Ann,
The US corollary is the Alameda studies; it was a population-based study
(not civil servants) but it found strong associations between social
determinants and health. Lisa Berkman was involved and her advisor, Len
Syme. Nancy Adler has done work in this area as has George Kaplan and
Ichiro Kawachi. Barbara Starfield has addressed the issue head on. If
you check pub med, you should find enough to get you started. I wrote a
chapter in a book that discusses both social determinants and the
medical care system with a view to trying to sort out which is important
when (Chapter 9 Social Discrimination and Health: Gender, Race and
Class in the US pp 223-256 in Engendering International Health: the
Challenge of Equity edited by Gita Sen, Asha George, and Piroska Ostlin.
http://books.google.com/books?hl=en&lr=&id=zURBbhLPpIQC&oi=fnd&pg=PR7&dq
=%22Sen%22+%22Engendering+International+Health:+The+Challenge+of+Equity%
22+&ots=paqEIapFmP&sig=Fo73dJZ5ZA1El3pXZW1lKEzlxq4#PPA223,M1 ) The book
was published in 2002 so the chapter is not up to date, but it cites
many sources that could be of help to you.
As to why the US might favor a health care fix rather than one which
addresses social determinants, we need to take a broader view of the way
the US political economy works. From the economic point of view widely
held by business that predominates in the US, "fixing" social
determinants is a drain on the economy because it requires government
expenditures which takes away resources for investment in for-profit
sectors of the economy. Meanwhile providing health care is a highly
profitable sector of the economy (arguably the only one that still is).
Though many economists and most public health practitioners would not
agree with this, it is the view that currently predominates in the US.
Cheers,
Nancy
-----Original Message-----
From: Randy Reiter [mailto:[log in to unmask]]
Sent: Tuesday, July 01, 2008 10:23 PM
To: [log in to unmask]
Subject: Re: -Any articles/infor will help
all of the Whitehall studies that went so far in establishing gradients
for
all all kinds of health outcomes are done among British civil servants,
all
insured in same system. (Look under Michael Marmot)
____________________________________________
Randy Reiter, PhD, MPH, Population and Community Health Analyst
Community Programs
Community Health Epidemiology
San Francisco Dept. of Public Health
30 Van Ness, Suite 260
San Francisco, CA 94102
[log in to unmask]
phone: 415 575-5767 fax: 415 575-5799
Ann Pobutsky
<[log in to unmask]
EDU>
To
Sent by: Social [log in to unmask]
Determinants of
cc
Health
<[log in to unmask]>
Subject
Re: [SDOH] -Any articles/infor
will
help
07/01/2008 05:43
PM
Please respond to
Social
Determinants of
Health
<[log in to unmask]>
HELP-does anyone have any articles/information I can use to combat the
idea
that access to care will eliminate health disparities.
Is there some peculiar focus in the U.S. on 'access to care' as the
'solution'?
Ann M. Pobutsky, PhD
Chronic Disease Epidemiologist
Community Health Division
Hawaii State Department of Health
1250 Punchbowl St., Rm. 218
Honolulu, HI 96813
email: [log in to unmask]
phone: (808) 586-4485
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