02/21

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21
Feb 14

Structures of Health (Ch.2-3)

It seems that in attempting to map out, define, and understand the field of public health, we have only revealed more of its complexities and difficulties.  This weeks readings traced the evolution of public health from 19th century “environmental and ecological approaches” and biased, simplistic miasma theories (17) to the current integration of public health into educational, political, psychological, and social systems.  It began as a reaction to cholera epidemics in London, which established the ruling theory that environmental factors and social status affected health.  The poor, the immigrants, the minorities, the laborers were all blamed for creating the dirty environments that were said to have caused these outbreaks of disease and malaise.  While environmental factors are extremely important influences on overall health, they are certainly not the only pieces in the public health puzzle.  As the readings discuss, as public health has evolved over the years to adapt parallel to cultural shifts, more and more factors that affect well-being and health are being discovered.  Some of these include income levels, spending and support for public health aid programs, education levels, gender, genetics, ethnicity, geography, and workplace conditions.  I wonder what the miasma theorists would think if someone explained to them that there are a lot more contributors to health than merely air quality and so-called sinful lifestyles. There are obvious drawbacks to placing too much emphasis on the impact of social factors on health, as we have seen with the treatment of HIV/AIDS patients and the bias against the poor when dealing with cholera.  However, viewing public health issues through a purely scientific biomedical lens or “to explain disease without any of the disruptive implications of class analysis” can be equally problematic as it opens up the possibility of ignoring important social factors, as these very elements of class and status are directly linked to health (22-23, 29).

But which is a better and more important predictor of levels of health, social status or biological and environmental factors? What do you think?

JE

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21
Feb 14

Chapters 2&3

Probably because I have never discussed the idea of public health in any college classes before, I had no idea what that term included. From the readings we were assigned this week, I was struck by the amount of factors that fall under the category of public health- politics, economics and education all play a role, as made clear in chapter 3. It is incredible to think of all of the things that affect our individual and collective health as opposed to thinking of disease as a more random idea that affects whoever it happens to affect. In addition to feeling enlightened about the meaning of public health, the chapters we had to read made me feel like the issue is far bigger than I had imagined, involving so many different compartments of society, and therefore more difficult to rectify. One particular passage in chapter 3 caught my attention in regards to this idea was on page 38:

“Every sector of government and society has the potential to affect health and health equity…it is particularly important that policies are coherent, that is, that one policy (or set of policies) does not work against the other. For example, a recent proposal in the United Kingdom to increase the speed limit on motorways from 70 miles per hour to 80 miles per hour, if enacted, might increase transportation efficiency but would increase both carbon dioxide emissions and the risk of road deaths.”

This paragraph highlights the difficulties of public health, that because so many branches of society are involved, they must be careful not to step on each other’s toes. We have to always approach an issue with an idea of the effects a solution could possibly have on all sectors of our society.

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21
Feb 14

Structural Approaches in Public Health

I definitely agree with Annalisa’s post that these chapters, just as our previous readings, are disturbing. To me, learning about diseases in general, even from a strictly science perspective is scary enough. It makes me feel vulnerable. However, learning about diseases and public health in relation to politics and social activities is even scarier. Not only do I realize how easily we can all be killed, but also I realize how sometimes there isn’t really anything we can do to prevent certain diseases from affecting us. We can’t always control what we’re exposed to. Additionally, I like to believe that we can trust our doctors and scientists to, in a sense, just take care of everything. However, maybe we should be doubting these individuals, and also realize that they are not the only ones needed to protect us from diseases.

“Medicine is a social science, and politics is nothing else but medicine on a large scale. Medicine, as a social science… has the obligation to point out problems and to attempt their theoretical solution: the politician…must find the means for their actual solutions”- Virchow (a physician in Germany in the 1800s). Virchow, however, also had really rational ideas, to the point where the Prussian government removed him from his position to investigate a disease.

We never really know what mistakes the people with authority may make. Hopefully, we can learn from the past to be more speculative, and make sure that we don’t get fixated on theories so quickly, or at all.

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