| The book,
published by Jossey-Bass, features a wide range of expert opinions
on the future of international health, and what is required to promote
health, prevent disease, and provide adequate health care to various
populations, particularly those in developing countries.
In his foreword to the book, former President Jimmy Carter applauds
the progress that has been made in global health—including
the eradication of polio and smallpox and dramatic reductions in
infant mortality rates—while pointing out the enormous challenges
that lie ahead. The greatest among them, he notes, is how to close
the "growing chasm" between those who are "rich,
powerful, and healthy," and those who are "poor, weak,
and suffering from preventable diseases."
Vince Whitman and her co-authors argue that one of the most effective
ways to close this gap is to address the health needs of children
and adolescents through schools. Among the world's nearly six billion
people, more than two billion are younger than 20 years old, and
one billion are enrolled in schools. "The formal education
system thus provides the world's most powerful means to dispense
vital information and skills for its citizens," the authors
point out.
And the challenges are many: by 2020, tobacco is expected to kill
more people worldwide than any single disease; injuries, both unintentional
(such as car and motor bike crashes) and intentional (suicide, violence,
war) could rival infectious diseases as causes of death, injury,
and illness. Meanwhile, HIV and other sexually transmitted diseases
may cause up to 10 percent of the world's burden of illness.
Vince Whitman and her co-authors note that the leading causes of
premature death and disability in the 21st century could be markedly
reduced by enabling schools to educate young people about injuries
and disease and by providing simple health services. An HHD partner
who shares this view is Education International (EI), the global
trade union of about 25 million teachers. In 1998, EI proclaimed
that "schools are the irreplaceable and most useful place in
a country to improve both health and education," and called
on all governments to strengthen policies and resources for school
health programs.
In the United States, the authors point out, studies have shown
that well-designed school health programs reduce tobacco use, improve
nutrition, increase standardized test scores and math grades, and
reduce absences, alcohol use, sexual activity, and pregnancy rates.
In the developing world, the World Bank notes that one of the most
cost effective ways to improve health is to implement a public health
package that includes immunization, treatment of worm infections,
family planning and nutrition, and programs to reduce consumption
of tobacco, alcohol and other drugs, and AIDS prevention programs
with a strong STD component.
Since publication of the book, the World Health Organization, UNESCO,
UNICEF and the World Bank have joined together on FRESH (focusing
resources on effective school health), which advocates that all
schools have, at a minimum: health-related policies, safe water
and sanitation, skills-based health education, and health and nutrition
services.
Indeed, research indicates that a population's physical and mental
health is directly linked to its economic health, Vince Whitman
and her co-authors say. Students who suffer health problems—who
are hungry, depressed, ill, injured or are abusing drugs—do
notlearn as well as those who are healthy and do not become as productive
as others.
The key to the success of these programs, say the authors, is collaboration
among international, national, and local agencies, and schools,
parents, and communities. "…they will need to work together
in new ways on behalf of young people," say the authors. Such
programs will not only improve health and academic achievement,
but social stability and economic productivity, they conclude.
Critical Issues in Global Health is available in major bookstores
or from online booksellers such as www.amazon.com or www.barnesandnoble.com.
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