The MDG is a concept derived from the United Nations (UN) millennium declaration set in place in 200 by 189 member nations. [13] [7] The global agenda of the MDG is to bring about improvement in the well being of people worldwide by 2015. [13] [7] The MDGs also include the following:

• Eradicate extreme poverty and hunger
• Achieve universal primary education
• Promote gender equality and empower women
• Reduce child mortality
• Improve maternal health
• Combat HIV/AIDs, Malaria and other diseases
• Ensure environmental sustainability, and
• Develop a global partnership for development. [7]

There are challenges that affect MDG in those countries who are not yet achieving the set goals and lacking in progress, even though there are billions of dollars in funding available for successful and effective interventions.  The challenges that are incurred by some countries include “major shortfalls in the health workforce, lack of donor coordination, and weak information systems as critical challenges to achieving the Millennium Health Goals”. [13] Another concern that arises is the allocation of resources to an existing weak system because over concentration of resources in one area will leader to under concentration in another area. [13] Failure to proceed properly in taking corrective actions in achieving the MDGs will result in inadequate progress of the poorest countries: therefore, fueling the growth infectious diseases associated with poverty and further demonstrating that some countries are not able to handle the proposed changes. [2] [13] Strategic plans needs to be composed to allocate assistance in the areas that are lacking proficiency.  Having the MDGs as the foundation and starting point is exceptional.  However, constant assessment of a countries need will have to be performed so a more personal plan of action can be developed.

Infectious Diseases

    Between 300 and 500 million people worldwide develop malaria annually, resulting in a million deaths; and dengue fever effects between 50 and 100 million people annually, resulting in 2200 deaths. [11] “The field of infectious disease is vast, complex, and rapidly expanding phenomena that is clinically comprised of illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism”. [15]  The rise of the spreading of infectious diseases is attributed to human migration, poverty, water and air quality, land use decisions, ecological change, the strength of the local public health system, listed immune system depression, health care and sanitation deficiencies, pollution and even access to air conditioning are themselves intertwined with climate change. [12] [15] Water is a basic component of biological necessity for human beings. The major source of drinking water throughout the world is groundwater; with the recommended daily intake of water is between two and more leaders; therefore, a significant of safe and reliable source of drinking water is beyond question. [10] [3] Climate change is occurring as a result of warming of the earth’s atmosphere due to human activity generating excess amounts of greenhouse gases. Because of its potential impact on the hydrologic cycle and severe weather events, climate change is expected to have an enormous effect on human health, including on the burden and distribution of many infectious diseases. The infectious diseases that will be most affected by climate change include those that are spread by insect vectors and by contaminated water. [11] These infections can also lead to a wide range of clinical illness, but herein we will only focus on infections causing diarrheal disease since this is currently the second leading cause of death among children under the age of five worldwide. [11]

     Infectious diseases spread by insect vectors will be affected most by climate change and contaminated water. [11] In order to get a handle on this epidemic governments and individuals need to put an end to causing climate changes and get a better understanding of the ecology of infectious diseases in order to protect vulnerable populations. [11] Some international efforts have been made to reduce the production of emissions such as the Kyoto Protocol developed in 1997 by the UN Framework Convention on Climate Change and put into action on 2005 by 187 nations. [11] The Intergovernmental Panel on Climate Change has determined that a 50% reduction in greenhouse gas emissions (compared with 1990 levels) by 2050 will be necessary to stabilize the global temperature increase at 2–2.4 °C compared with preindustrial times. [11] Climate change is a very real phenomenon which has already impacted the global distribution of infectious diseases. If climate change continues unabated, it is likely that the range of deadly diseases such as malaria will expand or shift, resulting in sickness and death as populations without pre-existing immunity are increasingly affected. It is our responsibility to take action now to prevent this from occurring. We must reduce greenhouse gas emissions by developing an international treaty, enacting legislation locally, and acting responsibly as individual citizens of the world. Finally, we must continue to seek answers as to how climate change will affect our most vulnerable populations, and we must do what we can to protect them. [11]

Chronic Diseases Associated with Lifestyle

     A significant portion of rising health care expenditures can be attributed directly or indirectly to lifestyle; in fact, psychological and behavioral factors contribute to the development, maintenance, and exacerbation of some of our most common and costly health conditions. [11] “Because many chronic conditions stem from similar, largely lifestyle-related risk factors, such as smoking, poor diet, or inadequate physical activity, primary prevention programs aimed at addressing these causes have the potential to affect multiple conditions”.[6]  Tobacco use, unhealthy diet, and physical inactivity are among the leading causes of the major noncommunicable diseases, including cardiovascular disease, type 2 diabetes and certain types of cancer. These preventable factors contribute substantially to the global burden of disease, death and disability.  

     These three lifestyle risk factors are significant because of their etiological background and the modification abilities that could lead to prevention. [4] Lifestyles of individuals change with changes in income, health status, price of the good, the prices of other goods, tastes and trends, and population size and composition. [5] There are several factors that an individual can implement into a lifestyle that can reduce or even eliminate the chances of acquiring this disease process.  In contrast, living a healthy lifestyle staying at a healthy weight, following a healthy diet, not smoking, and participating in regular exercise could potentially prevent more than three-quarters of the risks of cardiovascular diseases. There are many risk factors that accompany the smoking of cigarettes such as cardiovascular disease, cancer and hypertension, and complication associated with premature mortality in industrialized nations. [14] Cessation of smoking can possibly lead to prolong life and a reduction in morbidity. [14] An essential and effective intervention that will lead to the reduction of worldwide mortality and morbidity is the promotion of smoking cessation. Combing pharmacotherapy and behavioral counseling produces better long-term outcomes.[8] Socioeconomic and political factors, along with public awareness, are three crucial areas that cannot be neglected if the fight against disease and for positive health, well-being, and human development has to succeed. [12]

Recommendations for Rectification

     The first line of defense when addressing public health is heath education.  Health education is a prevalent component especially when dealing with countries where ignorance and rituals supersede common knowledge. The three economic global health care issues can be tackled through the use of health education and health literacy.  Health education must be administered on all levels from the health care provider to the individual, all the way to the government. [7] [11] Health education is not just simply telling people what will make the world a better place to stay in or what will make the people live in paradise on earth. No, it goes beyond that to include empowering people to understand who they are, where they come from, and what they and their community can be.  The role of health education is to make people understand what it means to be healthy, aware of the value of good health, how to obtain good health, and how to maintain good health. [7] Health education therefore serves as the cheapest and easiest tool to dismantle this vicious cycle.  Through health education, the misconceptions based on ignorance can be clarified, and awareness created on how to reduce poverty and disease and thereby avert problems that affect health. [7] Possessing health literacy through health education provides individuals with “the ability to obtain process and understand the basic information and services needed to make appropriate decisions regarding one’s health”. [2]
When implementing a health education program there are key factors that need to be included:

1. Collection of Information and Facts
2. Determining the prevailing Practices and identifying the problems
3. Deciding on priorities objectives and actions
4. Identifying and obtaining resources
5. Selecting appropriate methods for carrying out the action
6. Implementation
7. Evaluation of the effectives of the talk. [7]

Making the program effective is going to require that the program is interesting and motivational, comprehensible and communicating, involves simplicity and complexity, repetitious reinforcement, integrating, involves leaders, and constant evaluation for corrective actions. [7] Even when these steps are adopted, the manner in which the health education is conveyed may produce a negative result because of certain barriers. For this reason, the nurse or health educator must guard against barriers to effective communication of health education package. The barriers to effective communication in the delivery of health education package include the following: Language barrier, negative attitude of provider, poor knowledge of subject matter by service provider, finance, timing, physical environment, religious constraints, cultural beliefs and values. [7]

Conclusion

     The treatment of any disease can be quite costly.  There is an assumption “that population-based primary prevention activities lead to reduced disease onset in the short run and, consequently, to reduced complications associated with the avoided diseases and their biological antecedents in the medium run”. [6] This manuscript has provided insight to three pertinent global economic health care issues; millennium development goals, infectious diseases, and chronic illness as it relates to lifestyle. Each issue has deficiencies that can be tackled primarily through health education and health literacy.  Arming individuals with information that will allow them to make clear and concise decisions about their overall health will lead to better outcomes of health and a decrease in health care expenditures.  Taking this concept one step further, by having other get involved with the global economic health care issues such as the community and the government can give individuals more confidence to take the necessary steps to be proactive with acquiring a healthy lifestyle.  All individuals need to take the A.P.P. Life Approach, being active and proactive of one’s health to possibly prevent undesirable outcomes.

References

1. Benatar, S. R., Gill, S., & Bakker, I. (2011). Global health and the global economic crisis. American Journal Of Public Health, 101(4), 646-653. doi:10.2105/AJPH.2009.188458
   
   
2. Blackburn, M. L. (2010). Cognitive and motivational factors support health literacy and acquisition of new health information in later life. California Agriculture, 64(4), 189-194.
   
   
3. Krewski, D., Balbus, J., Butler-Jones, D., Haas, C., Isaac-Renton, J., Roberts, K. J., & Sinclair, M. (2002). Managing health risks from drinking water—A report to walkerton inquiry. Journal of Toxicology & Environmental Health: Part A, 65(21), 1635-1823. doi:10.1080/00984100290071711
   
   
4. Lv, J., Liu, O., Ren, Y., Gong, T., Wang, S., & Li, L. (2011). Socio-demographic association of multiple modifiable lifestyle risk factors and their clustering in a representative urban population of adults: a cross-sectional study in Hangzhou, China. International Journal of Behavioral Nutrition and Physical Activity, 8(40), 1-13.
   
   
5. Morris, S., Devlin, N., & Parkin, D. (2007). Economic analysis in health care. West Sussex, England: John Wiley & Sons, Ltd.
   
   
6. Ormond, B., Spillman, B., Waidmann, T., Caswell, K., & Tereshchenko, B. (2011). Potential national and state medical care savings from primary disease prevention. American Journal Of Public Health, 101(1), 157-164.
   
   
7. Osuala, E.O.  (2011). Health education: Implications for the achievement of the health-related Millennium Development Goals. West African Journal of Nursing, 22(1), 53-60.
   
   
8. Raupach, T., & Van Schayck, C. (2011). Pharmacotherapy for smoking cessation: current advances and research topics. CNS Drugs, 25(5), 371-382. doi:10.2165/11590620-000000000-00000
   
   
9. Schwartz, S.M., Ireland, C., Strecher, V., Nakao, D., Wang, C., & Juarez, D. (2010).  The economic value of a wellness and disease prevention program.  Population Health Management, 13 (6), 309-317. doi: 10.1089/pop.2009.0070.
   
   
10. Sharma, S. K., Petrusevski, B., & Amy, G. (2008). Chromium removal from water: a review. Journal Of Water Supply: Research & Technology-AQUA, 57(8), 541-553. doi:10.2166/aqua.2008.080
11. Shuman, E.K. (2011).  Global climate change and infectious diseases.  The International Journal of Occupational and Environmental Medicine, 2(1), 11-19
    
    
12. Singh A. R, & Singh S. A., (2008).  Diseases of poverty and lifestyle, well-being and human development.  Mens Sana Monographs, 6(1), 187-225.
    
    
13. Travis, P., Bennett, S., Haines, A., Pang, T., Bhutta, Z., Hyder, A., Pielemeier, N. R., Mills, A., & Evans, T.  (2004). Overcoming health-systems constraints to achieve the Millennium Development Goals. The Lancet, 364, 900-906.
    
    
14. Ussher, M. (2011). Exercise interventions for smoking cessation. Cochrane Database Of Systematic Reviews, (11)
    
    
15. Zyga, S. & Zografakis-Sfakianakis, M. (2011).  Emerging and re-Emerging Infectious Diseases: A potential pandemic threat.  Health Science Journal, 5(3), 159-168.