#fastest death was like. 6 seconds. maybe less. i was playing on normal

[cozylittleartblog]

50+ deaths at 5 am got me yelling absolute nonsense to the bosses kicking my whole entire ass

[juniperpublishers-gjorm]

Life Expectancy; Factors, Malaria the Most Common Disease Affecting Pregnant Women in Africa [Nigeria and Cameroon]

To Know More About Please Click on: Journal of Reproductive Medicinehttps://juniperpublishers.com/gjorm/index.php To Know More About Open Access Publishers Please Click on: Juniper PublishersAuthored by:İlker Etikan*

Introduction

Africa is the second largest and also the second most populous continent in the world. It comprises of 54 countries and total population of about 1.2 billion. The current population states that the population of the youth is higher to the one of the old because the average mean of the whole Africa population falls among the age of the youth. It is also confirmed by the world health organization (WHO) that Africa as a continent has the worst life expectancy at birth, while this is because more than half of the countries that falls under low life expectancy at birth are from African continent especially the sub-Sahara part. It may be due to some effects such as; climatic effects, economic effects, political effects, lack of access to good health center, etc. Life expectancy is the average mean length of life based on their birth, current age and other demographic factors including gender [1-4]. Life expectancy at birth is the breakdown of the death rate that arises across any form of age group in a given year be it young or old. The global life expectancy in the year 2015 was in the average mean of 71.4 years, which 73.8 years for the female while 69.1 years for the male. Since 1960, the life expectancy increased by 5 years between 2000 and 2015, which is said to be the fastest increase [5].

Life expectancy is a very crucial measure that effect the developing world’s striving to achieve socio and economic progress in health sector, education, sanitation, social safety and environmental management. Life expectancy shows the condition of a region or country, in developed countries, life expectancy is relatively high compared to the developing or under developed country because life expectancy is low. This may be due to lack of clean drinking water, proximity to the hospital or health care centre, etc. Some less developed countries, life expectancy at birth may be lower than life expectancy at age 1 , because of high infant mortality rates commonly due to lack of access to a clean water supply or infectious disease. To calculate life expectancy, a table has to be constructed called “Life Table”. It can only be constructed by considering two core factors; death rate of a total population and healthy life expectancy or disability free life expectancy. These two factors determine the average number of years a person is expected to live [6].

Life expectancy is usually reported at birth, although it can be applied to other ages as well, is a commonly used summary measure that can also be used to compare across countries. Life expectancy is calculated using life tables. Life Table consist of some elements that is derived after it is been constructed such as, the probability of surviving the next year, age of person at the particular time, number of death between ages, number of person lived after the particular age, life expectancy at the age. Before considering the construction of the life table, it is well known that there is a significant difference in the mortality rate of both the male and female. Therefore, the construction of life table is separately constructed between the both sex; the male and the female.

Construction of life tables

A life table explains the mortality rate of a population which also gets information about the length on life expectation. It contains columns with different interpretation. Through the construction of life table, many indicators are computed [7,8] (Table 1). This periodic table is the most used when constructing life table. It’s only based on the current age and death rate of different age circle. Furthermore, the actual life expectancy can also be calculated when everyone in a particular age range or define age group is dead. It is called a cohort life table [9,10]. This kind of table requires information or data over many years before a cohort life time table can be completed. An example on how it can be constructed and the mathematics involved can be downloaded from the statistical analysis website [11].

Definition: Life expectancy at birth tells the number of years a newborn baby would live at the period of birth to the time of death [12-14].

Historical Background of Life Expectancy

Nigeria: Nigeria is a federal republic in west Africa, surrounded by some neighboring countries like Benin, Cameroon, Ghana, Togo, Chad [9,13]. It official language is English with 3 major languages; Hausa, Igbo and Yoruba, and also lots of indigenous languages. It comprises 36 states and federal Capital Territory located in Abuja. Nigeria with total population of 186 million as at 2016 reported by the World Health Organization(WHO). Nigeria is the most populous and the most populated country in Africa, and 7th most populous country in the world. Nigeria life expectancy at birth is at a minimum of 36.98 in 1960, while the value for life expectancy at birth total (years) was approximately 52.98 as of 2015. The table below shows the life expectancy of both male and female since the year 1996 till 2015 (Table 2).

Cameroon: Cameroon, officially the republic of Cameroon is a country in central Africa with neighboring countries like; Nigeria, Equatorial Guinea, Central Africa Republic, Chad, and Republic of Congo. Her official languages are; English and French. Cameroon is one of the wettest places on earth because it receives plenty of rainfalls every year. As at 2016, the population of Cameroon was 23.4 million according to the World Health Organization (WHO) [14]. The life expectancy in Cameroon in 1960 was 41.52, while in 2015, life expectancy for Cameroon was 57.56 years. The table below shows the life expectancy of Cameroon at birth since the year 1996 till 2015 [2] (Table 3).

Reasons for Low Life Expectancy in Africa (Nigeria and Cameroon)

In most Africa countries, there is vivid record of imbalance of food when compared to her population growth. Africa which is said to be the hottest continent, the effects of food growth maybe from the lack of raindrops because more than half of the entire land surface of Africa consisting of dry lands and deserts due to lack of raindrops . Growing of foods and vegetations, mostly in the sub-Sahara part of Africa, result in a negative outcome during harvest due to low rainfall which affect the growth of negatively and during circulations, it cannot cover the whole population. Improper intake of food causes malnutrition which seems to be one of the major factors affecting low life expectancy at birth [15,16].

Illiteracy is very high in most Africa countries; one of it is affected by the low level of allocation from the government to build more schools for easy learning of dwellers which make it unavailable to most people [17]. Level of literacy is high in the major cities in Africa while in the rural part of Africa; the level of literacy is extremely low because there is no proximity to the education centre [18]. The United Nations Educational, Scientific and Cultural Organization (UNESCO) defines a literate person as someone who can read and write simple statement about their life [19,20], therefore education plays a big impact many aspects of life and also in the health aspect. Education teaches lots of things which include not to be ignorant of the latest things related to health issues. A well educated woman will is more likely keep their children healthy and also send them to school for additional literacy skills [12]. Others factors are; corrupt government officials, Availability of clean water, Widespread of diseases etc.

Malaria

Malaria is said to be one of the leading cause of death in Africa when it’s been compared with other diseases like HIV/ AIDS, Tuberculosis, Cholera, etc, according to World Health Organisation (WHO). Most of these disease are common in Africa due to the climatic condition of the part of the globe, lack of good infrastructural facilities such as good drainage, drinking water, low level of literacy (lack of knowledge about these disease) and again poverty; because majority of the population in Africa lives below normal standard of living [16]. It is an old disease which was originated in Africa. Hippocrates, the father of medicine born in ancient GREECE was the first to describe the manifestations of the disease [17]. Malaria is an infectious disease caused by mosquitoes after bitten, with symptoms like fever, headache, vomiting and tiredness. The manifestation of these (symptoms) begins after 10 to 15 days after being bitten by the host [21]. Malaria is caused by a parasitic protozoan’s carried and transmitted through the female mosquitoes (Anopheles). It occurs once bitten by the Anopheles mosquito. It releases the plasmodium parasite into human blood stream. During pregnancy, the immune system runs at a very low speed, this is to ensure the featus rejected as something strange. This simply means that the body will not be able to fight many infection and illness. Malaria during pregnancy has a high probability of losing the baby, premature delivery, and also can lead to the baby and the mother. Pregnant women are 3 times likely to contact any disease compared to when she is not. This is due their low level of immunity [19,8]. To prevent malaria, the World Health Organization (WHO) current guidelines are

I. Use of Long Lasting Insecticide Net (LLIN) to prevent mosquitoes from biting. It is also applicable to everybody because it is a well treated net.

II. Intermittent Preventive Treatment In Pregnancy (IPTP) with Sulfadoxine-Pyrimethamine (SP) as part of antenatal care service and taking iron with folic acid supplement as a routine [22].

Methods

The study of life expectancy at birth in Africa; between Nigeria and Cameroon, the periodic life expectancy table at birth is extracted from the World Data Atlas, Health data base. The life expectancy at birth extracted for only 20 years ranging from 1996 to 2015 estimated in the 2018 revision of World Data atlas, Health. The source contains the most recent used life expectancy table at birth which was as at 2016.

Results

The data is analyzed by the use of IBM SPSS 20, using the t-test method. The t-test is used to compare two average mean telling if there are different from each other. The t-test also tells how significant the differences are; Also, t-test tells by comparing the means of the two groups and letting you know the probability of those results happening by chance. In the comparison of the two countries, the results shows that Cameroon with the mean of 53.1185 and standard deviation of 2.809 09 and standard error mean of 0.62813 greater than Nigeria having the mean of 48.8250 with standard deviation of 2.47656 and standard error of 0.55378 (Table 4). The minimum and the maximum age of life expectancy in Nigeria respectively is 45.88 and 52.98 while the minimum and the maximum age of life expectancy in Cameroon is 49.51 and 57.56 respectively. This also vividly show that there is a significant different in the comparison between the two countries. Therefore we strongly reject null hypothesis that states that there is a significant difference in the life expectancy of Nigeria and Cameroon. This is because our p-value 0.00 is greater than the significant level 0.05 that is we reject null hypothesis (Figure 1-3).

To Know More About Please Click on: Journal of Reproductive Medicine

https://juniperpublishers.com/gjorm/index.php

 To Know More About Open Access Publishers Please Click on: Juniper Publishers

[healthpolicymaven]

Medicare For All-An Idea Whose Time May Have Come

With the 2020 Presidential election looming on the horizon and tortuous months of political speeches one thing that clearly sets the Democrats apart from the Republicans, currently in control of the national purse strings, is their vocal promotion of healthcare access and protections for all. Republicans raced into Congress on the anti-Affordable Care Act platform only to learn that voters like their government sponsored healthcare, resulting in their rout in the midterm elections last November. This article reviews the motive, financial implications, and method to assess a national Medicare Plan.

Motive

The United States spends 40% to 60% more for healthcare than any other industrialized country and this does not produce improved health or better outcomes than nations spending considerably less per capita. In 2017 the U.S. spent $10,224 per person for healthcare, as tracked by the Petersen-Kaiser Health System Index Tracker. (Cox, 2019) This total is 28% higher than when my book, Unraveling U.S. Healthcare-A Personal Guide was published in 2013. (Winter, 2013) The next closest country in medical spending was Switzerland which still spent 28% less than the U.S. France, whose health system provides family clinics, coverage for all, and high tech services spent $4,902, less than half of the U.S. And Australia spent only $4,543 per capita for their national healthcare system. Canada spent $4,826 per person for their national healthcare program. Everyone of these industrialized nations are capitalistic in terms of business, but they offer healthcare to all of their citizens.

The cost of healthcare in the U.S. is impeding resources that could be used to improve education, rebuild critical infrastructure such as bridges, and improve the quality of life for most families. By refusing to enact and enforce national healthcare policy the nation continues to be overcharged by profiteers who gouge the American public. The government has the domain to negotiate better policies for drugs, medical devices, and reimbursements at the clinic/hospital level. However, only Bernie Sanders from Vermont, had the political will to actively run on a platform for nationalizing healthcare. This phenomenon all changed with the mid-terms and public polls show a sizeable majority of the American people want government run healthcare. Families are tired of being forced to spend more on their health insurance than for housing.  Diabetics are forced to skip their doses, because of the high cost of insulin, which has resulted in deaths. Even seniors, who have benefited greatly from Medicare, the Bush Medicare Modernization Act which provided drug coverage, and the Affordable Care Act which closed the doughnut-hole exclusion for drugs are still gouged for the cost of care. A public case could be made that Medicare enrollees are better off in terms of healthcare access and coverage than working class families in the United States. This situation is untenable financially and politically. The 2020 election will give us a chance to see how far the American people are willing to go to reform their expensive and exclusionary health system.

Means

In 2003 I was part of a team of graduate students at the University of Washington School of Public Health and Community Medicine who analyzed a single payer health system. In fact, I published an article on it in this column in 2009.[1] My role, as an MHA student, was to come up with a financing model that was plausible. For a 3% increase in the payroll tax, born equally by employees and employers, which currently funds Medicare and Social Security, we could implement a national healthcare program.

A second way to fund healthcare is through an income tax increase, which is how most other nations do it. Crucial information which would inform any financing of a citizen’s initiative would include the 2020 census findings. However, Trump and his administration aren’t anxious to conduct this census and are still seeking to restrict access and questions based on citizenship and other factors.

Social programs are consuming a larger portion of the national budget, which is normal for an aging population. Republicans like to brag about defense budget increases yet rail at any increase in spending for entitlements for our residents. Higher taxes are necessary to even meet the current Social Security and Medicare projects, which must be addressed.

 U.S. Proposed Federal Budget-2018 is  $4,407,000,000,000

Defense, includes security for national nuclear supply,  Veterans Affairs, Homeland Security, State Department, Afghanistan, Iraq,  Syrian wars; Does NOT include discretionary private contracting which  consumes another 10-20%

Proportion of Federal Budget

20%= $892,700,000,000

Social Security- paid through trust fund until 2032@1.046 trillion  Medicare-partially funded by payroll tax Medicaid-100% paid from general fund@1.037  trillion

Proportion of the Federal Budget-2018

24%+24%= 47%

$2,083,000,000,000

The federal budget item that is growing the fastest is the national deficit, which the Trump Administration exploded with it’s corporate and wealth tax cuts in 2018. Currently the deficit is 985 billion dollars or 22% of the federal budget. (Amadeo, 2019)

Method

Any healthcare program in the U.S. will include private insurance at some level, as Medicare, the healthcare expansion model currently does. The idea that the behemoth private medical insurance industry will go away is wrong. However, private insurance has a much higher administration cost than Medicare/Medicaid, which uses 6% of cash inflows for overhead as opposed to 15-20% for the private sector. And you can expect that the insurance industry/medical/pharma lobby, which is the largest and most well-funded of the shark infested Washington DC lobbying cabal will be drafting the details, just like they did for the Affordable Care Act. They succeeded in eliminating the Medicare-for-all idea during the Obama Administration, but that was just buying time. The longer the nation waits to draft a sane health policy the costlier it will be for the tax payers.

Many employers would thankfully get out of the medical insurance business. Also, a national health policy which has the same costs everywhere, would create an even playing field for business competition and innovation. It will also greatly reduce regulatory costs, which are the bane of clinical staff everywhere. Efficiency could go up in clinics because the doctors and nurses would have more time to actually see patients instead of processing insurance paperwork.

Finally, with national healthcare policy, we could also fund the scary shortage of primary care providers, by providing free medical education (and maybe forgiveness of school loans) to those who go into primary care, such as pediatrics, family practice, and obstetrics.

End to the Madness

Obviously, we will have to enact some type of policy which will mute the overcharging, take back control of generic drug prices, create true price transparency for services, and quit gouging American families. We can hardly expect the Millennials, whom will have to clean up our mess, to pay higher and higher payroll taxes and not get anything in return. We can start by offering affordable healthcare for all, which won’t happen under the current, reimbursement based on the prevailing inflated cost method of pricing.

 And this is the health policy maven signing off encouraging you to learn as much as you can about healthcare systems outside the U.S. so that we can build a better one for our people.

Works Cited

Amadeo, K. (2019, January 21). US Federal Budget Breakdown-The Components and Impact on the US Economy. Retrieved from The Balance.com: https://www.thebalance.com/u-s-federal-budget-breakdown-3305789

Cox, B. S. (2019, February 10). How does health spending in the U.S. compare to other countries. Retrieved from Petersen-Kaiser Health System Tracker.org: https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/#item-start

Winter, R. E. (2013). Unraveling U.S. Healthcare-A Personal Guide. In R. E. Winter, Unraveling U.S. Healthcare-A Personal Guide (pp. 31-35). Rowman & Littlefield.

 This article was written by Roberta Winter, a freelance journalist and health policy analyst in the Seattle area.

[1] https://healthpolicymaven.blogspot.com/2009/08/overhauling-healthcare-czarina-style.html