Living in the US - I have to say that it is not as amusing as it is useful. Especially for those who are scared by some of the changes necessary to improve health.
There are parts that I'm not necessarily enthusiastic about. I prefer to worry about them working. They seem to do OK. I even use one of their suggested quotes in my signature.
Just dealing with people around sector planning is tough enough. And then so many of our health advocates here only focus on medical service access. They get upset that I would propose eliminating poverty as equal to or more important than access. And I rarely get to discuss the electoral issues that would need to change for any real quality change in health outcomes.
And I don't belong to either of the two parties in power. Which just adds a whole extra level of frustration.
Enrique Cardiel
Urban Health Extension Coordinator
505-925-7393
It's time we made it possible for all Americans to afford to see a doctor,
but it's also time we made it less likely that they need to!
-----Original Message-----
From: Social Determinants of Health on behalf of Sara Stephens
Sent: Thu 11/18/2010 9:27 AM
To: [log in to unmask]
Subject: Re: [SDOH] A New Way to Talk About the Social Determinants of Health
Hello,
This was definitely an interesting document. I agree that our
challenges are different than those in the US, but we do still have
challenges in Canada.
Perhaps 70% of Canadians have values consistent with the SDOH, but what
percentage of those people would relate to and identify with the words
"social determinants of health"? How many people would know what
political party best reflects the values of SDOH? Or what policies
contribute to addressing SDOH?
I think there is still some value in finding a language that is actually
engaging, and that illustrates to people that we are actually talking
about the same thing and have the same values. You can't start a
movement until people realize that they belong to a group with common
values and interests.
If this document can appeal to people who otherwise wouldn't think twice
about SDOH, that's the first step. They can go on to get a more nuanced
understanding the more they learn. (But they'll only want to learn more
if their interest is sparked in the first place.) It's not perfect, but
it's a start. We all had our journeys towards our current understanding
of SDOH, so why expect anyone else to be any different?
Best wishes, Sara
From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf Of
Beattie, Tanya
Sent: Thursday, November 18, 2010 8:46 AM
To: [log in to unmask]
Subject: Re: [SDOH] A New Way to Talk About the Social Determinants of
Health
Hi everyone,
I can certainly appreciate your comments and mostly agree, however, for
us on the front lines who are trying to convince the powers that be, we
absolutely need a new way to talk about this, in a language that will
not immediately close doors. Unfortunately, the language of the SDOH,
equality and equity is scary to some and can elicit an angry, defensive
response. I see that getting everyone on board to work and direct our
energies towards the SDOH as a continuum of understanding... at the far
end are folks who don't agree and will completely disregard the
information and at the other end are folks such as us SDOHers who get it
and are comfortable with these concepts. It is a process to move people
along this continuum and I think this resource provides ideas and
language that could help the conversation to at least happen, rather
than be shut down from the get go.
Best,
Tanya
From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf Of
John Macdonald
Sent: Wednesday, November 17, 2010 7:07 PM
To: [log in to unmask]
Subject: Re: [SDOH] A New Way to Talk About the Social Determinants of
Health
Dear Dennis et al,
My two cents worth - I was also amused/saddened when I first saw the
document so I am glad to share:
A new way to talk about the social determinants of health
The three steps mentioned in the "Breaking it down" section are good,
surely: everyone should be able to afford a to see a doctor (not quite
saying with the UN that everyone as a right to see one, but still..);
promote universal screening for cancer and heart disease and our need to
expand our idea of health as something to keep "not just to get back".
All good,
As for "don't use the words "social determinants" or the "E" word,
"Equity"", well, since social determinants are about the role of
context, the social determinants of the "discourse" around health in the
context of the USA make these daft statements at least understandable if
not really acceptable. Yes, there are funny bits where the researchers
try to avoid upsetting the American public rather than educating them.
Sure, good education starts from where people are, but a touch of Freire
would do no harm here, in helping people see the limits of "where they
are".
Also, the document is indeed sad not just because it advocates avoiding
the "E" word or anything that could be seen as tainted with the
political social context, e.g. the issue of job security or the right to
a fair wage (despite the appeal to "fairness"!).
Finally, unless we begin to see health as the engagement of persons in
community with the total environment, political, social, cultural and
emotional contexts of our lives the potentially strong impact of the
research into the social determinants will be lost.
People can learn new words!!!
John Macdonald,
Professor John Macdonald,
Foundation Chair in Primary Health Care
University of Western Sydney
________________________________
From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf Of
Dennis Raphael
Sent: Thursday, November 18, 2010 9:55 AM
To: [log in to unmask]
Subject: [SDOH] A New Way to Talk About the Social Determinants of
Health
Colleagues:
I have read this document and would appreciate feedback from others.
http://www.rwjf.org/files/research/vpmessageguide20101029.pdf
<http://www.rwjf.org/files/research/vpmessageguide20101029.pdf>
I have two main concerns.
1) Do you really want to cater to rather reactionary attitudes of many
or do you want to help change them?
2) After you present the issue and get some buy-in, how do you discuss
the public policies that would actually serve to improve them?
I am particularly amused by the guideline of avoiding use of the terms:
equality, equity, or level-playing field! :-(
Its rather an amusing document...
dr
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