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Social Determinants of Health

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Subject:
From:
Robert C Bowman <[log in to unmask]>
Reply To:
Social Determinants of Health <[log in to unmask]>
Date:
Wed, 17 Jan 2007 11:59:15 -0600
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There are a number of hypotheses available that fit with the social
determinants

1. those who had rich and influential parents do live longer and they also
get a boost from parent influences for health, education, top college, and
professional school. These "credentials" also are more likely to result in
better positions and more support for their research efforts. They also
have the financial situations that can allow them to pursue their own
individual efforts should these not be found worthy of institution or
government support

2. those who manage themselves and others well not only gain the prize, but
do a better job managing their own efficiency and effectiveness and
influencing those around them in the same ways. The individual efforts for
any such award are a myth compared to the researcher-staff,
researcher-colleagues, researcher-personal life, researcher-family. Given
stress levels when any of these areas are poorly managed....

Other considerations
Those driven to the immersion necessary to make truly significant
contributions may not have much care or interest in awards or recognition
because it is the pursuit and learning that really engage them the most.

Several of the award winners have not received the award for years or
decades. Associating the very highest quality work to a prize and then to
longevity becomes a more and more complicated analysis. If those who have
been delayed in receiving the award were considered as a group, those who
had to endure the frustration of not having the work (not the individual)
recognized and applied to important areas in society, would be interesting.
Such lack of individual recognition and the lack of advancement in humanity
would be a double share of stress.


The elite at the top are a very exclusive group.

Those with the parents, credentials, and support are a superior group,
however those with parents, credentials, support, and management abilities
are in even better shape.

Great advances depend upon all of these efforts, some bit of good fortune,
and an innate ability to follow the best leads from the many identified as
most likely to be important.

To test alternatives you could also wait until the prize winner died to
award the prize, save the money, and then calculate who lives longest. My
bet is that they will live longer with or without the prize.

Areas of education, career choice, and longevity are more complex than we
realize, and more simple. More and more we are realizing that age 0 - 6
cuts a path that is difficult to change in education, career, and health
outcomes, especially in nations where there are narrow distributions of
resources that could level the playing field. More and more we realize that
as we suppress opportunity for increasing segments of the population, then
we limit the potential for advances, especially those truly different,
original, and relevant.

A read of Great Influenza 1918 by John Barry is a fascinating study in how
breaking the mold allows major advances, limited only perhaps by how
quickly those involved in research become a very narrow segment of society,
how rapidly increasing income related to physicians take more and more away
from research (and teaching), and how researchers are moved toward
profitable areas rather than beneficial areas.

Robert C. Bowman, M.D.
[log in to unmask]

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