”Where is a stick here?” asks Hans Rosling, the famous Professor in global health from Karolinska Institutet and a keynote speaker at the conference “Health Equity in an Unequal World”, organized by the Swedish Network for International Health (SNIH) and taking place in Stockholm, 20-21 November, 2015.
The famous star in global health Prof Hans Rosling begins his speech from finding a good pointer and prepares the audience for some important things that need to be pointed out. “How many children in the world get the measles vaccine? Is it one, two… or ten out of ten? How many girls go to school? How many people in the world have electricity, and how many have access to contraceptives?” This quick test quickly reveals that majority perceives the world as it was still in the fifties. But it is changing and it´s time to upgrade Your World view! 85% of the world´s children are vaccinated against measles (and it is a shame that it is not 100%), 90% of all girls are educated, and 80% of people have electricity. By asking these questions and showing what answers he already got before, Prof Rosling quickly draws a conclusion, what is the main problem of the world – it´s ignorance!
“I talk too long without showing bubbles” continues the speaker with his famous graphical presentation about the new world we have. Eight out of ten people in the world use contraceptives and this does not at all depend on religion, neither politic views. Rosling quickly draws a comparison between China with its one child policy (recently abolished) and Taiwan. Apparently, how you pray and how you behave in bedroom are completely different things. So how many children will be there in 2100 and how many people will walk this earth?
Well, according the UN estimations, it´s 11 billion (be careful and never say “population explosion” as it refers to racism!). But if it´s not children (the correct answer for the question in the picture is C), then who will fill the rest? It´s adults. And it happens when the large young generations grow up – without increasing number of children, without increasing the length of life – this could be called “inevitable filling by the adults”. Now one of seven billion people live in Americas, one – in Europe, one – in Africa, and four – in Asia (“PIN-code of the World – 1114”). But what will happen in the future? Well, no more people neither in Europe, nor Americas, but +1 billion in Asia, and +3 billion in Africa. 80% of the world´s population will live in Asia and Africa. Soon the “Old West” (Europe and North America) will be outnumbered in the rich consumer market and out-centred, and not only by Asia but by Africa as well. “Better start being friendly with them now!” J
“So do not use the heart in global health, use brain” advices Hans Rosling and concludes his speech with the most strong need here for Factfulness – learn the facts and have opinion!
The speakers at the conference also discuss and reflect on addressing health inequality among vulnerable populations and health inequalities between migrant groups: do foreign born individuals die earlier and perceive their own health as poorer; does mortality vary between different specific immigrant groups; are such inequalities transmitted to the next generation; do results depend on the reason for migration; which factors could explain potential health inequalities by country of origin?…
Jan Semenza from the European Centre for Disease Prevention and Control (ECDC), and Prof Mikael Rostila from The Centre for Health Equity Studies (CHESS) in Stockholm, touch the immigrant health paradox: most immigrant groups report poorer health but some live longer. Possible explanations are these:
- “Salmon bias hypothesis” – migrants return to their country of origin when they retire or become seriously ill
- “Healthy migrant hypothesis” – those who migrate constitute a selection of relatively advantaged and health individuals from their country of origins (like “healthy workers effect”)
- “Overcoverage” – migrants return to their country of origin without informing the authorities. This causes problems of validity and bias in mortality analyses.
While majority in the panel agrees that women empowerment is a key issue to address health inequity, Prof Mikael Rostila summarizes research findings about immigrant health in Sweden:
- The number of people with foreign background have increased considerably and will increasingly contribute to the public health of the Swedish society in the future
- Mortality risks vary by country of birth and socio-economic position explains much of the differentials. Particularly high mortality among immigrant men
- Male offspring of foreign-born have higher mortality risks. SEP explains much of the differentials
- Foreign-born groups report much poorer self-perceived physical and mental health
- Studying alternative categories of particularly vulnerable migrants, such as unaccompanied children and refugees, is important for the understanding of migrant health
- Mechanisms linking migration and health should be further studied and are highly important for the formation of public health policies.
The conference closes with a discussion of young leaders about what is leadership and what are the challenges of young leaders in global health, as well as with some advice and tips for the younger ones.
SNIH (www.snih.org) is an independent network for students and alumni of master’s degrees in international and public health at universities in Sweden. At present the Network includes: Gothenburg University, Karolinska Institute, Lund University, Umea University & Uppsala University. The Network is a non-profit organization with a mission to support a collaborative network within public and international health that will facilitate interaction between members, and provide tools for personal and professional development. SNIH´s vision is a world where students and professionals communicate, and together contribute to the improvement of international health.
This blog was written by the Young Gasteiner Andrius Kavaliunas