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**[[Summary of Category>http://www21.atwiki.jp/muppy/?page=Summary]] A. General Question [1. Public Health vs Medicine] -Lab Research vs Existing Public Health Intervention -Infectious disease vs. Non-infectious disease [2. Resource Allocation: Vertical vs Horizontal] [3. Africa/Development/Money] [4. General Family Planning Topics] [5. MDGs] [6. AIDS] B. Economics Question [1. Development(Health and Demography)] -HIV and Economic Growth(New) -Malaria and Economic Growth(New) [2. Inequality] [3. Definition of Development] [4. Market Failure] [X. Lewis/Harris-Todaro Model(less likely to be in exam)] C. Demography Question [1. Demographic Transition] [2. Population Growth] [3. Historical Decline in Mortality] [4. Fertility/Family Planning] -Abortion [5. African Fertility Decline] [6. Below-Replacement Level and Aging (Immigration/Social Security)] [7. Population Projection] D. Measuring Population Health/Health Risk Factor Question [1. DALY/DALE/QALY] [2. Population Health: Rose(1985)] [3. Determinants of Health] [4. Epidemiologic Transition] [5. Risk Factor Analysis(Obesity, Smoking, IAP)] E. Politics Question [1. Political Analysis] [2. Health System Performance/Reform] F. Ethics Question [1.Inequality/Inequity] [2.Maximization vs Fair Distribution] [3.Individual vs Social Responsibility] [4.Priority on Health Worker] [5.Global Burden of Disease/Priority Setting] [6.Research Ethics Question] **[[General>http://www21.atwiki.jp/muppy/pages/7.html]] [1. Public Health vs Medicine] [[The next major contribution to improvements in global health will stem from lab research. Discuss the accuracy of this statement and its implications for public health research.(2005 First)>http://docs.google.com/Doc?id=dc5gkw8z_6fvxg9t]] Describe the view that the focus on health care in developing countries should now focus on non-infectious rather than infectious disease(Practice Question) [ [[2>http://www21.atwiki.jp/muppy/pages/11.html]]. Resource Allocation: Vertical vs Horizontal] [[2. Do you think that countries' investment in the health care sector should focus on the underlying health systems or specific disease entities or some combinations of both? What types of investments were the most productive? Justify your answer using specific examples.(2006 First)>http://docs.google.com/Doc?id=dc5gkw8z_36db9whs]] [3. Africa and Development] 3. What factors account for the very poor levels of health in sub-Saharan Africa? Is money the answer to Africa's health problems?(2005 Second) [[4. Describe two salient public health problems facing Africa and the nature and degree of success of current efforts to address them. Assess critically the view that the most effective solution to these problems will be to increase dramatically the flow of financial aid to Africa. Give examples. >http://docs.google.com/Doc?docid=dc5gkw8z_29djnpkn&hl=en]] 5. (a)Describe two salient public health programs facing Africa and the nature and degree of success of current efforts to address them. (b)With reference to the problems described in your answer to part(a), evaluate the view that the key to addressing these problems is to increase dramatically the flow of financing aid to Africa. Cite research and other arguments or evidence in support of your views.(2006 Review Session) 6. Jeffrey Sachs has argued that the three top priorities for Africa’s health systems are: “One, money. Two, money. Three, money.”In particular, he has advocated for a substantial increase in funding to combat HIV/AIDS. Discuss the strengths and weaknesses of Sach’s stance using the “3 spheres” framework (capacity, value, support) to inform your answer [4. General Family Planning Related Topics] (HIV/AIDS and RH) 7. The movement against the spread of HIV/AIDs represents a threat to the goal of attracting more funding and attention to population growth, women’s mental health, and young people’s reproductive health and rights. This is because not only public attention but also financial and human resources will be drawn away from family planning, emergency obstetric care, and comprehensive sexuality education with the influx of funds for HIV/AIDs. Explain where and why you agree or disagree with the statement, discuss the implications the statement for policy; and discusses the implication of each statement for applied research.(2006)(Do not need it) (Men's Involvement) [[8. The issue of involvement of men can be seen as marginal to the goals of improving young people’s sexual and reproductive health and rights, and reducing maternal mortality and morbidity. A gender-sensitive approach to women and girls is sufficient. Explain where and why you agree or disagree with the statement, discuss the implications the statement for policy; and discusses the implication of each statement for applied research.(2006 Review)>http://docs.google.com/Doc?id=dc5gkw8z_35cvwvhg]] [5. MDGs politics] (MDGs&RH) [[9. The population and reproductive health fields is on the defensive against a powerful set of opponents. Proponents are cling to the ICPD/Cairo goals but PRI's omission from the MDGs that are shaping the international development and indicators has been a major setback. Explain where and why you agree or disagree the implications the statement for policy, and discusses the implications of each statement for applied research(2006 Review)>http://docs.google.com/Doc?id=dc5gkw8z_25hcs4nz]] 10. The MDGs are an ambitious agenda for reducing poverty and improving lives that world leaders agreed on at the millennium summit in September 2000. For each goal one or more targets have been set, most for 2015, using 1990 as a benchmark. It has been argued that the goal of reproductive health for all, and the associated target to universal access to quality reproductive health services, is also worthy of inclusion on its list. (A)Discuss briefly what is meant by the notion of "development" in MDGs. To what extent can it be argued that reproductive health of all should be a development goals in its own right? (B) Suppose we accept the MDGs as they are. Discuss how using reproductive health as an instrument could contribute to the achievement of the other MDGs. Focus on two MDGs where you think access to reproductive health services might be most effective and be sure to cite, and critically assess, theoretical and empirical evidence relevant to your arguments.(2006 Review) (MDGs&Achievement) [[11. The Millennium Development Goals are an ambitious agenda for reducing poverty and improving lives that would leaders agreed on at the Millennium Summit in September 2000. For each goal one or more targets have been set, most for 2015 using 1990 as benchmark.a. Discuss the health targets set in the Millennium development goals; how likely are they to be achieved. b. To what extent can health also be viewed as an instrument for achieving the other goals?(2006 Review)>http://docs.google.com/Doc?docid=dc5gkw8z_30q5ppvd&hl=en]] 12. The following goals is part from the Millennium Development Goals. Choose one goal and justify its inclusion in the list of development goals; a. Justify the goal’s inclusion in the list using both theory and evidence discussed in class. b) Comment on the appropriateness of one of the indicators used to assess the attainment of the goal. (2006 Review) [6. AIDS] [[13. Describe and evaluate the methods that can be used to prevent and treat HIV/AIDS in developing countries. Should prevention or treatment be the priority for government? What framework would you use to decide on the best course of action?>http://docs.google.com/Doc?id=dc5gkw8z_0dtr2kx]] 14. Discuss critically the criteria that are used for priority setting for health interventions. Which criteria do you think are most useful? Illustrate your answer with reference to treatment and prevention programs for HIV/AIDS in developing countries.(2005 First) **[[Economics>http://www21.atwiki.jp/muppy/pages/9.html]] [1. Development] (Health->Economy) 15. Discuss the routes through which health might affect economic outcome. Does empirical research confirm a causal path leading from better health to improved economic outcome? (2005 Second) 16. How do improvements in population health affect economic growth?(2007 Preview) 17. What new evidence can be marshaled to link economic well-being with population health? In what ways has our conceptualization of the direction and nature of these connections changed in recent years? (2007 Prep) 18. (A) What are the conceptual links between population health and poverty reduction? (B) Describe the nature of the empirical evidence on the existence and strength of these links. (C)To what extent is the knowledge base in this area applicable to Sub-Saharan Africa?(2005 First) 19. Can population health be improved dramatically in a resource poor setting such as found in much of Sub-Saharan Africa without first increasing income levels dramatically? (2006 Review) 20. Discuss the concept of health-development spirals. Be sure to explain their nature, and to summarize empirical evidence related to their existence and their strength Comment also on their implications for policy interventions aimed at promoting population health and human development.(2007 Prep) 21. Using the “triangle diagram” below, describe how exogenous interventions influence links between population/health, income, and capital. In particular, choose three exogenous interventions (one for each of the dashed arrows) and describe how that intervention might influence the endogenous links. When choosing the exogenous interventions, pick one medical intervention, one non-medical health intervention, and one non-health intervention to make your case.(2006 Review) (Demography->Economy) 22. What effect does falling fertility have on economic development? Using examples, explain the mechanism through which such demographic changes affect development.(2007 First) 23. Discuss the interaction between the demographic transition and economic development.(2006 Second) [2. Inequality] 24. If one ranked the world’s population by their per capita income, the average income of the top 1 billion would be about 100 times the average income of the bottom 1 billion. a)What is the impact of income inequality on population health? b) Describe 2 pieces of evidence that demonstrate the associaton between income inequality and health; c) Describe 2 mechanisms that have been proposed that link income inequality to health 25. Is there empirical evidence that proves that greater income equality contributes to an overall improvement in health? Are there population in which income inequalities are wide and health differentials are small?(2007 prep) 26. Is there a consistent positive relationship between good health and socio-economic status? What is the basis of this relationship? Are there exceptions to this relationship?(2007 prep) [3. Definition of Development] 27. A major goal of the international community is to promote development in the least developed countries. What is meant by “development”? What roles dose health has to play in this development agenda?(2006 Review) [4. Market Failure] 28. In economic theory, free markets lead to efficient outcomes. Why does the free markets fail to provide efficient outcomes in the provision of health services?(2005 Second) 29. Why can we not simply leave health care to the market?(2006 First) **[[Demography>http://www21.atwiki.jp/muppy/pages/10.html]] [1. Demographic Transition] [[30. (i) Explain what is meant by the demographic transition (ii)What are the causal forces that lie behind the transition? (iii)Give examples of countries that appear to have followed the pattern predicted by transition theory: Are there countries that have not followed this pattern?(2006 First)>http://docs.google.com/Doc?id=dc5gkw8z_17ccd4px]] Describe the demographic transition. To what extent does it capture the experience of developing countries today.(Practice question) (Fertility/Mortality relationship) [[31. Do decline in fertility translate into improvements in mortality and morbidity? Give examples of cases where the links are very clear and explain why the relationship is difficult to examine elsewhere.(2005 second)>http://docs.google.com/Doc?docid=dc5gkw8z_5hswqk2&hl=en_US]] 32. What are the health benefits of low fertility? Should governments promote policies to lower fertility? Give examples of policies that governments have implemented to successfully reduce fertility. 33. Is an improvement in child survival a necessary precursor to fertility decline? Are there exceptional cases? Discuss with reference to specific countries or regions. [[34. What are the necessary precursors to a decline in a population's fertility? Are there exceptional cases? Discuss with reference to specific countries or regions.(2005 First)>http://docs.google.com/Doc?docid=dc5gkw8z_23c2cghn&hl=en_US]] [2. Population Growth] [[35. Is there still cause for concern about rapid population growth rates in low-income countries? Using one country or region to illustrate your answer, outline the evidence available to support your answer.(2007 prep)>http://docs.google.com/Doc?docid=dc5gkw8z_18htgn4k&hl=en_US]] [[36. Explain what Thomas Malthus meant by "positive" and "preventive" checks to population growth. Do either of these concepts have any relevance to understanding today's population growth rate? Explain your answer with reference to specific cases.(2007 prep)>http://docs.google.com/Doc?id=dc5gkw8z_21fd4c4k]] [3. Historical Decline in Mortality] 37. Are the lessons learned from studying the causes of the early 20th centaury improvements in childhood mortality in Europe and North America applicable to the reduction of mortality in low-income countries today? Give reasons for your answer and provide examples and comparisons.(2006 Review) 38. Does the study of the improvement in child survival in NW Europe and the US in 1900 help us in promoting child survival in high mortality countries today? (2006 Prep) 39. Explain the factors that lie behind the long term decline in mortality rates throughout the world over the last 200 years. [[40. Which factors explain the major reduction in under 5 mortality in the sub-Saharan African countries surveyed by DHS in the 1990s? How do these factors differ from those responsible for the improvements in childhood mortality in NW Europe and North America in the early 1900s.>http://docs.google.com/Doc?id=dc5gkw8z_2283mxhj]] [4. Fertility/Family Planning] [[41. How would you justify an investment in a publicly supported family planning program? What evidence is there that such investment positively affect reproductive health?(2005 First)>http://docs.google.com/Doc?docid=dc5gkw8z_24fh7c8z&hl=en_US]] 42. Have past investments in modern family services paid off? Why has international support for fertility limitation program reduce recently?(2007 prep) 43. With reference to one region or country of your choice, comment critically on the view that national, publicly supported family planning programs have had a major impact on the speed and timing of the decline in fertility. Does this evidence justify the continued pubic support of such programs in high fertility countries? Discuss the rationale for government provision of reproductive health service in low income countries.(Practice Question) (More attention on FP/RH) 44. What is needed now to promote attention and funding to reproductive health is to effect a “paradigm shift” in the global health sector, ensuring that the health policy agenda will value, rather than ignore, the investments required to achieve the Cairo census. Alliances of researchers and advocates will be required in this effort. Explain where and why you agree or disagree with the statement, discuss the implications the statement for policy; and discusses the implication of each statement for applied research(2006 Review). 45. In the current political climates in Washington, it is not worth investing much in advocacy work inside the Beltway, media education and cultivation, etc. that focuses on international population and reproductive health issues. Explain where and why you agree or disagree with the statement, discuss the implications the statement for policy; and discusses the implication of each statement for applied research(2006 Review) (abortion) 46. What is the contribution of induced abortion to contemporary fertility transition? Is the use of abortion always an indicator of unmet need for contraception?(2007 prep) [5. Fertility/Africa] [[47. Why is fertility falling in sub-Saharan Africa today? Does existing fertility theory help us to interpret these new trends?(2007 prep)>http://docs.google.com/Doc?docid=dc5gkw8z_3dh34fm&hl=en_US]] 48. Why did fertility fall so rapidly in south-east Asia compared with more recent decline in Africa and the Middle East?(2006 prep) [6. Below-Replacement Level and Aging (Immigration/Social Security)] [[49. Are there economic and social argument for intervening to raise below-replacement fertility levels in advanced market economies? What policies are likely to be effective and why? Refer to specific countries if appropriate.(2007 prep)(2006 Revie)>http://docs.google.com/Doc?docid=dc5gkw8z_4wsmrt3&hl=en_US]] 50. Should governments in countries with below-replacement fertility implement policies to increase natality? What benefits would flow from any resultant increases in fertility? Which policy measures are most likely to be successful and why?(2006 Second) 51. What are the social and economic consequence of below-replacement fertility? What remedies are being proposed to raise population growth rate? Which seem to you most likely to succeed?(2006 prep) [7. Population Projection] (Cohort Component) [[52. Why have long-term population projections of the world's population proved so unrealiable in the past? What can be done to improve the accuracy of future population projection? >http://docs.google.com/Doc?id=dc5gkw8z_14d9dkmb]] (Brass Method) 53. UNICEF has asked you to describe the trends in under 5 mortality for a sub-Saharan African country with incomplete vital registration. The country has three recent DHS surveys and four censuses- each asked about the survival of near relatives(mothers-children;adults-parents). What analytic methods would you employ and why? Discuss the merits and drawbacks of each(2007 First) **[[Measuring Population Health>http://www21.atwiki.jp/muppy/pages/4.html]] [[54. Apart from life expectancy, what measures would you propose to assess the contribution of a health system to the health of a population? Justify your choice of measures and illustrate with examples. (2006 First)>http://docs.google.com/Doc?id=dc5gkw8z_31fnd8j7]] 55. Over the last decade there have been some new developments in the approach to the measurement of the health of populations for priority setting at national, regional, and global scales, Disability Adjusted Life Years being the most prominent at the international level. Using the table below: a) Briefly describe how DALYs are calculated. b) Describe 2 advantages to using DALYs to measure population health compared to using strictly mortality based measures such as the crude death rate or age-specific death rates. c) Identify 2 criticisms of the use and/or measurement of DALYs. What are the bases for those criticisms and how might a proponent of DALYs counter those criticisms?(2006 Review) [[56. Discuss the theoretical properties a good measure of population health should have and the advantages and disadvantages of at least two measures that are currently used(2007 Prep).>http://docs.google.com/Doc?id=dc5gkw8z_33gprqwd]] **[[Health Risk Factor>http://www21.atwiki.jp/muppy/pages/4.html]] [Population Health: Rose(1985)] 57. Describe the trade-offs of individual vs population level approaches to disease control using appropriate examples. If countries focus on a population approach, what changes would this require to current policies and programs?(2006 Second) [[58. Explain the concept of "population health". Why is this term widely used today? What are the implications for research of adopting the population health approach to assessments of health status and for health interventions?(2007 prep)>http://docs.google.com/Doc?id=dc5gkw8z_28t4rx5b]] 59. Explain what you understand by the term "population health". Is this useful concept? How can it help in improving a nation's health (2006 prep) [Determinants of Health] 60. Why are some population healthy and others are not?(2007 prep) 61. What are the main dimension of health disparities in low-income countries? Are there the same dimensions as we see in the US and Europe?(2006 prep) [Epidemiologic Transition] 62. Describe the concept referred to as the "epidemiologic transition". Use the graph below, as well as other appropriate examples, to describe if there are epidemiological phenomena and patterns for which the current notion of epidemiological transition is incorrect or inadequate.(2006 Second) [[63. Distinguish the mortality transition, the epidemiologic transition and the health transition Which framework seems to you most useful in understanding contemporary trends in population health worldwide?(2007 prep)>http://docs.google.com/Doc?docid=dc5gkw8z_19ffzm47&hl=en_US]] [Risk Factor Analysis] [[64. Some researchers have predicted that the rise in obesity will lead to a reversal of the gains in life expectancy and population health in developed nations. Discuss the empirical evidence for and against this prediction using an analytical framework(2007 First)>http://docs.google.com/Doc?docid=dc5gkw8z_268ntjd&hl=en_US]] [[65. More than half of the world population uses biomass in traditional ways for their household energy needs. In many contexts, indoor air pollution is the result, causing respiratory and other ailments that impede the demographic transition and the process of economic and social development. >http://docs.google.com/Doc?docid=dc5gkw8z_268ntjd&hl=en_US]] Explain where and why you agree or disagree with the statement, discuss the implications the statement for policy; and discuss the implication of each statement for applied research(2006 Review) **[[Politics>http://www21.atwiki.jp/muppy/pages/8.html]] [Political Analysis] [[66. What is political analysis for policy reform and why is it important for health sector reform? Provide a clear justification and refer to possible problems, using cases where possible(2007 First)>http://docs.google.com/Doc?id=dc5gkw8z_374vnr4c]] [Health System] (evaluation) [[67. Discuss and critically evaluate the criteria that could be used to evaluate the performance of health system in low-income countries.(2005 Second)>http://docs.google.com/Doc?id=dc5gkw8z_374vnr4c]] 68. What criteria would you use to evaluate the performance if a health system? Briefly justify your answer?(2005 First) 69. What should the goal of the health system be? Given this goal how should priorities be set?(2007 Prep) (health reform) 70. Select a health problem(such as high maternal mortality, high infant mortality, high personal costs of health care) in one country whose health system you know well. Discuss how reforms to the health system might help address that problem(such as introduction of social health insurance or decentralization). Then discuss how that solution will change different elements of the health system and how those changes will affect the health problem.(2006 Second) [[71. Discuss how health system reform has progressed in a country that you are familiar with. How has reform affected the working of health system? Explain in detail how the reform has impacted the burden of disease and how it has affected the distribution of health care benefits and cost in the society.(2007 Prep)>http://docs.google.com/Doc?id=dc5gkw8z_374vnr4c]] **[[Ethics>http://www21.atwiki.jp/muppy/pages/6.html]] (Maximization vs Fairness) 73. The goal of resource allocation in the health sector should be to maximize aggregate measure of population health. Critically discuss with reference to an important contributor to the burden of disease in developing countries.(2006 First) [[74. Health policy has two goals: maximizing population health and distributing it fairly. Unfortunately, they may conflict with each other. On what basis can such conflict be resolved? Discuss with reference to a specific country.(2007 First)>http://docs.google.com/Doc?docid=dc5gkw8z_2dkjh74&hl=en_US]] (Priority Setting-Cost-effectiveness and Other criteria) 75. What problems are there in setting priority for investment in public health services based on the estimates of the national burden of disease? What additional measures and considerations would improve the priority-setting process?(2007 prep) 76. “The bigger the burden of disease associated with a particular disease, the more resources we should devote to it.” According to the table below, then the majority of resources should be devoted to non communicable diseases. Critique this statement, discussing a)Principles of resource allocation; b) Limitations of the data and how that might affect your answer(2006 Review) (Public Health/Medicine + priority setting) 77. Imagine that for the same amount of money: A 65-year old with advanced TB could be provided treatment, saved from imminent death, and go on to live the remainder of his life in a healthy state; OR 10 malnourished children could be provided treatment, saved from imminent death, and go on to live the remainder of their lives in a healthy state. A physician treating TB patients cites a professional and ethical obligation for her to use that money to cure her patient of TB regardless of the opportunity cost. From the point of view of a public health professional, how might you respond to the physician? In your response compare the field of public health and medicine.(2006 Review) (When is inequality unjust?) [[78. When are health inequalities unfair? Illustrate your answer with examples. (2005 Second)>http://docs.google.com/Doc?id=dc5gkw8z_16cxpbd9]] (Individual vs Social Responsibility) [[79. How should we divide responsibility for health between individuals and society? Illustrate with reference to a central example, such as smoking, alcohol or obesity.(2006 First)>http://docs.google.com/Doc?id=dc5gkw8z_15cbgxgp]] (Priority on Health Worker) [[80. Should health care workers be given priority in prophylaxis and treatment in the event of a pandemic or avian flue? Should states ever depart from the goal of avoiding as many death as possible?(2006 Second)>http://docs.google.com/Doc?id=dc5gkw8z_20c9dxxz]] *Other Study Guides -[[Gary Becker's Price Theory/ゲイリー・ベッカー流価格理論>http://www21.atwiki.jp/muppy/pages/14.html]] -[[Health Risk Decision Analysis/健康リスク意思決定分析>http://www21.atwiki.jp/muppy/pages/17.html]] -[[Health Economics in the U.S and Europe/アメリカとヨーロッパの医療経済学>http://www21.atwiki.jp/muppy/pages/15.html]] -[[Health Economics in Japan and Asian Countries/日本とアジアの医療経済学>http://www21.atwiki.jp/muppy/pages/25.html]] -[[Demography/人口学>http://www21.atwiki.jp/muppy/pages/30.html]] -[[Environmental Economics/アメリカの環境経済学>http://www21.atwiki.jp/muppy/pages/29.html]] -[[Law and Economics/法と経済学>http://www21.atwiki.jp/muppy/pages/16.html]] -[[Global and Domestic Health Law/グローバル・国内医療法>http://www21.atwiki.jp/muppy/pages/21.html]] -[[Empirical Microeconomics/実証ミクロ経済学>http://www21.atwiki.jp/muppy/pages/24.html]] -[[Social Insurance/社会保険>http://www21.atwiki.jp/muppy/pages/27.html]] -[[Financial, Health, and Consumer Literacy/金融・健康・消費者リタラシー>http://www21.atwiki.jp/muppy/pages/22.html]]
**[[Doctoral Reading List>https://docs.google.com/document/d/1AwOcOb-R-vb33hd5iJ_l2pgJQ2s78hzLgMNsCoT3ERE/edit?hl=en_US]] **[[Summary of Category>http://www21.atwiki.jp/muppy/?page=Summary]] A. General Question [1. Public Health vs Medicine] -Lab Research vs Existing Public Health Intervention -Infectious disease vs. Non-infectious disease [2. Resource Allocation: Vertical vs Horizontal] [3. Africa/Development/Money] [4. General Family Planning Topics] [5. MDGs] [6. AIDS] B. Economics Question [1. Development(Health and Demography)] -HIV and Economic Growth(New) -Malaria and Economic Growth(New) [2. Inequality] [3. Definition of Development] [4. Market Failure] [X. Lewis/Harris-Todaro Model(less likely to be in exam)] C. Demography Question [1. Demographic Transition] [2. Population Growth] [3. Historical Decline in Mortality] [4. Fertility/Family Planning] -Abortion [5. African Fertility Decline] [6. Below-Replacement Level and Aging (Immigration/Social Security)] [7. Population Projection] D. Measuring Population Health/Health Risk Factor Question [1. DALY/DALE/QALY] [2. Population Health: Rose(1985)] [3. Determinants of Health] [4. Epidemiologic Transition] [5. Risk Factor Analysis(Obesity, Smoking, IAP)] E. Politics Question [1. Political Analysis] [2. Health System Performance/Reform] F. Ethics Question [1.Inequality/Inequity] [2.Maximization vs Fair Distribution] [3.Individual vs Social Responsibility] [4.Priority on Health Worker] [5.Global Burden of Disease/Priority Setting] [6.Research Ethics Question] **[[General>http://www21.atwiki.jp/muppy/pages/7.html]] [1. Public Health vs Medicine] [[The next major contribution to improvements in global health will stem from lab research. Discuss the accuracy of this statement and its implications for public health research.(2005 First)>http://docs.google.com/Doc?id=dc5gkw8z_6fvxg9t]] Describe the view that the focus on health care in developing countries should now focus on non-infectious rather than infectious disease(Practice Question) [ [[2>http://www21.atwiki.jp/muppy/pages/11.html]]. Resource Allocation: Vertical vs Horizontal] [[2. Do you think that countries' investment in the health care sector should focus on the underlying health systems or specific disease entities or some combinations of both? What types of investments were the most productive? Justify your answer using specific examples.(2006 First)>http://docs.google.com/Doc?id=dc5gkw8z_36db9whs]] [3. Africa and Development] 3. What factors account for the very poor levels of health in sub-Saharan Africa? Is money the answer to Africa's health problems?(2005 Second) [[4. Describe two salient public health problems facing Africa and the nature and degree of success of current efforts to address them. Assess critically the view that the most effective solution to these problems will be to increase dramatically the flow of financial aid to Africa. Give examples. >http://docs.google.com/Doc?docid=dc5gkw8z_29djnpkn&hl=en]] 5. (a)Describe two salient public health programs facing Africa and the nature and degree of success of current efforts to address them. (b)With reference to the problems described in your answer to part(a), evaluate the view that the key to addressing these problems is to increase dramatically the flow of financing aid to Africa. Cite research and other arguments or evidence in support of your views.(2006 Review Session) 6. Jeffrey Sachs has argued that the three top priorities for Africa’s health systems are: “One, money. Two, money. Three, money.”In particular, he has advocated for a substantial increase in funding to combat HIV/AIDS. Discuss the strengths and weaknesses of Sach’s stance using the “3 spheres” framework (capacity, value, support) to inform your answer [4. General Family Planning Related Topics] (HIV/AIDS and RH) 7. The movement against the spread of HIV/AIDs represents a threat to the goal of attracting more funding and attention to population growth, women’s mental health, and young people’s reproductive health and rights. This is because not only public attention but also financial and human resources will be drawn away from family planning, emergency obstetric care, and comprehensive sexuality education with the influx of funds for HIV/AIDs. Explain where and why you agree or disagree with the statement, discuss the implications the statement for policy; and discusses the implication of each statement for applied research.(2006)(Do not need it) (Men's Involvement) [[8. The issue of involvement of men can be seen as marginal to the goals of improving young people’s sexual and reproductive health and rights, and reducing maternal mortality and morbidity. A gender-sensitive approach to women and girls is sufficient. Explain where and why you agree or disagree with the statement, discuss the implications the statement for policy; and discusses the implication of each statement for applied research.(2006 Review)>http://docs.google.com/Doc?id=dc5gkw8z_35cvwvhg]] [5. MDGs politics] (MDGs&RH) [[9. The population and reproductive health fields is on the defensive against a powerful set of opponents. Proponents are cling to the ICPD/Cairo goals but PRI's omission from the MDGs that are shaping the international development and indicators has been a major setback. Explain where and why you agree or disagree the implications the statement for policy, and discusses the implications of each statement for applied research(2006 Review)>http://docs.google.com/Doc?id=dc5gkw8z_25hcs4nz]] 10. The MDGs are an ambitious agenda for reducing poverty and improving lives that world leaders agreed on at the millennium summit in September 2000. For each goal one or more targets have been set, most for 2015, using 1990 as a benchmark. It has been argued that the goal of reproductive health for all, and the associated target to universal access to quality reproductive health services, is also worthy of inclusion on its list. (A)Discuss briefly what is meant by the notion of "development" in MDGs. To what extent can it be argued that reproductive health of all should be a development goals in its own right? (B) Suppose we accept the MDGs as they are. Discuss how using reproductive health as an instrument could contribute to the achievement of the other MDGs. Focus on two MDGs where you think access to reproductive health services might be most effective and be sure to cite, and critically assess, theoretical and empirical evidence relevant to your arguments.(2006 Review) (MDGs&Achievement) [[11. The Millennium Development Goals are an ambitious agenda for reducing poverty and improving lives that would leaders agreed on at the Millennium Summit in September 2000. For each goal one or more targets have been set, most for 2015 using 1990 as benchmark.a. Discuss the health targets set in the Millennium development goals; how likely are they to be achieved. b. To what extent can health also be viewed as an instrument for achieving the other goals?(2006 Review)>http://docs.google.com/Doc?docid=dc5gkw8z_30q5ppvd&hl=en]] 12. The following goals is part from the Millennium Development Goals. Choose one goal and justify its inclusion in the list of development goals; a. Justify the goal’s inclusion in the list using both theory and evidence discussed in class. b) Comment on the appropriateness of one of the indicators used to assess the attainment of the goal. (2006 Review) [6. AIDS] [[13. Describe and evaluate the methods that can be used to prevent and treat HIV/AIDS in developing countries. Should prevention or treatment be the priority for government? What framework would you use to decide on the best course of action?>http://docs.google.com/Doc?id=dc5gkw8z_0dtr2kx]] 14. Discuss critically the criteria that are used for priority setting for health interventions. Which criteria do you think are most useful? Illustrate your answer with reference to treatment and prevention programs for HIV/AIDS in developing countries.(2005 First) **[[Economics>http://www21.atwiki.jp/muppy/pages/9.html]] [1. Development] (Health->Economy) 15. Discuss the routes through which health might affect economic outcome. Does empirical research confirm a causal path leading from better health to improved economic outcome? (2005 Second) 16. How do improvements in population health affect economic growth?(2007 Preview) 17. What new evidence can be marshaled to link economic well-being with population health? In what ways has our conceptualization of the direction and nature of these connections changed in recent years? (2007 Prep) 18. (A) What are the conceptual links between population health and poverty reduction? (B) Describe the nature of the empirical evidence on the existence and strength of these links. (C)To what extent is the knowledge base in this area applicable to Sub-Saharan Africa?(2005 First) 19. Can population health be improved dramatically in a resource poor setting such as found in much of Sub-Saharan Africa without first increasing income levels dramatically? (2006 Review) 20. Discuss the concept of health-development spirals. Be sure to explain their nature, and to summarize empirical evidence related to their existence and their strength Comment also on their implications for policy interventions aimed at promoting population health and human development.(2007 Prep) 21. Using the “triangle diagram” below, describe how exogenous interventions influence links between population/health, income, and capital. In particular, choose three exogenous interventions (one for each of the dashed arrows) and describe how that intervention might influence the endogenous links. When choosing the exogenous interventions, pick one medical intervention, one non-medical health intervention, and one non-health intervention to make your case.(2006 Review) (Demography->Economy) 22. What effect does falling fertility have on economic development? Using examples, explain the mechanism through which such demographic changes affect development.(2007 First) 23. Discuss the interaction between the demographic transition and economic development.(2006 Second) [2. Inequality] 24. If one ranked the world’s population by their per capita income, the average income of the top 1 billion would be about 100 times the average income of the bottom 1 billion. a)What is the impact of income inequality on population health? b) Describe 2 pieces of evidence that demonstrate the associaton between income inequality and health; c) Describe 2 mechanisms that have been proposed that link income inequality to health 25. Is there empirical evidence that proves that greater income equality contributes to an overall improvement in health? Are there population in which income inequalities are wide and health differentials are small?(2007 prep) 26. Is there a consistent positive relationship between good health and socio-economic status? What is the basis of this relationship? Are there exceptions to this relationship?(2007 prep) [3. Definition of Development] 27. A major goal of the international community is to promote development in the least developed countries. What is meant by “development”? What roles dose health has to play in this development agenda?(2006 Review) [4. Market Failure] 28. In economic theory, free markets lead to efficient outcomes. Why does the free markets fail to provide efficient outcomes in the provision of health services?(2005 Second) 29. Why can we not simply leave health care to the market?(2006 First) **[[Demography>http://www21.atwiki.jp/muppy/pages/10.html]] [1. Demographic Transition] [[30. (i) Explain what is meant by the demographic transition (ii)What are the causal forces that lie behind the transition? (iii)Give examples of countries that appear to have followed the pattern predicted by transition theory: Are there countries that have not followed this pattern?(2006 First)>http://docs.google.com/Doc?id=dc5gkw8z_17ccd4px]] Describe the demographic transition. To what extent does it capture the experience of developing countries today.(Practice question) (Fertility/Mortality relationship) [[31. Do decline in fertility translate into improvements in mortality and morbidity? Give examples of cases where the links are very clear and explain why the relationship is difficult to examine elsewhere.(2005 second)>http://docs.google.com/Doc?docid=dc5gkw8z_5hswqk2&hl=en_US]] 32. What are the health benefits of low fertility? Should governments promote policies to lower fertility? Give examples of policies that governments have implemented to successfully reduce fertility. 33. Is an improvement in child survival a necessary precursor to fertility decline? Are there exceptional cases? Discuss with reference to specific countries or regions. [[34. What are the necessary precursors to a decline in a population's fertility? Are there exceptional cases? Discuss with reference to specific countries or regions.(2005 First)>http://docs.google.com/Doc?docid=dc5gkw8z_23c2cghn&hl=en_US]] [2. Population Growth] [[35. Is there still cause for concern about rapid population growth rates in low-income countries? Using one country or region to illustrate your answer, outline the evidence available to support your answer.(2007 prep)>http://docs.google.com/Doc?docid=dc5gkw8z_18htgn4k&hl=en_US]] [[36. Explain what Thomas Malthus meant by "positive" and "preventive" checks to population growth. Do either of these concepts have any relevance to understanding today's population growth rate? Explain your answer with reference to specific cases.(2007 prep)>http://docs.google.com/Doc?id=dc5gkw8z_21fd4c4k]] [3. Historical Decline in Mortality] 37. Are the lessons learned from studying the causes of the early 20th centaury improvements in childhood mortality in Europe and North America applicable to the reduction of mortality in low-income countries today? Give reasons for your answer and provide examples and comparisons.(2006 Review) 38. Does the study of the improvement in child survival in NW Europe and the US in 1900 help us in promoting child survival in high mortality countries today? (2006 Prep) 39. Explain the factors that lie behind the long term decline in mortality rates throughout the world over the last 200 years. [[40. Which factors explain the major reduction in under 5 mortality in the sub-Saharan African countries surveyed by DHS in the 1990s? How do these factors differ from those responsible for the improvements in childhood mortality in NW Europe and North America in the early 1900s.>http://docs.google.com/Doc?id=dc5gkw8z_2283mxhj]] [4. Fertility/Family Planning] [[41. How would you justify an investment in a publicly supported family planning program? What evidence is there that such investment positively affect reproductive health?(2005 First)>http://docs.google.com/Doc?docid=dc5gkw8z_24fh7c8z&hl=en_US]] 42. Have past investments in modern family services paid off? Why has international support for fertility limitation program reduce recently?(2007 prep) 43. With reference to one region or country of your choice, comment critically on the view that national, publicly supported family planning programs have had a major impact on the speed and timing of the decline in fertility. Does this evidence justify the continued pubic support of such programs in high fertility countries? Discuss the rationale for government provision of reproductive health service in low income countries.(Practice Question) (More attention on FP/RH) 44. What is needed now to promote attention and funding to reproductive health is to effect a “paradigm shift” in the global health sector, ensuring that the health policy agenda will value, rather than ignore, the investments required to achieve the Cairo census. Alliances of researchers and advocates will be required in this effort. Explain where and why you agree or disagree with the statement, discuss the implications the statement for policy; and discusses the implication of each statement for applied research(2006 Review). 45. In the current political climates in Washington, it is not worth investing much in advocacy work inside the Beltway, media education and cultivation, etc. that focuses on international population and reproductive health issues. Explain where and why you agree or disagree with the statement, discuss the implications the statement for policy; and discusses the implication of each statement for applied research(2006 Review) (abortion) 46. What is the contribution of induced abortion to contemporary fertility transition? Is the use of abortion always an indicator of unmet need for contraception?(2007 prep) [5. Fertility/Africa] [[47. Why is fertility falling in sub-Saharan Africa today? Does existing fertility theory help us to interpret these new trends?(2007 prep)>http://docs.google.com/Doc?docid=dc5gkw8z_3dh34fm&hl=en_US]] 48. Why did fertility fall so rapidly in south-east Asia compared with more recent decline in Africa and the Middle East?(2006 prep) [6. Below-Replacement Level and Aging (Immigration/Social Security)] [[49. Are there economic and social argument for intervening to raise below-replacement fertility levels in advanced market economies? What policies are likely to be effective and why? Refer to specific countries if appropriate.(2007 prep)(2006 Revie)>http://docs.google.com/Doc?docid=dc5gkw8z_4wsmrt3&hl=en_US]] 50. Should governments in countries with below-replacement fertility implement policies to increase natality? What benefits would flow from any resultant increases in fertility? Which policy measures are most likely to be successful and why?(2006 Second) 51. What are the social and economic consequence of below-replacement fertility? What remedies are being proposed to raise population growth rate? Which seem to you most likely to succeed?(2006 prep) [7. Population Projection] (Cohort Component) [[52. Why have long-term population projections of the world's population proved so unrealiable in the past? What can be done to improve the accuracy of future population projection? >http://docs.google.com/Doc?id=dc5gkw8z_14d9dkmb]] (Brass Method) 53. UNICEF has asked you to describe the trends in under 5 mortality for a sub-Saharan African country with incomplete vital registration. The country has three recent DHS surveys and four censuses- each asked about the survival of near relatives(mothers-children;adults-parents). What analytic methods would you employ and why? Discuss the merits and drawbacks of each(2007 First) **[[Measuring Population Health>http://www21.atwiki.jp/muppy/pages/4.html]] [[54. Apart from life expectancy, what measures would you propose to assess the contribution of a health system to the health of a population? Justify your choice of measures and illustrate with examples. (2006 First)>http://docs.google.com/Doc?id=dc5gkw8z_31fnd8j7]] 55. Over the last decade there have been some new developments in the approach to the measurement of the health of populations for priority setting at national, regional, and global scales, Disability Adjusted Life Years being the most prominent at the international level. Using the table below: a) Briefly describe how DALYs are calculated. b) Describe 2 advantages to using DALYs to measure population health compared to using strictly mortality based measures such as the crude death rate or age-specific death rates. c) Identify 2 criticisms of the use and/or measurement of DALYs. What are the bases for those criticisms and how might a proponent of DALYs counter those criticisms?(2006 Review) [[56. Discuss the theoretical properties a good measure of population health should have and the advantages and disadvantages of at least two measures that are currently used(2007 Prep).>http://docs.google.com/Doc?id=dc5gkw8z_33gprqwd]] **[[Health Risk Factor>http://www21.atwiki.jp/muppy/pages/4.html]] [Population Health: Rose(1985)] 57. Describe the trade-offs of individual vs population level approaches to disease control using appropriate examples. If countries focus on a population approach, what changes would this require to current policies and programs?(2006 Second) [[58. Explain the concept of "population health". Why is this term widely used today? What are the implications for research of adopting the population health approach to assessments of health status and for health interventions?(2007 prep)>http://docs.google.com/Doc?id=dc5gkw8z_28t4rx5b]] 59. Explain what you understand by the term "population health". Is this useful concept? How can it help in improving a nation's health (2006 prep) [Determinants of Health] 60. Why are some population healthy and others are not?(2007 prep) 61. What are the main dimension of health disparities in low-income countries? Are there the same dimensions as we see in the US and Europe?(2006 prep) [Epidemiologic Transition] 62. Describe the concept referred to as the "epidemiologic transition". Use the graph below, as well as other appropriate examples, to describe if there are epidemiological phenomena and patterns for which the current notion of epidemiological transition is incorrect or inadequate.(2006 Second) [[63. Distinguish the mortality transition, the epidemiologic transition and the health transition Which framework seems to you most useful in understanding contemporary trends in population health worldwide?(2007 prep)>http://docs.google.com/Doc?docid=dc5gkw8z_19ffzm47&hl=en_US]] [Risk Factor Analysis] [[64. Some researchers have predicted that the rise in obesity will lead to a reversal of the gains in life expectancy and population health in developed nations. Discuss the empirical evidence for and against this prediction using an analytical framework(2007 First)>http://docs.google.com/Doc?docid=dc5gkw8z_268ntjd&hl=en_US]] [[65. More than half of the world population uses biomass in traditional ways for their household energy needs. In many contexts, indoor air pollution is the result, causing respiratory and other ailments that impede the demographic transition and the process of economic and social development. >http://docs.google.com/Doc?docid=dc5gkw8z_268ntjd&hl=en_US]] Explain where and why you agree or disagree with the statement, discuss the implications the statement for policy; and discuss the implication of each statement for applied research(2006 Review) **[[Politics>http://www21.atwiki.jp/muppy/pages/8.html]] [Political Analysis] [[66. What is political analysis for policy reform and why is it important for health sector reform? Provide a clear justification and refer to possible problems, using cases where possible(2007 First)>http://docs.google.com/Doc?id=dc5gkw8z_374vnr4c]] [Health System] (evaluation) [[67. Discuss and critically evaluate the criteria that could be used to evaluate the performance of health system in low-income countries.(2005 Second)>http://docs.google.com/Doc?id=dc5gkw8z_374vnr4c]] 68. What criteria would you use to evaluate the performance if a health system? Briefly justify your answer?(2005 First) 69. What should the goal of the health system be? Given this goal how should priorities be set?(2007 Prep) (health reform) 70. Select a health problem(such as high maternal mortality, high infant mortality, high personal costs of health care) in one country whose health system you know well. Discuss how reforms to the health system might help address that problem(such as introduction of social health insurance or decentralization). Then discuss how that solution will change different elements of the health system and how those changes will affect the health problem.(2006 Second) [[71. Discuss how health system reform has progressed in a country that you are familiar with. How has reform affected the working of health system? Explain in detail how the reform has impacted the burden of disease and how it has affected the distribution of health care benefits and cost in the society.(2007 Prep)>http://docs.google.com/Doc?id=dc5gkw8z_374vnr4c]] **[[Ethics>http://www21.atwiki.jp/muppy/pages/6.html]] (Maximization vs Fairness) 73. The goal of resource allocation in the health sector should be to maximize aggregate measure of population health. Critically discuss with reference to an important contributor to the burden of disease in developing countries.(2006 First) [[74. Health policy has two goals: maximizing population health and distributing it fairly. Unfortunately, they may conflict with each other. On what basis can such conflict be resolved? Discuss with reference to a specific country.(2007 First)>http://docs.google.com/Doc?docid=dc5gkw8z_2dkjh74&hl=en_US]] (Priority Setting-Cost-effectiveness and Other criteria) 75. What problems are there in setting priority for investment in public health services based on the estimates of the national burden of disease? What additional measures and considerations would improve the priority-setting process?(2007 prep) 76. “The bigger the burden of disease associated with a particular disease, the more resources we should devote to it.” According to the table below, then the majority of resources should be devoted to non communicable diseases. Critique this statement, discussing a)Principles of resource allocation; b) Limitations of the data and how that might affect your answer(2006 Review) (Public Health/Medicine + priority setting) 77. Imagine that for the same amount of money: A 65-year old with advanced TB could be provided treatment, saved from imminent death, and go on to live the remainder of his life in a healthy state; OR 10 malnourished children could be provided treatment, saved from imminent death, and go on to live the remainder of their lives in a healthy state. A physician treating TB patients cites a professional and ethical obligation for her to use that money to cure her patient of TB regardless of the opportunity cost. From the point of view of a public health professional, how might you respond to the physician? In your response compare the field of public health and medicine.(2006 Review) (When is inequality unjust?) [[78. When are health inequalities unfair? Illustrate your answer with examples. (2005 Second)>http://docs.google.com/Doc?id=dc5gkw8z_16cxpbd9]] (Individual vs Social Responsibility) [[79. How should we divide responsibility for health between individuals and society? Illustrate with reference to a central example, such as smoking, alcohol or obesity.(2006 First)>http://docs.google.com/Doc?id=dc5gkw8z_15cbgxgp]] (Priority on Health Worker) [[80. Should health care workers be given priority in prophylaxis and treatment in the event of a pandemic or avian flue? Should states ever depart from the goal of avoiding as many death as possible?(2006 Second)>http://docs.google.com/Doc?id=dc5gkw8z_20c9dxxz]] *Other Study Guides -[[Gary Becker's Price Theory/ゲイリー・ベッカー流価格理論>http://www21.atwiki.jp/muppy/pages/14.html]] -[[Health Risk Decision Analysis/健康リスク意思決定分析>http://www21.atwiki.jp/muppy/pages/17.html]] -[[Health Economics in the U.S and Europe/アメリカとヨーロッパの医療経済学>http://www21.atwiki.jp/muppy/pages/15.html]] -[[Health Economics in Japan and Asian Countries/日本とアジアの医療経済学>http://www21.atwiki.jp/muppy/pages/25.html]] -[[Demography/人口学>http://www21.atwiki.jp/muppy/pages/30.html]] -[[Environmental Economics/アメリカの環境経済学>http://www21.atwiki.jp/muppy/pages/29.html]] -[[Law and Economics/法と経済学>http://www21.atwiki.jp/muppy/pages/16.html]] -[[Global and Domestic Health Law/グローバル・国内医療法>http://www21.atwiki.jp/muppy/pages/21.html]] -[[Empirical Microeconomics/実証ミクロ経済学>http://www21.atwiki.jp/muppy/pages/24.html]] -[[Social Insurance/社会保険>http://www21.atwiki.jp/muppy/pages/27.html]] -[[Financial, Health, and Consumer Literacy/金融・健康・消費者リタラシー>http://www21.atwiki.jp/muppy/pages/22.html]]

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