Global Comparisons: Public Health Through an International Lens

As a public health student that ended up studying more than half of their college career within a pandemic it was especially unique to be enrolled in HEPB 470: Global Health in January 2020, when the Covid-19 pandemic was just starting in China. We were assigned to read an article relating to global health every week and were randomly selected to present it to the class throughout the semester. While that concept to keep students engaged is not rare on a college campus, it was happening at a time when global health was starting to define the conversation, as it would continue to do until now. In taking an Honors section of the course we were expected to complete a "World News Update" or WNU. In this report we were supposed to subscribe to a site relevant to Global Health and follow it throughout the entirety of the semester, then ruminate on our thoughts and discuss what we thought about the site and what we learned. This was also happening as we dove into the concepts of developing versus industrialized nations, common causes of mortality broken down by region of the world, and how chronic and acute illnesses permeate through a culture. In discovering these differences we were also able to find out where the United States falls behind. Our country spends more per person than any other industrialized nation and is a rare example of a country with no socialized component of our healthcare. While every country manages health with a slightly different perspective, our peers like Great Britain, Canada, and Germany all provide more comprehensive healthcare at a lower cost. I held this in the back of my mind and was interested when these comparisons came up again, albeit in a different context. 

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When completing my Meta-synthesis: Patient Perceptions of Medication Adherence Post-Hospital Discharge the initial literature I was finding all seemed to come from other countries. This itself was not completely out of the ordinary (as database searches bring up all relevant articles) but there was a clear difference in the kind of work it was providing for in comparison with the United States. Medication Adherence is an issue that has grown in the United States over the past few decades, as technology has advanced. It is not remarkable that literature about it has grown, poor adherence costs people (and their health systems) a great deal of money every year. The divergence was that the literature we were examining was supposed to be completely qualitative, comprised of patient and/or caregiver interviews about the barriers to properly maintaining a medication regimen. Studies from Norway, from Italy, and Germany, were all rife with quotes about the factors that impacted their adherence, including unpleasant side effects, polypharmacy or complex medication regimens, or even memory issues. When we eventually found literature from the United States, a whole other category of barriers opened up: the ability to afford or acquire medication. It wasn't that a patient didn't like taking or didn't want to take their medication, they simply were not able to get it. I thought back to our discussions and debates in class, the reading I had done throughout my semester: Is Healthcare a Human Right? Do sick people deserve to have medication at no cost? These were oft-relevant topics in our classroom and seeing these concepts reappear shifted my frame of reference with our search and analysis of literature moving forward. I am finishing up the manuscript for this study and have taken a greater part of the discussion to focus on differences in literature conducted in the United States and that which was conducted abroad. Expanding our view in whatever field of study to consider the differences of how it is viewed and synthesized in another country is not only specifically applicable to Public Health but to any concept.