The history of international health in the last century has been one of prioritization and increased responsibility. It began in the early 20th century with the name international health, and emphasis was on global control of infectious diseases. This was largely because of colonial trading prospects and the fear that diseases like cholera or plague could break out in the poor economies and affect the richer ones. With the rise of such institutions as the World Health Organization (WHO) after World War II, the shift towards cooperative activities and the increased conceptualization of health as the whole well-being occurred (WHO, 2024). During the late 1900s, smallpox was being eradicated, and primary healthcare made available to all. Health in the modern world is more expansive. Besides focusing on pandemics such as HIV/AIDS or COVID-19, it addresses chronic illnesses, mental health, and impact of climate change (WHO, 2024). The field recognizes that health challenges are interconnected and must be addressed by government, non-profit, and scientific intervention on an international basis.

Equity in health, social justice, prevention, and population-based approaches are the key concepts of global health. The global burden of disease can be explained using such notions and is defined as a collective impact of morbidity, impairment, and untimely mortality in the world (Walton et al., 2022). The burden of disease is not equally shared and very much relies on social determinants of health, which are income, education, housing, employment, environment, and access to healthcare. The developing economies continue to experience high rates of infectious diseases and maternal mortality, while developed countries face an aging population and lifestyle problems (Walton et al., 2022). Global health underlines the fact that poverty, inequality, conflict, and poor health systems are among those factors contributing to increased disease burden. These determinants must be addressed to ensure reduced illness and improved health outcomes are realized within populations.

Gauging healthcare systems in the world is a complicated yet a necessary undertaking. The analysis reveals the need to have better health outcomes (such as life expectancy), the need to be responsive to the demands of people, and the need to offer equitable financial protection. These objectives are generally met by high-performing systems, which are common in certain European and East Asian countries, and they are met by universal health coverage, primary care, and resource efficiency (Thomas-McLean et al., 2025). Assessment demonstrates extreme differences. In most of the low- and middle-income countries, the systems are not well financed or integrated resulting in high out-of-pocket expenses that plunge families into poverty. Effective assessment draws on both data, both health outcomes and financial statements, as well as surveys of patients. It indicates that it is not necessary to spend more money to get better health. Rather, the most effective systems will invest in social safety nets and primary prevention to deal with the determinants (Thomas-McLean et al., 2025).

Two main DNP Essentials are incorporated while developing this discussion. First, Essential V: Health Care Policy was used when the evolution of the system in relation to legislation was analyzed over the years. Second, the Essential II was utilized in the analysis of transition to value care and system consolidation (Waldrop et al., 2023). The combination of these necessities shows that sustainable health system reform takes both the skills of policy design and the leadership skills to effect change in complex organizations effectively. Moreover, this discussion fostered the essential role-specific competency of an in-depth understanding of the intricate healthcare setting, which is crucial in the field of advanced nursing practice leadership (Waldrop et al., 2023).

References

Thomas-McLean, H., Mak, R., Noonan, C. M., & Yip, W. (2025). Global Progress Toward Universal Health Coverage: Learning from Successes and Failures. Annual Review of Public Health, 47.

Waldrop, J., Reynolds, S. S., McMillian-Bohler, J. M., Graton, M., & Ledbetter, L. (2023). Evaluation of DNP Program Essentials of Doctoral Nursing Education: A scoping review. Journal of Professional Nursing, 46, 7-12.https://doi.org/10.1016/j.profnurs.2022.11.009

Walton, A. L., Nikpour, J. A., & Randolph, S. D. (2022). Population Health in a Global Society: Preparing Nurses for the Future. Public Health Nursing, 39(5), 1098-1106.

World Health Organization. (2024). History as A Partner in Public Health: A Report of the Foresight Think Tank on The History of Pandemics. World Health Organization.

Step-by-Step Guide to Writing a Global Health Discussion or Paper

Step 1: Introduction

Introduce global health as a discipline, briefly highlighting its historical evolution.
Mention the transition from infectious disease control to a focus on equity, chronic diseases, and social determinants.
Example:
“Global health has evolved over the last century from controlling infectious diseases to addressing complex, equity-driven challenges influenced by social, economic, and environmental factors. This evolution underscores the interconnected nature of health and the need for coordinated, multidisciplinary approaches across nations (WHO, 2024).”

Step 2: Historical Context and Evolution

Discuss the early 20th-century focus on infectious disease control, largely motivated by colonial trade and fear of epidemics.
Explain the post-World War II establishment of WHO and the shift toward cooperative global health strategies.
Highlight late 20th-century achievements such as smallpox eradication, global primary healthcare initiatives, and the expansion to chronic diseases, mental health, and climate-related health issues.
Example paragraph:
“Initially, international health prioritized infectious disease control to protect trade and economic interests. With the founding of WHO after World War II, global health shifted toward coordinated, cooperative approaches emphasizing overall well-being and health as a human right. By the late 20th century, eradication campaigns, such as for smallpox, demonstrated the effectiveness of collaborative efforts, while modern global health addresses chronic diseases, mental health, and climate-related challenges (WHO, 2024).”

Step 3: Health Equity and Social Determinants

Define health equity and social determinants of health (income, education, environment, housing, employment, access to healthcare).
Compare developing and developed countries: high infectious disease rates and maternal mortality in low-resource settings versus NCDs and aging populations in developed countries.
Example paragraph:
“Health equity and social justice are central to modern global health. The global burden of disease reflects disparities caused by social determinants, including poverty, education, and healthcare access. Low- and middle-income countries face higher rates of infectious disease and maternal mortality, while developed nations contend with lifestyle-related illnesses and aging populations. Addressing these determinants is essential for reducing preventable morbidity and mortality worldwide (Walton et al., 2022).”

Step 4: Evaluating Health Systems

Describe indicators of health system performance: life expectancy, responsiveness, equity, financial protection, and cost-effectiveness.
Discuss differences in high-performing systems (Europe, East Asia) versus low-resource systems, emphasizing the importance of social safety nets and primary prevention rather than just high spending.
Example paragraph:
“Evaluating global health systems requires analyzing both outcomes and financial efficiency. High-performing systems, common in parts of Europe and East Asia, achieve better health outcomes with universal coverage, robust primary care, and resource efficiency. In contrast, many low- and middle-income countries experience fragmented financing and high out-of-pocket costs, highlighting the need for investments in social safety nets and preventive care to address population health needs effectively (Thomas-McLean et al., 2025).”

Step 5: Application of DNP Essentials

Connect DNP Essentials to global health:
- Essential II: Systems leadership for value-based care and organizational improvement
- Essential V: Health care policy to understand legislative evolution and reform
Explain how DNP-prepared nurses use evidence-based practice and leadership skills to improve health systems globally.
Example paragraph:
“The DNP Essentials guide advanced nursing practice in global health. Essential V (Health Care Policy) supports understanding the historical and legislative evolution of health systems, while Essential II (Systems Leadership) enables nurses to lead reforms toward value-based care and organizational integration. Together, these Essentials equip DNP-prepared nurses with the skills to effect sustainable improvements in complex health systems (Waldrop et al., 2023).”

Step 6: Conclusion

Summarize global health evolution, social determinants, system evaluation, and DNP nurse contributions.
Reinforce the importance of evidence-based, equity-focused approaches and leadership in global health.
Example:
“In conclusion, global health has evolved from controlling infectious diseases to addressing complex, equity-focused challenges influenced by social determinants and system-level factors. Evaluating health systems and applying DNP Essentials empowers nurses to implement evidence-based reforms, promote health equity, and lead sustainable improvements worldwide.”

Step 7: References (APA 7th Edition)

Thomas-McLean, H., Mak, R., Noonan, C. M., & Yip, W. (2025). Global progress toward universal health coverage: Learning from successes and failures. Annual Review of Public Health, 47.
Waldrop, J., Reynolds, S. S., McMillian-Bohler, J. M., Graton, M., & Ledbetter, L. (2023). Evaluation of DNP program Essentials of Doctoral Nursing Education: A scoping review. Journal of Professional Nursing, 46, 7–12. https://doi.org/10.1016/j.profnurs.2022.11.009
Walton, A. L., Nikpour, J. A., & Randolph, S. D. (2022). Population health in a global society: Preparing nurses for the future. Public Health Nursing, 39(5), 1098–1106.
World Health Organization. (2024). History as a partner in public health: A report of the foresight think tank on the history of pandemics. World Health Organization.

Global Health Evolution and the Role of DNP Essentials