hand, adults usually make a full recovery when treated.

Clinical signs and symptoms of malnutrition include loss of weight and fat (adipose tissue), difficulties in breathing and higher risk of respiratory failure, depression, higher risk of hypothermia – abnormally low body temperature, total number of some types of white blood cells falls, higher susceptibility to feeling cold, Longer recovery from illnesses, reduced tissue mass, tiredness and fatigue, irritability, decreased social responsiveness, anxiety, and attention deficit. In more severe cases of malnutrition, the skin becomes thin, dry, inelastic, pale, and cold, cheeks look hollow and the eyes sunken as facial fat is lost, hair becomes dry, sparse, and falls out easily and finally, there may be heart, liver and respiratory failure.

Clearly malnutrition is a dangerous condition… but the good news is that it can be prevented. Since malnutrition is caused mainly by not consuming the right balance of nutrients- balanced diet- from major food groups including carbohydrates, fruit and vegetables, protein, dairy and fats, prevention is majorly by ensuring that foods consumed contain these. However, when malnutrition is caused by other underlying conditions such as eating and digestive disorders, mental health issues and other factors, a healthcare professional should be contacted for a treatment plan. National Institute for Health and Clinical Excellence (NICE) in the United Kingdom recommends that the average human should drink at least 1.2 liters of fluid per day, so drink enough water, eat a balanced diet and stay nourished!!!

What can you do to end malnutrition? Let’s start with this mindset… always remember that that the food you waste can save a child’s life!

The Health Belief Model (HBM) is a model used to explain and understand health behavior, especially in view of preventing a negative health outcome. The model was developed in the early 1950’s and has been used to develop health education strategies and promote healthy behaviors including condom use, seat belt use, medical compliance, and health screening use. The rationale behind the model is that a person will take a health-related action, for example, eat healthy foods, if that person feels or believes that a negative health condition, for example obesity, can be prevented.

Our culture and belief system have the potential to influence the actions (health behaviour) we take or fail to take regarding our health. Here’s an example- if, by reason of your culture or who you are, you believe that eating unhealthy foods would lead to obesity, then, it’s very likely that you’ll choose to eat healthy foods. On the contrary, if you neither see unhealthy foods as threat to your health nor perceive any benefits from it, then you’re probably not going to care about your diet. As with many models, the flaw here is that the likelihood of making a behaviour chance is not actually an action but an intention, Therefore, it is possible for one to intend to eat healthy foods (perceive weight gain or obesity as a health threat and really want the benefit not being obese) and still not follow it through by eating healthy foods. Structural factors such as cost of healthy foods and proximity to grocery stores are typical reasons why intentions may not translate to behaviour.

In general, the Health Belief Model is structured to inspire people to take positive health actions- example, HIV is a negative health outcome, so, the desire to avoid HIV can be used to motivate sexually active people to practice safe sex. Similarly, the perceived threat of a heart attack can be used to motivate people suffering high blood pressure to engage in physical activity. People choose their behaviors due to various factors such as their beliefs, cultures, education, gender, social class and economic situations. The following are constructs of the HBM:

1. Perceived Susceptibility: A person’s belief about the probability of ending up with a negative health condition- the subjective perception of the risk of acquiring a condition.
2. Perceived Severity: A person’s belief of how serious a condition and its consequences will be if acquired- the subjective evaluation of the seriousness of the consequences associated a condition
3. Perceived Benefits: A person’s conviction of the effectiveness of the advised action to reduce risk or seriousness of the condition- the subjective positive gains of taking a positive health action.
4. Perceived Barrier: A person’s opinion of the costs and difficulties associated with the advised health behaviour.
5. Cues to Action: Reminders to take follow through with the advised and intended behaviour.
6. Self-Efficacy: This represents the confidence in oneself to make follow through with the advised and intended behaviour.

Sustainability can be described as the processes by which natural systems continue to function, remain diverse and produce everything necessary for the ecology to remain in balance. It takes into account how humans can live in harmony with the natural world around; protect it from depletion, damage and destruction and most importantly, preserving it for the future generation. In general, sustainability and sustainable development focus on maintaining a balance between two essential but competing human needs- the need for technological and economical advancement, and the need to protect the environments in which we inhabit. Environmental sustainability is defined as the interaction of human beings specifically with the environment to avoid depletion or degradation of natural resources and allow for long-term environmental quality. It is the ability of communities of plants, animals, micro-organisms, and their non-living surroundings to sustain themselves, and people, far into the future. Environmental sustainability ensures that the needs of today’s population are met without endangering the capability of future generations to meet their own needs.

The natural environment has the amazing ability to replenish itself through a recycling system in order to remain viable and sustain life- for example, a dead and decomposed plant adds nutrients to the soil which helps to sustain the growth of other plants. The major principle underlining environmental sustainability and sustainable development is that we, as human beings, must be able to live within our environmental limits. The consequences of going beyond these limits by stretching, wearing out and depleting the natural environment and resources are climate change and scarcity of resources. Presently, humanity is facing serious environmental and social sustainability challenges- global warming and inequity respectively. These challenges have been worsened by the dependence on innovation and technological solutions.

Human beings and other living things can interfere negatively or positively with the recycling capacity of the environment thereby influencing health, well being and survival. Unfortunately, human actions can deplete natural resources to a point where the environment cannot keep up with replenishing them; hence, the need to apply sustainability methods to support long-term viability.

However, sustainability is not just about the environment, it’s also about the health of the society- ensuring that environmental legislation and actions of humanity are conducive to the health of individuals and populations. This means fostering a strong, healthy and just society by meeting the diverse needs of all people, promoting personal well-being, social cohesion and inclusion, and creating equal opportunities. Sustainability is a broad discipline that gives insight to most aspects of the human world from business to technology to environment and the social sciences. It draws on politics, economics, philosophy, civic planning, environmental science, agriculture, corporate strategies, health assessment and planning, law and decision making and other social sciences.

The attainment of global environmental sustainability is dependent on intact and healthy ecosystems. Healthy ecosystems are crucial to maintaining health, food security, economic growth, and social peace. Unfortunately, the earth’s ecosystems have been degraded- some to the point where recovery is impossible. Natural resources such as potable water and local food sources have been compromised and compounded by climate change and natural disasters.

For over 30 years, the global community has been collaborating to preserve the environment and sustain human life and health. These collaborations have achieved some progress in key areas such as carbon emissions, desertification, organic pollutants, and biodiversity. More so, sustainable agriculture, forestry and energy are some of the specific applications of environmental sustainability where agriculture, selective logging and use of renewable energy sources respectively, are used to sustain the environment.

Pollution is a major environmental health problem which affects both developed and developing countries. It may be defined as the contamination, or introduction into the environment, of substances and particles that are harmful or poisonous, thereby negatively affecting human health and the ecosystem. The first time I heard the word pollution, I was a child- I’m pretty sure the same is the case for every one because being a consequence of man’s existence, the history of pollution is as old as the human race itself and has persisted since time immemorial. Pollutants enter the environment through a number of natural and/or anthropogenic activities- consequently; increased combustion of fossil fuels in the last century is the reason for the present change in the atmospheric composition.

Different kinds of pollution include Air, Water, Soil, Thermal, Radioactive, Noise and Light pollution- the most common being Air and Water pollution. Frequent pollutants of air are carbon-monoxide, lead, nitrogen oxides, ozone, particulate matter, sulfur dioxide while water can be polluted by sewage, microorganisms, chemicals, suspended matter and oil spillage. Most people experience pollution-related symptoms such as watery eyes, coughing, wheezing and respiratory irritation, in the case of air pollution. However, the actual risk of health deterioration from pollution depends on an individual’s current health status, type and concentration of the pollutant, and the length of exposure to the pollutant. Individuals more susceptible to severe health problems from air pollution are those suffering heart and lung diseases, pregnant women, outdoor workers or athletes and children whose lungs are not fully developed.

In 2013, World Health Organization’s International Agency for Research on Cancer (IARC) assessed and concluded that outdoor air pollution is carcinogenic, particularly associated wih lung cancer. Other complications such as cardiovascular and respiratory diseases, stressed heart and lungs, damaged cells in the respiratory system, accelerated aging of the lungs, loss of lung capacity, decreased lung function and development of diseases such as asthma, bronchitis and emphysema have been attributed to exposure to air pollutants. The implicated air pollutants causing most health problems are small particulate matter of 10 microns or less in diameter (PM10) and ozone. An estimated 3 million premature deaths worldwide were attributed to outdoor air pollution alone in 2012. About 87% of these deaths occurred in low and middle income countries, which are disproportionately burdened by the health consequences of air pollution. Concurrently, water pollution results in disruption of food-chains, lead poisoning from eating contaminated sea foods and ill health or death of aquatic animals and lives that depend on the water bodies. It also causes diseases such as cholera, gastroenteritis and dysentery.

Some major air and water pollution disasters in history include Great Smog of London, Southeast Asian haze, Kuwaiti oil fires, Woburn-Massachusetts Water Contamination, Ghana Cyanide Spill, Elk River-West Virginia Chemical Spill, Walkerton-Canada Water Contamination Disaster and Zhuozhang River- Changzhi China Toxic chemicals leak.

Going forward, there are several measures to address pollution and preserve our health and that of our world. Examples include increased use of clean technologies that reduce industrial emissions, clean modes of power generation, cleaner heavy duty diesel vehicles and low-emissions vehicles and fuels and renewable combustion-free power sources (like solar, wind or hydropower), improved management of urban and agricultural waste, increased energy efficiency of buildings and compacting of cities, improved strategies for waste reduction- separation, recycling, reuse and anaerobic digestion to produce biogas. Additionally, we must do the little we can as individuals by being friendly to the environment!

The World Health Organization recognizes that the highest attainable standard of health is a fundamental human right. This includes access to timely, acceptable and affordable health care of suitable quality. Human right to health is influenced by health policies and programs which have the ability to either promote or violate them. Certain social criteria are also essential this right including the availability of health services, safe working conditions, adequate housing and nutritious foods. The right to health is similar to other human rights such as right to food, housing, work, education, non-discrimination, access to information, freedom, entitlements and participation. It constitutes the following:

1. Right to control one’s health and body (sexual and reproductive rights)
2. Right to be free from non-consensual or harmful medical treatment and experimentation
3. Right to a health system of accessibility, availability, equality, equity, universality and quality
4. Right to receive treatment or refuse treatment

Despite the fact that health is a basic human right… or should be, about 100 million people globally hit below the poverty line due to health care expenses yearly. Most vulnerable and marginalized groups within countries such as indigenous and minority groups bear a disproportionate amount of health problems, healthcare costs and limitations to accessing quality and affordable healthcare. This population experiences significantly higher mortality and morbidity rates than the general public. Some groups such as women, men who have sex with men and people who inject drugs also suffer poorer health outcomes due to social and economic disadvantage and discrimination. Moreover, the world’s most fatal communicable diseases – malaria, HIV/AIDS and tuberculosis – affect the world’s poorest countries, causing a burden on the economies of these countries.

Clearly, bigotry in the delivery of health services violates fundamental human rights and can have serious health consequences. Some examples include keeping people with mental health problems against their will, denying women access to sexual and reproductive health care and services, using people for experiments without informed consents or using them for harmful experiments, discharging unwell patients due to lack of hospital beds and forced procedures such as sterilization, abortions or virginity examinations in developing and developed countries. These violations create unequal health outcomes and can lead to ill health or death of the victims. Sometimes, it is often difficult to make fair decisions in the face of complicated and competing health priorities- however, researchers, health professionals and decision makers must be as fair as reasonably possible in policies and service delivery.

Reducing, and eventually closing the gaps in equality and access to health care and services require the effort of all individuals. More specifically, the responsibility of finding means to respect and protect human right to health is that of the health sector, government and international organizations that uphold human rights. In the last few years, there has been a growing acceptance for universal health coverage (UHC), a comprehensive means for strengthening health systems and improving health equity and access to health services. UHC has been identified as the third global health transition, following public health improvements like basic sanitation and epidemiological transition that decreased communicable diseases. International health and development organizations such as World Health Organization, World Bank, Rockefeller Foundation, Oxfam, Gates Foundation, International Labor Organization, and United Nations Children’s Fund support and promote UHC.

In the words of Dr. Margaret Chan, WHO’s director-general, “UHC is the single most powerful concept that public health has to offer and represents the ultimate expression of fairness.” Termed by many as a practical expression of the right to health, UHC was selected in September 2015 as one of the key targets to implement the health goal in the United Nations Sustainable Development Goals (SDGs). It is believed that through the continued worldwide adoption of UHC, the right to health will gradually be endorsed across all countries and social groups.

Access to comprehensive healthcare is fundamental to health and affects the overall physical, social, and mental health status. It is the ability of individuals or groups to obtain the services they seek, and is widely regarded as an important health determinant. Disparity in healthcare can be defined as differences or inequalities in accessing or receiving health care and services that help to achieve the best health outcomes. These differences and inequalities can be reflected in coverage, services, workforce, timeliness and quality of services received. Accessing healthcare requires 3 distinct steps which are: entry into the health care system, access to a health care location where needed services are provided and availability of health care provider with whom the patient can communicate and trust.

Research has shown inequalities in the distribution of health by race, income, education, neighborhood location, social class, gender and ethnicity. Health outcomes used to measure these include infant deaths and other preventable diseases and deaths, mortality rates, morbidity, disability, quality of life and life expectancy. Many individuals and families face barriers to health care and services including physical inaccessibility, socio-cultural issues or the cost of non-insured health services (e.g. eye and dental care, mental health services and prescription drugs). Other barriers include racism; language difficulties experienced by immigrants who cannot communicate in French or English; inadequacy of service providers available; lack of insurance; lack of cultural sensitivity, humility and understanding from health-care providers; location and the cost of transportation; extensive wait times; services not covered by benefits, a shortage of doctors/nurses in the area; low income and inability to create time from work and family responsibilities. To illustrate this, a study in Canada on immigrant women’s health showed that while immigrant women viewed health and prevention similarly to Canadian-born women, their ability to access the resources needed to stay healthy were different. At the same time, access to health care is also a challenge for Canadians in remote communities’ and Aboriginal populations who live off-reserve mostly due to location and the cost of transportation. Despite the fact that this population is more likely to report having unmet health care needs (20% compared to 13%), they are less likely than the overall population to regularly visit a physician.(77% compared to 70%). Barriers and challenges in accessing health care can lead to a deterioration of health, emotional distress and feelings of exclusion and isolation.

Few programs attempt to close the gaps in accessing health services by the undeserved population and reduce disparities in healthcare. They include West Prince TeleHomeCare, which provides another option for people deciding to live in their own homes while dealing with health issues and Toronto’s Mobile Health Unit which provides sexual health services onsite to the many immigrant women working in garment factories in Toronto’s downtown core.

The World Health Organization’s recommendation to address inequities and disparities in healthcare is that countries must address the systemic and structural stratification of their societies as a national priority. This means reducing the gap and inequalities in healthcare between those at the highest and lowest income levels through actions that will eradicate poverty and increase opportunities for employment, education and early child development among the entire population.

Social class is a function of socioeconomic status, a root cause and health determinant, which accounts for most of the health disparities seen in the world today. It is reflected in racial, gender and income differences between population groups both within and between countries. For example, the higher disease rates of African Americans in the United States when compared to Caucasians, have remained consistent despite many attempts to address them. This gap in morbidity among racial groups is widening in recent years for several causes of death. Specific minority populations have also shown higher rates for some health conditions just by being in their group, even when their social status is somewhat “equivalent” when compared to other groups. Factors that contribute to the differences in social status and negatively affect health by restricting socioeconomic opportunities include income, education, power, individual and institutional discrimination, gender, residence in poor neighborhoods, employment, bias in medical care, racism, and inferiority stigma. These factors, and their combinations constitute an individual’s social class.

Research has consistently proved that health is not only a function of genes and habits but is also influenced by class and status. The unequal distribution of power, money and resources also creates health inequities through a systematic and unequal distribution of opportunities to be healthy. Analyses of data from the German National Health Interview and Examination Survey  showed that in the last decade, the proportion of people belonging to lower social class has decreased while middle and upper social classes have increased. Some risk factors attributed to the differences in social class were smoking, obesity and inactivity, which were mostly associated with people belonging to lower social class. Concurrently, hypertension and hypercholesterolemia were more often observed in men of the upper social class compared to those belonging to lower class. Regarding morbidity, diseases such as  chronic bronchitis and gastric and duodenal ulcer were found to have higher prevalence in the lower social class while allergic rhinitis were observed more often in the higher class. Differences in social class are clear and many attributes are unique to people depending on which of the classes they belong. The contentment about life and health status was higher in the upper class while the level of complains and dissatisfaction about life and health status was higher in the lower class. Additionally, a study in Australia showed that the richest 20% of the population can expect to live an average of six years longer than the poorest 20%, just by belonging to then richer social class.

The British Epidemiologist, Michael Marmot, is a pioneer in this field of research. He studied English civil servants over some decades and found that irrespective of universal healthcare and race, people higher up the ladder (richer and upper status) lived longer and were less sick than those lower down (poorer and lower status)- even when behavior is accounted for. This effect or “social gradient” was consistent throughout the ladder as people just below the highest statuses tended to have shorter lives and be sicker than those just above them all the way down. Marmot discovered two variables that seemed to have a great impact on health and well being: a sense of autonomy or control over one’s life and work, and the ability to fully participate in the society. Naturally, people with higher incomes and education levels tend to have more control and power and contribute more to the society than those with fewer resources- a plausible explanation for the health differences. For example, a job loss may not really affect a rich educated man with multiple investments like Dr. K, but can trigger a disastrous chain of events including ill health for a low-wage worker.

Unity is simply defined as the state of being united or joined as one, usually towards achieving a common goal. It is a crucial feature for every venture in order to achieve set goals and objectives. Words like teamwork, group, affiliation, alliance, association, partnership, and collaboration buttress unity. Most times, nothing can succeed without unity because in its absence, disorientation and disorganization are not lacking. Be in it in our homes, schools, workplaces, churches, and the world at large, unity is essential to peace, progress and good health.

Given the relevance of unity, organizations such as United Nations (UN), World Health Organization (WHO), Economic Community of West African States (ECOWAS), International Monetary Fund (IMF), World Bank (WB), Universal Postal Union (UPU) and so much more exist. These organizations attempt to bring oneness and unity to our world today in various areas of life including social, health and economy. As huge and diverse as the world is, we are somehow connected through the internet, business, transportation… and this connection makes us vulnerable to one another by promoting the rapid transfer of health risks internationally. Many health issues are global in nature in that they transcend the boundaries and borders of countries… affecting continents and the world at large. In response to these global issues such as HIV/AIDS and other infectious diseases, climate change and health equality, solidarity is needed to help countries tackle health problems. Unity increases strength and empowers less developed countries through the assistance of more developed ones and large international donors.

The need for oneness and centralization in health provision is not new. The global community reached an agreement on the importance of providing holistic sexual and reproductive health services as far back as 1994. Increased unity is naturally beneficial because it increases coverage and access at lower cost as well as improves the quality of care and acceptance for stigma. Current priorities for Joint United Nations Programme on HIV/AIDS (UNAIDS) include sexual transmission of HIV, violence against women and girls, punitive laws and human rights and youth empowerment. These factors mostly affect developing countries and have spurred an increase in the number of global health initiatives (GHIs).

For almost two decades, the appearance of several disease-specific GHIs has modified the way international donors provide assistance for global health. WHO’s collaborative group on maximizing positive synergies reviewed and analyzed existing data, and 15 studies and described the complex nature of the interaction between country health systems and GHIs. Sometimes, the health systems and structures of individual countries do not align or integrate with GHIs, causing misunderstandings and frictions between countries and donors on the global scale. They concluded however, that if the necessary adjustments to the interactions between countries’ health systems and GHI are made by fostering unity, it will improve efficiency, equity, value for money, and outcomes in global public health. Hence, health systems and GHIs can complement each other and work together in order to mutually and positively strengthen global health.