Social Political & Environmental Issues in International Healthcare

This report discusses the impact of social, political, and environmental issues on international healthcare, with a focus on COPD. It covers risk factors, diagnosis, disease management, prevalence, and management of COPD in developing and developed countries. It also discusses the strengths and limitations of global strategies for addressing the burden of COPD.

Social Political &
Environmental Issues in
International Healthcare

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
TASK 1............................................................................................................................................3
TASK 2............................................................................................................................................6
Discussion on aetiology and assessing the prevalence of COPD within developing country
and in developed country........................................................................................................7
Discussing strength and limitation of global strategies forwarded by WHO like organisation in
addressing global burden of COPD........................................................................................8
PART C............................................................................................................................................9
CONCLUSION..............................................................................................................................10
REFERENCES..............................................................................................................................11

INTRODUCTION
International healthcare refers to the geographic medicine that may also know as the
international medicine or global health. This include the healthcare field within the public health
emphasis and lead to deal with the healthcare across regional and national boundaries. There is
highly impact of social, political along with environmental issues which have high impact on the
international healthcare. In this report, there is discussion about the key risk factor which are
associated with COPD (chronic Obstructive Pulmonary disease) along with their key features in
terms of diagnosis, aetiology and disease management. This also includes the health definition
and various stages in progression in chronic diseases. There is also discussion about impact of
international, economic environmental along with political issues on diagnosis, prevalence along
with management of COPD in any developed country. This also include the prevalence of COPD
in developing country and developed country. There is also discussion about strength and
limitations of global strategies which are forwarded by the organisation like WHO in addressing
the global burden of COPD. This also includes the reflection about learning and understanding
about the health equity or inequality, healthcare accessibility along with effectiveness of
interventions (Viniol et. al., (2018)).
MAIN BODY
TASK 1
Risk factors for COPD:
 Smoking: Smoking can cause lung disease by damaging airways and the small air sacs
present in lungs.
 Exposure to air pollution: Breathing in air filled with harmful particulate matter can
irritate the airway and result in causing shortness of breath, coughing, wheezing, asthma
attacks, and chest pain.
 Environmental factors: Exposure to chemicals, fumes, burning fuel and dust can
damage the lungs like: silica dust, grain and floor dust, cadmium fumes, welding fumes,
coal dust.
Genetics: Main genetic risk factor of COPD is alpha 1-Antitrypsin deficiency. Apart from alpha
1-AT, other tentative factors responsible are GSM-M1(glutathione S-transferase), VDBP

(Vitamin D binding protein) and CFTR (cystic fibrosis transmembrane conductance regulator)
genes (Young et. al., (2019)).
 People already suffering from asthma problems
 Family history with asthma or any other breathing problem.
Key features of COPD in terms of aetiology:
It is usually caused by long term exposure to harmful and irritating gases, particulate
matter and mainly due to smoking tobacco like cigarette, cigar, pipe and inhalation of other types
of harmful materials. Smoking materials contains harmful chemicals that can destroy air passage
lining as well as lining of lungs. Age is also a factor which can cause symptoms of breathing
problem after age of 40. Global prevalence of COPD estimated in 2019 was 10.3% accounting
for people aged between 30-79 years. According to data on prevalence of COPD in US
approximately 14.8 million adults have been diagnosed with COPD, and approximately about 12
million people have not been diagnosed yet.
Diagnosis of COPD:
COPD generally remain undiagnosed at initial stage and until the disease is advanced. Doctors
may suggest several test to diagnose this problem.
 Lung function test: To measure the amount of air your lungs can hold, measurement of
lung capacity and diffusion as well whether your lungs deliver enough oxygen to your
blood circulation.
 CT Scan: CT Scan is performed to determine whether you need surgery for COPD. It can
also be used for screening of lung cancer. It is a type of radiographic scan that uses X -
ray technology to create internal images of the chest. The scan involves a specialised
machine that takes multiple images of the chest (López-Campos et. al., (2019)).
 Laboratory test: Laboratory test is basically used to determine the actual cause of
symptoms outbreak. It helps in identify whether the person has a family history to the
related problem or whether the individual is sensitive to certain type of internal or
external factors.
 Chest X- ray: Chest X Ray helps doctor to assess problems related to COPD. It can help
in identification of hyperinflation (signs of large lungs), flattened diaphragm (structural
changes in the lungs or surrounding tissues), changes in airways, bullae (pockets of air),
narrow heart.

Disease management for COPD:
COPD management is important to analyse complete condition of patient, their
symptoms, their medication and route to cope up with existing condition. It basically helps to
control the disease by reducing risk and emergency situation to go to hospital. The main
component of COPD management are appropriate pharmacotherapy, pulmonary rehabilitation,
follow up monitoring on regular basis to monitor the progression of disease. The main focus of
COPD management is to improve functional status of patient and improve quality of life by
improving symptoms, reducing the disease progression, and preserving optimal functioning of
lungs.
Medication:
 Bronchodilators: Usually available in nebulized or inhaler form. Anticholinergics act by
blocking acetylcholine, which causes airways to constrict. Beta agonist bind to beta
receptors on smooth muscles and regulate bronchodilatory effect.
 Corticosteroids: They are effectively act by reducing irritation and swelling in the
airway.
 Antibiotics: This treatment usually recommended for patients who have an increase in
sputum volume, sputum purulence and breathlessness.
 Anxiolytics: They help in reduce anxiety symptoms, facilitate to breathe easily.
 Opioids: Also known as pain relievers, act by depressing the central nervous system.
Some Surgery options are also available for the treatment of COPD like: Bullectomy, Lung
volume reduction surgery, Lung transplant, Bronchial rheoplasty.
 Bullectomy: In this surgical process, bullae (large air spaces) are removed which form
due to destruction of air sacs (Sun et. al., (2019)).
 Lung volume reduction surgery: During this surgery, damaged lung tissues are being
removed. It is an effective method but also risky.
 Lung transplant: A damaged lung is replaced by a healthy lung given by a donor. Lung
transplant may have risk of major infection and risk of graft rejection is also associated.
 Bronchial rheoplasty: By this surgery doctors mainly focus on mucus-producing cells in
the lungs. These cells are bursts to destruction so that new, healthy cells can grow.
Various stages in progression of the COPD and impact on health with these stages:

There are 4 stages of COPD: mild, moderate, severe, very severe. Determination of these stages
are based on the functioning capacity of lung and measuring amount of air hold by lung, amount
of air being inhaled and exhaled (Cao et. al., (2020)).
STAGE 1 (mild): Airflow obstructed in a mild limitation. This is the initial stage in which
generally people are not aware about abnormal functioning of lungs. Release of cough is the
main symptom seen during this stage. About 44.16% of global population estimated to be
suffering from mild COPD.
STAGE 2 (Moderate): This is the stage where people usually experience observable difficulty in
breathing and carry on for medical expertise. In this stage air flow limitation get worsen. About
44.22% of global population had moderate COPD.
STAGE 3 (Severe): In this stage, person start experiencing more shortage in air flow cause
shortness of breath. In this situation person should restrict more physical exercise.
STAGE 4 (Very severe): People experience severe airflow limitations. Quality of life reduced to
a great extent and worsening of symptoms can lead to death of an individual (Soriano et. al.,
(2018)).
TASK 2
There is high impact of international, economic and environmental factor that can lead to
create the high risk of getting improvement in the air condition. In this, due to international
factor like industrialisation and other use of the international effect lead to create impact on air
pollution which can also lead to create high impact on getting exposed and occurs the risk of
lung disease. This is the one that are effective and have high response towards impact air
pollution which are the factor toward the COPD. Due to economy, people are having high
quality of lifestyle where they need to work and due to this, they face different stress in which
people like to consume cigarette that cause the risk of COPD. There is another environmental
factor where due to pollution that are generally caused due to industry and vehicle. Due to air
pollution, it leads to create high impact on individual health which are associated with taking
care of effective response towards risk of COPD. These are some of the factor which impact the
diagnosis within country. These issue lead to create high impact on the population which
increases the prevalence of COPD (Alqahtani et. al., (2020)).
Prevalence and management of COPD in UK

COPD is stated to be the second most diagnosed lung disease with an emergency
admission rate of one in eight every day counting to approximately 115,000 hospital admissions
every year. In UK, Scotland and England accounts for the highest number of COPD prevalence
and incidences. Such high number of cases of COPD has made its treatment second most
expensive for the NHS.
Last decade has observed a hike of 27% in the number of COPD cases in UK. The age
group that accounts for the maximum hospitalization cases are the ones above the age of 70
years. The mortality rate of COPD reaches to about 30,000 every year and its mortality rate is
observed to be higher in males than in female patients (Hikichi et. al., (2019)).
Management of COPD in UK
As there is no cure for COPD yet, its management involve providing treatment for
minimizing its symptoms.
Cessation of smoking: Patients diagnosed with early stage COPD are advised to
immediately cease smoking because COPD cannot be reversed but further damage to the lungs
can be prevented (Ritchie et. al., (2020)).
Inhalers: As COPD causes inflammation in the airways resulting in the narrowing of the
lumen, patients diagnosed with COPD are prescribed with bronchodilator inhalers for dilating
the airways. Bronchodilators prescribed are of two types;
Short acting bronchodilator – Salbutamol and Ipratropium
Long acting bronchodilators – Salmetrol and Formetrol
Corticosteroid inhalers are also prescribed in some cases to reduce inflammation in the
airways.
Oral medication: Theophylline (Bronchodilator), Carbocisteine (Mucolytic) and certain
antibiotics are prescribed to the patients.
Specialized programs– Pulmonary rehabilitation programs are also included in COPD
management (MacLeod et. al., (2021)).
Discussion on aetiology and assessing the prevalence of COPD within developing country and in
developed country
In developing country like India, there are some of the risk factor and causes for COPD
which may include tobacco smoke inhalation where poverty and lack of education is one of the

main factor in India. Due to poverty people have less knowledge and adopting such type of
lifestyle also lead to cause the risk of getting COPD .
There are about 7.4% of population who are highly exposed to the risk of COPD. There is
crude estimation which are about 30 million of COPD patient within India are facing COPD.
This has been estimated about highest in the world in year 2017 (Darawshy et. al., (2021)).
In developed country like United Kingdom where due to lifestyle where people like to smoke
which is one of the major cause for the risk of COPD within large population that are associated
international disease. Due to working and busy lifestyle people like to deal with their stress
which enable them to smoke. Here, smoking cause risk of COPD to smoker where they are
active smoker or passive smokers.
There are about 1.7 million people are having COPD which is about 1.9% of the population
in year 2021. There is increased cases of prevalence among people aged 50s which has been
identifies (Chand et. al., (2020)).
There is difference between the number of COPD cases in the India in comparison to United
Kingdom is higher because there is some of the factor which highly impact the large population.
Here, education and poverty is one of the main factor where due to lack of education and less
economy they are not having proper knowledge which include less quality of life that lead to
create risk of smoking and other causes.
Due to less access to healthcare services India has difficulty in providing better diagnosis that
is impacting diagnosis along with treatment issues of COPD. Here, India has less access to
healthcare services that are effective and lead to create high impact on diagnosis and treatment.
Due to healthcare policy, it leads to create high impact on delivery of better and effective
response towards diagnosis and treatment of COPD (Chan et. al., (2019)). Within UK, there is
need to ensure about taking care of effective response that are associated with ensuring of getting
better and effective response towards the care and ensuring about the diagnosis and treatment of
COPD.
Discussing strength and limitation of global strategies forwarded by WHO like organisation in
addressing global burden of COPD
There is a global strategy from WHO which include stop smoking awareness. This is one of
the strategy which is effective and provide better understanding about reduction in the global
burden of COPD. In this through creating awareness about stop smoking allow to achieve the

goal to reduce the number of high consumption (Halpin et. al., (2019)). In this, there is need to
share the information about stopping smoking which are effective and can lead to create high
impact on reducing the cases of COPD. Through creating awareness, it can help to get better and
improved health which are associated with COPD. This can be effective that can help in ensuring
about reducing the health impact. In this, healthcare professional should get involved ensuring
about reducing the risk of COPD. Here, through applying this strategy, it can lead to create high
impact on reducing the cases of COPD. Through applying this strategy which can allow to get
high reducing in the number of cases where people avoid smoking.
There are different strengths along with limitation of strategy which are effective and have
high impact on reducing the cases (Ho et. al., (2019)).
There is high impact on creating awareness which are associated with reducing the negative
cases of COPD. This can help to reduce the cases of patient with COPD and make society and
nation healthier. This can also help in reducing negative health impact which are generally
causes where lung disease can lead to create different diseases.
However, there is also some limitation where it does not create impact highly on people
health. Through applying this strategy, there is little impact on reduction of cases of COPD.
There is also some limitation where stopping smoking cannot provide fully protection against the
risk of COPD. Due to applying this strategy, there is limitation that it can cause some mental
health related issue which are like stress and anxiety. Smoking can help to reduce the stress and
anxiety within people but due to stopping smoking it can lead to increase the cases of stress and
anxiety within large population (Laucho-Contreras et. al., (2020)).
PART C
There is use of Kolb reflective model which is effective and can lead to create high impact
on sharing of information that are associated with reflecting through different stages like
concreate experience, reflective observation, abstract conceptualisation, active experimentation.
This is the framework for examining experience of individual and allow to share the experience
to others (Patel et. al., (2019)).
Concreate experience- As a responsible global citizen it can help to perform well as a good
citizen. In this individual may lead to create high impact on delivery of better and effective
response towards dealing with creating high impact that includes different response for
community. As a responsible global citizen there is need to ensure that there should not

consumption of cigarette that are highly effective and can lead to create negative health impact to
individual. This is effective and have negative health impact. This is important to take care about
the environment and ensure that it should not create any type of negative health impact either
active or passive (Kouijzer et. al., (2018)). This can have high impact on the global level and also
influence other people to adopt this behaviour which are associated with taking care of good
health. This can also lead to create high positive health impact and help in improving people
health and their wellbeing. It also helps to improve the quality of life. There are some of health
inequality which include income, power or health. Due to this, people are not able to get to
access of healthcare services which are associated with taking care of good health which have
effectiveness of intervention to the large population.
Reflective observation- As a responsible citizen, it can help to include different response
towards the where applying non-smoking and reducing pollution can be effective and help to
reduce the cases of COPD. This can also have better positive impact on large population and
provide better health and wellbeing (Duffy et. al., (2020)).
Abstract conceptualisation- Responsible citizen can be effective and can perform well in
reducing the cases of COPD through adopting sustainable process where avoiding smoking and
reducing pollution can be effective.
Active Experimentation- There is need to reduce the cases of COPD which can be done
through leaning smoking and adopting the good process which are associated with taking care of
good health. Through this, it allows to learn that through reducing smoking and leaving good life
where avoiding smoking can help to reduce the cases of COPD and provide opportunity for good
health and wellbeing (van Dijk et. al., (2020)).
CONCLUSION
From the above discussion, it can be concluding that there is high impact of COPD on
large population. There is also need to take care of good health. In this, there is need to reduce
the risk of COPD through applying good behaviour. In this report, there is discussion about
adopting good practice which can allow to live effectively. This include the information about
impact of international, economic issues on diagnosis, prevalence along with management of
COPD within developed country.

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