9.1: Introduction - What is Global Health?

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Dino Bozonelos, Charlotte Lee, Austen Thelen, Lauren Blanchard, Steven Cauchon, Masahiro Omae, Elizabeth Walker, and Travis Ritt
Victor Valley College, Berkeley City College, Allan Hancock College, San Diego City College, Cuyamaca College, Houston Community College, and Long Beach City College via ASCCC Open Educational Resources Initiative (OERI)

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Learning Objectives

By the end of this section, you will be able to:

Define global health
Understand global health inequities within countries and within the states in the United States of America

Introduction

The complexity of the definition of global health begins with an understanding of the various levels of responsibility more developed countries have to developing countries. The Consortium of Universities of Global Health asserts that a definition of global health must be defined with the following variables - climate change, the economy, food, and energy - in order for organizations and researchers to measure results. The underlying definition of global health is acknowledging the lack of accessibility in healthcare within communities around the world that affect the health of all people.

Global health disparities are evident within the Global North, yet even the poorest person in the Global North tends to have a longer life expectancy than a person that lives in the Global South. The CIA (2023 estimate) reports that the following countries have the highest and lowest life expectancy rates:

Table 9.1.1
Top 10 Countries for Life Expectancy
Country Ranking	Name of the Country	Life Expectancy (yrs)
1.	Monaco	89.6
2.	Singapore	86.5
3.	Macau	85.2
4.	Japan	85
5.	San Marino	84.1
6.	Canada	84
7.	Switzerland	83.8
8.	Hong Kong	83.8
9.	Iceland	83.8
10.	Andorra	83.6

SOURCE: CIA (2023). Life Expectancy at Birth. https://www.cia.gov/the-world-factbo...ancy-at-birth/.

According to the CIA (2023), the United States is number 48 in life expectancy, as the average American lives 80.8 years.

Table 9.1.2
Top 10 Countries with the Lowest Life Expectancy
Country Ranking	Name of the Country	Life Expectancy (yrs)
227.	Afghanistan	54.1
226.	Central African Republic	56
225.	Somalia	56.1
224.	Mozambique	57.7
223.	Sierra Leone	59.1
222.	Chad	59.6
221.	South Sudan	59.7
220.	Lesotho	59.9
219.	Eswatini	60.2
218.	Niger	60.5

SOURCE: CIA (2023). Life Expectancy at Birth. https://www.cia.gov/the-world-factbo...ancy-at-birth/.

Most of the countries with the lowest life expectancy are located within Africa and South Asia. This is due to a myriad of issues. On one side, it is economic in nature, these countries have some of the lowest gross domestic products (GDPs) in the world. Political considerations can also effect life expectancy. One ramification of the United States leaving Afghanistan was reasserting the complete control of the Taliban. The effects of a Taliban government is a lack of healthcare that has left everyone vulnerable, especially women. Many people are dying due to lack of medicine, as the World Health Organization (WHO) estimates that two-thirds of the Afghan population need some sort of health aid (Abbasi 2022). The population is plagued with not only COVID-19, but they are so malnourished that other conditions, such as measles and diarrhea, are rampant (Abbasi 2022). Economics and politics can also collide, as Afghan health workers can often go for months without being paid. These kinds of health problems are not just limited to Afghanistan. In the Central African Republic there there are 56 million people waiting to have surgery, and it is estimated that 25 percent of all people under the age of 15 will die due to health problems (African Mission Healthcare 2024). Due to the lack of funding and global financial support, countries such as these, as well as many others see their populations continuously on the brink of one health crisis or another. These countries are also experiencing a great deal of political unrest, which further exacerbates global health inequalities because it makes it difficult to adequately implement international financial assistance that would help keep every citizen healthy.

Who is Responsible?

With an increasingly interconnected world, it begs the question, who is responsible for the global health of all people? After all, a health crisis in one country can have a resounding effect on the rest of world. Many countries look to the wealthiest nations for financial assistance to ensure the health of their citizens. According to the World Bank (2021), the United States of America has the largest GDP in the world, at $23.32 trillion. China has the second largest GDP in the world at $17.73 trillion, and the third largest GDP is Japan at $4.94 trillion. Yet, the United States itself suffers from health inequities, and depending on the state, a person can have a lower life expectancy. According to the U.S. Centers of Disease and Prevention, in 2020 the state with the lowest life expectancy was Mississippi (Table 9.1.3) while states that have the highest life expectancy include: Hawaii, Minnesota, Massachusetts, California, and New Hampshire (Table 9.1.4).

Table 9.1.3
Top 5 States for Life Expectancy
Ranking of the State	Name of the State	Life Expectancy (yrs)
50.	Mississippi	71.9
49.	West Virginia	72.8
48.	Louisiana	73.1
47.	Alabama	73.2
46.	Kentucky	73.1

SOURCE: National Center for Health Statistics and National Vital Statistics System. (2018, 2019 and 2020). Life Expectancy at Birth, https://www.cdc.gov/nchs/pressroom/s...expectancy.htm.

Table 9.1.4
Bottom 5 States for Life Expectancy
Ranking of the State	Name of the State	Life Expectancy (yrs)
1.	Hawaii	80.7
2.	Minnesota	79.1
3.	Massachusetts	79
4.	California	79
5.	New Hampshire	79

SOURCE: National Center for Health Statistics and National Vital Statistics System. (2018, 2019 and 2020). Life Expectancy at Birth, https://www.cdc.gov/nchs/pressroom/s...expectancy.htm.

There are a variety of reasons why some states have a higher or lower life expectancy, which include environmental laws and public medical spending. Yet, the fact remains, in the wealthiest country in the world, residents will live longer based on the state that they reside. One might ask, if the U.S. has its own struggles, should it really be responsible for helping the rest of the world? One might look to the most recent global pandemic for an answer. The COVID-19 crisis is just the most recent example of how no country can be ignored during a health pandemic because the world will continue to be affected negatively if countries are left to independently handle health crises on their own.

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