Globally, cancer remains one of the major causes of morbidity and mortality. It is projected that by 2020, cancer incidence may substantially increase by about 15 million new cases. Although cancer affects many communities worldwide, the prevalence, causes and types differ significantly among communities.
Cancer used to be associated with countries with advanced economies until recently- developing countries have succeeded in attaining lifestyles closely related to those in advanced economies. Now, the disease once associated with affluence has its highest burden on developing countries. The incidence, death and health burden of cancer is projected to rise in the developing world, whereas, these stats are expected to remain fairly stable in the developed world. Even though the total cancer burden may remain highest in advanced societies, less developed economies are closing the burden gap quickly.
This increase in cancer incidence in developing countries reflects a much broader evolution in the global burden of disease from infectious diseases to chronic diseases. Being acute and easily detected, infectious diseases such as HIV, malaria and tuberculosis are more preventable and at such have become less fatal when compared to the progressive long-term chronic diseases such as cancer and diabetes. Globalization of chronic diseases is evident in the fact that for years now, deaths due to chronic diseases have surpassed those from acute and infectious diseases.
The complexity of cancer control has changed and increased significantly given the shift of the disease burden. According to World Health Organization, 70% (about 5.5million) of all deaths resulting from cancer occur in the developing world. If nothing is done, cancer deaths in the developing world are projected to rise to 6.7 million in 2015 and 8.9 million in 2030. These values are more than the projected deaths for HIV, malaria, and tuberculosis combined.
The evolution of cancer globally, and the increased incidence in developing countries can be attributed to several factors including globalization, aging population, diet, urbanization, lifestyle, tobacco and other substance use and infectious agents. Specific types of cancer, such as breast, colon, and prostate cancers, have remained common in the developed world while developing countries are plagued with mostly preventable cancers caused by infectious diseases. Cancer is particularly fatal in developing countries due to late detection, and lack of access to advanced diagnostic technologies and cancer therapies. Additionally, the financial resources, facilities, equipment, infrastructure, staff and training required to cope with chronic care for cancers can be crippling for developing countries. There is also lack of response capacity regarding prevention, health education and promotion, screening and early detection, diagnosis and treatment of cancer. Even when available, the cost of treatment such as surgery, chemotherapy and radiotherapy is often too high. This further contributes to poverty because in these countries, healthcare is paid for out-of-pocket. Epidemiological data, which is not often available in developing countries, are useful to identify trends in cancer burden, morbidity, mortality, detection and prevention, as well as treatment outcomes such as survival. These epidemiological trends showing cancer burden can also show associated economic and policy factors and eventually help in the reduction of cancer cases in these countries.
The preceding paragraphs emphasize the menace of cancer in low and middle income countries especially the fact that it kills more people worldwide than HIV/AIDS, tuberculosis, and malaria combined. Despite this fact, cancer care and control in these countries is lacking in global health programs, including the United Nations Millennium Development Goals (MDGs). It is important to tackle cancer as a public health priority that it is starting by establishing functional primary care health infrastructures, particularly for cancers that are preventable, creating awareness and promoting early detection as well as investing in cost–effective generic drugs.
There is compelling evidence that our planet- Earth is changing in many different ways that affect human existence. The various forms and range of human activities continue to alter the physical and chemical characteristics and composition of the Earth’s land, water and air. These changes, which negatively affect global health, include weather variations, heat waves, heavy precipitation, flooding, droughts, storms, rise in sea levels and air pollution. Although the effects of a changing planet are global issues, their specific incidence and impact vary across geographic regions and populations. Given the projected world population of 10 billion people by 2050, it is crucial to ask and comprehend the “what, why, how and where” questions about the Earth’s alterations so as to reduce the impacts and the potential population burden on the planet. To save, sustain and efficiently manage Earth, there must be an understanding of these changes and how they influence our (all) lives, particularly, in relation healthcare and global health.
The major and most common terms used to describe our changing planet are climate change and global warming. Climate change refers to the changes in the global climate, resulting from increasing average global temperature while Global warming describes the long-term patterns of rising global temperature- sometimes, these terms are used interchangeably. How exactly does a changing climate affect global health? Technically, the increase in human-made carbon dioxide levels in the atmosphere creates a “greenhouse effect,” causing the world to become warmer. This warmth results in the melting of the arctic ice sheets and rise in sea levels which can cause flooding. Flooding in-turn leads to major public and global health emergencies such as homelessness, infectious diseases outbreak, poverty, and psychological trauma. Additionally, the warmer the earth becomes, the more unstable weather patterns become and the more regular violent storms, droughts, heat waves, and wild fires become. For instance, wild fires across Canada consume an average of 2.5 million hectares yearly; destroy thousands of properties and render hundreds people homeless. Higher CO2 in the atmosphere increases ocean acidity, causing harm to marine life. Droughts damage farmlands and hinder food production, leading to poverty, malnutrition, and starvation.
The fields of global health, as well as geological and geographical sciences have been instrumental in the advancement of knowledge in climate change, environmental pollution, sustainability, and the impacts of our rapidly changing planet, economy and society. The consequences of our changing planet increase conflict and create political, economic and social instability- all of which are detrimental to human health. The scientific evidence of the impacts of climate change abounds and so much is happening on a global level to counter these impacts. About 196 countries have signed the Paris Agreement, committing signatories to work toward keeping temperatures from rising above 2 degrees Celsius (3.6 degrees Fahrenheit). As individuals, choosing options that reduce carbon footprint are beneficial to our health and that of our planet. For example, walking or biking rather than driving prevents burning fossil fuels, provides exercise, and helps maintain a healthy weight. Also, opting for renewable energy prevents air pollution and results in fewer cases of asthma and lung cancer.
Fact is, it is impossible to live in an unhealthy planet and live a healthy life because a changing planet is a changing health. Therefore, it is our responsibility to do our part to take care of our planet home, Mother Earth.
Exercise and nutrition are major determinants of global health and wellbeing, particularly for adolescents and youths who are still in the developmental stage of life. Physical activity and healthy eating in adolescence are significant to growth and development, and can prevent, or delay several health conditions- specifically chronic conditions. The lack of appropriate nutrients and physical activity has become a global health challenge that hinders the growth, development and overall health of adolescents and youths. Given the inventions and fast pace of the 21st century, most adolescents are caught up with too much screen time and fast foods which are major barriers to physical activity, healthy eating and ultimately, global health.
According to an article by the American Heart Association (AHA), physical activity improves both mental and physical health as well as the overall quality of life. AHA recommends 30 minutes of moderate activity for 5 days weekly- at least, a total of 150 minutes of physical activity or exercise in a week. For nutrition, fruits and vegetables, whole grains, fat-free or low-fat dairy products, proteins and oils are healthy eating options proposed and recommended by the Dietary Guidelines for Americans. Additionally, reduced sodium intake and calories from fats and sugars are also recommended for healthy growth and development.
Many adolescents go to school, this makes the school environment one of the best places to provide students with opportunities to learn and practice healthy behaviors. Having a healthy breakfast and sufficient hydration are associated with improved memory function and overall mood, which are important for learning and comprehension. Physical activity causes a “feel good” sensation which can instantly relieve tension, stress, anxiety, depression and anger. Exercise also improves blood circulation, maintains healthy weight, boosts good cholesterol level, boosts energy level, inspires positivity, improves sleep, improves healthy self-image and increases muscle strength. In general, chronic conditions such as diabetes, high blood pressure, cancer, osteoporosis, heart disease and other health conditions can be prevented by engaging in physical activity (exercise) and adequate nutrition.
Just like poor diet, lack of physical activity and increased sedentary lifestyle can increase the risk of cardiovascular disease. Studies have shown that adults who spend more hours watching television have an increased risk of death from cardiovascular disease. More so, absence of regular physical activity leads to loss of physical strength, stamina and possibly, reduced life expectancy- all which are detrimental to global health.
Public Health Ontario (PHO) describes Health Promotion as the procedure or means of developing and implementing a broad variety of social, health, behavioral and environmental interventions that encourage change of attitudes or actions, create supportive or enabling environments and advocate healthy public policies. The purpose of health promotion is to empower and enable people to gain or increase control over their lives, so as to improve their health. Health promotion interventions typically occur in settings such as schools, hospitals, workplace and communities with partnership and capacity building across multiple stakeholders, sectors and organizations. Compared to clinical health, health promotion focuses beyond the care and treatment of patients and individuals. It consists of a wider range of social and environmental interventions addressing prevention of disease and protection of health across populations.
School and youth health promotion- as the name illustrates, are means of ensuring health and behavior-change interventions are carried out in schools and specifically targeting youths. The rationale of promoting health in schools is that schooling happens at the crucial age of childhood and adolescence where personal character, skills, attitude, physique and behavior are developed. Schools play significant roles in health education and promotion at the most crucial, addressing health, social, educational, psychological needs of children. A team made up of parents, teachers, administrators, students and health professionals should be formed and trained to develop values, activities and new direction for health education and promotion in schools. Health promoting schools (HPS) are schools that consistently strive to strengthen their capacity to promote and enable healthy living, learning and working conditions through education, program development and service provision. HPS promotes physical, emotional and intellectual development of students through healthy and hygienic practices. Making schools an environment for health promotion is an effective approach for early prevention of non- communicable disease risk factors.
HPS is a World Health Organization (WHO) Global School Health Initiative with the aim of strengthening health promotion and education activities at every level- locally and internationally. Important factors involved in effective HPS include health policies, physical and social environment, community involvement, healthy skills development and health service provision. School and youth health promotion provide an important opportunity to empower young people to make informed choices regarding their health behaviors such as tobacco and substance use, risky behaviors, alcohol use, dietary and hygienic practices, sedentary lifestyle, sexual activities and physical activity.