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Social Determinants of Health

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Social Determinants of Health <[log in to unmask]>
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Robert C Bowman <[log in to unmask]>
Date:
Thu, 24 Aug 2006 10:16:14 -0500
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Social Determinants of Health <[log in to unmask]>
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The errors in this are significant on the part of all mentioned or writing
this.

Societies have until age 8 to get reasonable child development and verbal
ability, and then the efforts regarding reasonable school performance and
other failures cost more and more money and have lower and lower
effectiveness (Risely and Hart)

Where there is good public transportation, there is actually good reason to
sequentially raise the driver's license age, about each 3 years it should
be raised about 6 months. This would improve accident rates, morbidity,
mortality, driving under the influence, traffic congestion, insurance
costs, and may decrease crime and teenage pregnancy. Eventually a license
would be a more detailed process where a person was examined for
responsible behavior and a license was granted or denied based on this
review. Many would fail, but they would have due process, regardless of
age. Driver's privileges could be extended to those who work and who are
going to work in areas with poor public transportation, as they are now to
those younger than driver's license age.

By the way, my 21 year old daughter does not drive for several good
reasons, there is not good public transportation in Omaha, it does greatly
burden my wife and I, but she does better, and it costs us less in money
and worry. Eventually her rate of improvement will allow her to earn the
privilege of driving.

Enforcement of tobacco, alcohol, and driving is a nightmare, but a
necessary effort.  I agree that dealing with the courts is useless and
costly and inefficient. The resources are wasted on punitive measures
instead of rehab, but they do tend to keep the streets safer. There are
numerous people out on the streets that do not need to be. The major
problem with the plan is that it has an age limit. If people are
demonstrated to be irresponsible, they should not drive at any age.

A high school dropout that managed to recover and get a medical license is
a 1 in a 5000 or greater shot. Those born most poor, minority, and from the
lowest educated families have a 1 in 2500 shot at medical school
admissions. A physician dealing with adolescents should understand that
schools, government, and parents need to be on the same page regarding
growing teens up. Understanding this earlier in my life would have helped
greatly in child raising.

Robert C. Bowman, M.D.
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