You are welcome, Jane Moseley -
Thank you for the thanks;  much appreciated -
Pete

----- Original Message -----
From: "Jane Moseley" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, November 20, 2009 7:42 AM
Subject: Re: [SDOH] SDOH vs Public Health?


> Thank you Peter Sarsfield, you articulate points which I so keenly agree
with!
> Jane
>
> Jane Moseley, RN, BScN, MAdEd
> Assistant Professor
> School of Nursing, St. Francis Xavier University
> PO Box 5000, Antigonish,
> Nova Scotia, B2G 2W5
> Tel: (902) 867-3582
>
>
>
> -----Original Message-----
> From: Social Determinants of Health on behalf of Pete Sarsfield
> Sent: Wed 11/18/2009 4:09 PM
> To: [log in to unmask]
> Subject: [SDOH] SDOH vs Public Health?
>
> Fellow SDOH folk:
>
> I suggest that we don't fall into the anti-Public Health/immunization
queue, as the results spill over from H1N1 to other potentially preventable
diseases, including ones (ie H1N1) that disproportionally affect those
people who suffer the most from social inequities.  The anti-Public Health
and anti-immunization zealots have dug themselves a destructive trap by too
often dismissing the efforts of Public Health in the hope that "the real
threat" of social inequities may then be addressed.  Public Health tasks and
SDOH work are not opponents, or should not be.
>
> Points arising:
> - There is no one "real threat",  there is only proportionality.
> Think relative risk, please, and not real   vs  unreal;
>
> - Of course the nonsensical hysteria re H1N1 is harmful, not only because
of the undue anxiety created, but more significantly due to the diversion of
resources (funds;  workforce efforts) into a relatively tiny venue of risk;
>
> - Any Public Health worker with a flicker of social awareness and
responsibility (ie most of them/us - this is old news) recognize that the
major threats to the health of the public are those imbedded in SDOH, but
governments (at least those elected by Canadians) will not adequately
resource Public Health to do more than focus primarily on acute risk
prevention and individualistic health promotion.  Public Health is usually
restricted to episodic and semi-muzzled lip-service to social justice and
SDOH work.  Many government funded Public Health workers are not even
allowed to use the words "advocacy" or "inequity",  let alone direct
significant resources to SDOH work;
>
> - Public Health receives about 2% of Canada's health care spending.  Look
for a tiny and short-lived upward spike in Public Health funding post-H1N1,
with a fall back to 2 or 3% of health-care funding within two years, until
the next communicable disease threat;
>
> - Many Public Health workers of my acquaintance are aware of the imposed
narrowness of their mandate, and try to expand that mandate without
abandoning the necessary work that is being done;
>
> - If we want to help others work in a productive way on SDOH, we should
consider limiting the mean-spirited snipping at Public Health and instead
work to increase population health funding to ~ 10% of the health-care
dollar and for the increase to be directed to SDOH work.  Public Health in
Canada has been almost shut down in order to sooth Canada's fears of H1N1.
Instead of railing against Public Health officials, perhaps we could try
helping them do their jobs in a broader and more realistic way;
>
> - Immunization has saved many millions of lives, mostly children.  Any
immunization is of less risk to the individual recipient than the disease
being addressed.  However, the cost to society of diverting funds from SDOH
work into immunization is a huge and mostly-unmeasured risk;  let's together
find ways to make SDOH work and Public Health services be both/and   and not
either/or  options;
>
> - Public Health is not the enemy.
>
> Pete Sarsfield, MD, FRCP(C) - retired
> Winnipeg, Manitoba
>
>
>   From: GRETA DOUCET
>   To: [log in to unmask]
>   Sent: Wednesday, November 18, 2009 10:58 AM
>   Subject: Re: [SDOH] letter
>
>
>         I totally agree Dennis,
>         And the CBC did do a reasonable report of the situation last
night.  I have personally asked Mark Kelley to address this amongst other
issues on his Connect program.  Somehow, he seems to have a more
humanitarian approach than most. I am told that Victor Mallerik recently has
written something quite interesting on the subject. Maybe just maybe,
eventually interventions and questionning will reach "critical mass"
proportions. I keep hoping.  We must continue our efforts.  I hope that it
will eventually bear fruit.   Greta
>
>
>
>         From: Dennis Raphael <[log in to unmask]>
>         Subject: [SDOH] letter
>         To: [log in to unmask]
>         Date: Wednesday, November 18, 2009, 1:11 PM
>
>         My heart is warmed by the Globe and Mail's  editorial board's
ongoing concern about children not being designated a priority group for
receiving the H1N1 vaccine (Patchwork of policies for children, Nov. 18). My
heart would be warmed even more if the board showed similar concern about
the hundreds of thousands of Canadian children who by virtue of their living
in poverty experience ongoing material and social deprivation exemplified
through their use of food banks and living in inadequate housing.  This is
the real threat to children's health, and as the evidence from numerous
research shows, excellent precursors of cardiovascular disease and type II
diabetes in adulthood.
>
>
>         Dennis Raphael, PhD
>         Professor of Health Policy and Management
>         York University
>         4700 Keele Street
>         Room 418, HNES Building
>         Toronto, Ontario M3J 1P3
>         416-736-2100, ext. 22134
>         email: [log in to unmask]
>         http://www.atkinson.yorku.ca/draphael
>
>
>
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