There appears to a connection to the Peter Senge (1990) work on systems
approaches that work on creating fundamental solutions (addressing the SDOH)
as opposed to symptomatic solutions (fix what is medically wrong with
people). We have all (including Canada) built a vast system of symptomatic
solutions for healthcare. This way of behaving is firmly entrenched in way
we structure services and what we count when judging healthcare for the
society.
Just as you say Diana 'Old habits are hard to break' .
-----Original Message-----
From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf Of
Diana Liw
Sent: November 20, 2006 12:00 PM
To: [log in to unmask]
Subject: Re: [SDOH] Health status of America 2006 report
I think that one of the main reasons that the US is behind many of the
developed countries in terms of its health outcomes is that fact even in
the 21st century, it still does not have universal health as a nation.
In the past 100 years, the main focus has been in advancing medical
research particularly in the technology. However, it's in the very
rudimentary stage to begin consider health in a mult-faced approach.
It's been talked about how all disciplines need to work together, but it
was never fully implemented. Just consider the lead positions of CDC,
NIH, and etc, most of them are physicians. Many of them do advocate for
incorporating the social determinants of health, but rarely have any
ideas of how to put them into action, or even how to work with other
disciplines. Just within the last ten to twenty years, US began to take
a grassroot approach (involving the communities) instead of tree top.
However, old habits are hard to break. There is still much tension
between community/grassroots organizatons and the "institutions". Other
countries seem to be more advanced in this respect. I see that we still
have a long way to go. It needs an entire cultural change and paradigm
shift of how the health field do business. I hate to use cliche, but
it's about working as team and that no single field or individual is
"superior" than the other. It's doable, but we all need to have an
open mind about this. In any case, these are definitely not critisms
but observations over time.
>>> [log in to unmask] 11/20/06 7:34 AM >>>
from [log in to unmask]
cc:
Subject: Re: Health status of America 2006 report
Hello Badri,
While the US has invested considerable sums in "bioterrorism" in the
past few years and this resulted in dollars invested in public health,
and while
the four areas mentioned -- "public health programmes, research,
health
care and health education" -- are indeed longtime priorities of the
CDC,
I would
not be overly optimistic about US health equity.
For starters, the US life expectancy has dropped to 30th in the latest
global health rankings, just below Cuba. Also, if you read further in
the
2006 report, you will see that the summary of the Overall Health of
the
Nation notes advances in such areas as "emphasizing healthy lifestyle"
and "medication, medical technology...procedures, new prescription
drugs" while also noting that in some areas, progress "has not been as
rapid as in earlier years or trends have been moving in the wrong
direction. Moreover, improvements have not been equally distributed
by
income, race, ethnicity, education or geography."
In short, health inequalities and health inequities in the US are
growing in the twenty-first century. In other words, in my view its
rhetoric not reality.
I look forward to hearing from others in the US about their views of
this report.
Barbara
Barbara Kivimae Krimgold
Director
Kellogg Health Scholars Program, Multidisciplinary Track
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