**Author details**

(b) Unwanted sell calls—Opportunistic people are everywhere, and SNS are not the exception. In the studied communities, we found several posts trying to sell different health-

(c) Irrelevant comments and posts—Not all participants have the same goal when joining a virtual community and that fact is reflected in their posts (e.g., jokes, nonrelated pictures).

(d) Reliability and trust—Individuals who chose to join a social support community are seeking for reliable advice. As one participant said during the interviews: "If I see that a virtual friend liked a post in Facebook I take it as a personal recommendation. If he/she likes a product I think that he/she has tried the article and his/her like becomes a reliable source

(e) Accuracy of data—Traditional apps require users to self-fed information regarding their habits and behaviors; some individuals might make involuntary mistakes while record-

(f) Use it or it won't work—People have to log in to the SNS to seek and receive the support, individuals have to wear their smart watches or smart bands in order to monitor their

The presence of a community manager can help overcome some of the limitations presented above. Unwanted members of the community can be eliminated and irrelevant posts can be erased. Also, a clear policy on what can be posted will help resolve some of the shortcomings. Regarding the accuracy of data, it is important to educate users of wearable devices and apps and show them how to register information and how to measure different things (e.g., the

Prizes and rewards can be employed to motivate people to use their apps or visit the virtual communities. But finally, we have to acknowledge that the use of SNS, wearable devices, and

The high costs of health care, the lack of time to visit the doctor on a regular basis, and the growing interest to prevent illness and diseases are some of the factors that motivate individuals to take health care into their own hands and that can be achieved with the use of technology. The use of apps to monitor exercise and calorie intake seems to be popular among participants in the studied Facebook communities, as well as in the group of runners. Nowadays, apps can be linked to SNS; therefore, individuals receive immediate feedback both from the apps and from their peers in their SNS. Sharing exercise information and badges affects feelings of connectedness among members of the communities, provides a tool that can be used to encourage others to change their current behavior and engage in a healthier one, and motivates individuals to aim higher in terms of exercise goals. By using specific tools like Telegram to create small communities, individuals find a network conformed of peers that have similar

apps is a personal choice, and people will exert their right to engage with them or not.

related articles, which were seen as unwanted intrusion by participants.

ing information; therefore, the provided feedback will not be accurate.

of advice for me."

124 Advances in Health Management

amount of food).

**7. Conclusion**

behaviors and receive the feedback.

Alicia De la Pena\* and Bernardo Amezcua

\*Address all correspondence to: mktgheraldo@yahoo.com.mx

Universidad Autónoma de Coahuila, Saltillo, México

### **References**


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**Universal Health Coverage and Environmental Health: An Investigation in Decreasing Communicable and Chronic Disease by Including Environmental Health in UHC**

Muhiuddin Haider and Katrina Bibb

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.69922

#### **Abstract**

Over 83% of major diseases are environmentally mediated. These environmental factors include access to clean air and water, nutritional food, adequate shelter and access to health care. As health care systems across the globe struggle to include not only preventive health, but also health literacy in their approaches, it has become apparent that the most feasible system to combine all of these necessities is the universal health care/coverage (UHC) approach. This system also ensures that everyone has access to health services without financial hardship. It is imperative that environmental health (EH) is included in this approach, however, considering the global burden of disease due to environmental health factors. Epidemiological evidence-based approaches such as Water, Sanitation and Hygiene (WASH), have proven the advantage of utilizing these environmental health practices. In order to integrate EH into UHC, a dual multipronged (preventive and clinical) approach can be implemented; however, many are using a multisectoral approach due to the array of public-private partnerships which aid in its success. In alignment with the Millennium and Sustainable Development Goals, nations must make strides to address health disparities, chronic disease and poverty. Low and middle income countries (LMIC) are disproportionately burdened by economic insecurity, global pollution and preexisting issues within their government infrastructure, creating the worst health outcomes in these nations. Bangladesh has some of the worst chronic disease morbidities in the world due to indoor air pollution, rural and urban health disparities and food insecurity. Although the nation has begun to integrate EH into UHC, better coordination among ministries implementing health care is necessary, along with increased monetary allocation from the government. There is also a dire need for more health care providers who possess appropriate skills to work in the public sector. Lastly, more equitable access to services in both rural and urban areas and an improved financing mechanism must be instilled to successfully implement this EH/UHC approach.

© 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

**Keywords:** universal health care, universal health coverage, UHC, multipronged approach, multisectoral approach, environmental health, noncommunicable disease, NCD, chronic disease, communicable disease, morbidity, mortality, global disease burden, Millennium Development Goals (MDGs), Sustainable Development Goals (SDGs), Bangladesh

### **1. Introduction**

According to the World Health Organization (WHO), it is estimated that over 100 million people are forced into poverty every year due to out-of-pocket health care expenditures [1]. Although there are numerous factors, including but not limited to social status, environmental agents and cultural aspects, which may contribute to an individual's susceptibility to this statistic, implementing universal health coverage (UHC)<sup>1</sup> would undoubtedly help to diminish this number. By working toward this type of system to ensure good health, economic growth will also follow, benefitting communities holistically rather than unilaterally [2].

The objective of universal health coverage is to ensure that "all people can use health services without financial hardship" [1]. In order for this to be attained successfully, governmental health financing systems must be put into place and encourage collaboration among different governmental levels and agencies. Implementing a UHC system would lessen the gap between rich and poor communities by ensuring health equity, unlike the free market system. The ultimate purpose of UHC, therefore, would be to lower both the disease and financial burden at the community level by providing adequate preventive and clinical health care services to all.

In terms of prevention, environmental health (EH) factors should be addressed within the service-oriented nature of UHC, due to their high attribution to disease [3]. Through counseling and behavioral change models, environmental health factors such as exposures to contaminated air and water can be prevented. Educating communities on these environmental exposures through UHC infrastructure is paramount in successfully addressing these issues and bettering community health. Furthermore, environmental epidemiology is a useful tool in providing evidence-based science to illustrate these successes; Water, Sanitation and Hygiene (WASH) programs via clinics have provided health education counseling on this practice, therefore exponentially decreased infectious and enteric diseases [4].
