Public Health and Social Justice - V Navarro 1976

"....there is a need to link the public health struggles, both at the local and national levels, with larger political struggles at all levels, political struggles that should be aimed at profoundly transforming a system that works primarily for the few and not for the many. To that end, we must struggle and organize."

Vicente Navarro, 1976

Invisibility of Poverty in Diabetes Research

Chaufan and Weitz write an important article pointing out that poverty as a cause of disease is ignored in academic research. They also point out that there is at least a 200 year tradition showing this to be the case. Poverty is ignored because it would make academics and others have to deal with how we benefit from the power dynamics that create poverty.

Dealing with these dynamics would require academics and public health workers have to face their role in the maintenance of poverty and disenfranchisement. Or, in an attempt to appear more academic researches focus on individual cause and effects which can be easily manipulated in a manageable experiment. Either way this leads to what the authors state as "business as usual."

They also point out that working for changes is one possible option. They suggest that living wages, affordable housing, and health care as a right will have greater impact than attempting to change individual behaviors. They also suggest that researchers look at the role of poverty as a cause of disease and propose structural changes to society that make the population healthier.

Some of these health improving changes are electoral, others are economic. Either way, it is important to begin to look at poverty as a structure which makes people sick. Then we can look at politics as one of many methods to make people healthier!

Register! Vote! Organize Raza Unida!

The Social Hierarchy of Health

Quotes from an article on Social Hierarchy of Health.

The disease and suffering of disadvantaged people in all countries are a result of the way we organise our societies.

A physician faced with a suffering patient has an obligation to make things better. If a society is making people sick, we have a moral obligation to improve public health and to reduce health inequalities as a matter of social justice.

The social gradient in mortality is a broader issue than that of poverty and health. A study by Marmot of government workers in Whitehall, London, found that while everyone had access to clean water, sanitation, abundant food, and shelter, the risk of dying was related to where they stood in the social hierarchy. In England, the life expectancy gap between men living in rich and poor areas is 11 years and the gap is even bigger in the United States of America between whites and blacks in the same geographical region.

There is a clear relation between a country's affluence and the life expectancy of its population, up to a per capita income of about $5,000. Beyond this, factors like social environment have a greater influence. The excess mortality among the poor in a rich country like the USA is from non-communicable disease and violent deaths.

Power, then, is the key. Control, autonomy, and freedoms might sound like psychological properties of the individual. Power relations in society, as they operate through social institutions and the opportunities afforded to those in relatively disadvantaged positions, are the social causes of degrees of empowerment. Freedom does not imply privileging the rights of some individuals at the expense of the well-being of others. Human rights can be taken as implying an obligation on society to do what is necessary to bring about the important freedoms for everyone.

World Health Day 2010

In New Mexico we often view the state as a rural place. In truth, much of it is. But it is fairly safe to say that about half of the state population now lives in an urban environment. This is challenging because of the traditional New Mexican cultures are tied to land.

The work of maintaining and supporting traditional land uses and healthy urban development in balance will require vision, leadership, and dedication. Urban health is best approached by dealing with a regional perspective rather than a city only view. Food, water, clean air, housing, jobs, and so much more really benefit from the regional coordination.

Today is World Health Day, and the focus is urbanization. So even if you only have a few minutes reflect on our cities and health. Cities are great for bringing lots of interesting things together. They are also places for the development of great inequities. Take a minute and think about what you can do to improve your local environment or social conditions.

Social Determinants of Health

How does politics impact health? By creating the situation of our social lives.

These are called "Social Determinants of Health." The World Health Organization released a Report on Social Determinants of Health. It's a 7MB document, but a good read for those really interested in how health and politics intersect.

Culture of Overwork

Working over 45 hours a week can be detrimental to your health. France created 350,000 jobs by going to a 35 hour work week. Shorter work weeks reduces green house emissions. Getting rid of the Culture of Overwork even makes employees happier!

Let's get smart and let's give everyone more time to spend with their friends and families.

Proportional Representation and Health

Politics and Inequality

Shirley Cereseto, in her little-known 1982 article, "Capitalism, Socialism, and Inequality," published in the Insurgent Sociologist 11(2): 5-38, is the most comprehensive study of quality of life under capitalism and socialism. She finds that poverty and misery among peoples of the “third world” are not caused by the reasons given by capitalist propagandists (backwardness and/or overpopulation), but rather result from the laws of motion inherent in the capitalist mode of production.

Read more...

Or read about political economies and quality of life. Or Is Democracy Good for Our Health?

Health Insurance Debate

We keep calling what we see in congress as a health care debate. True health care would be the societal policies and expectactions that would provide everyone an honest opportunity to live a health and long life. Only corporations are supported in that way.

What we have is a health insurance debate to attempt to provide access to illness treatement services. Changing the health of the country in the future will depend on preventing illness through policy. Medical services providers do very little prevention work.

If we want changes in health we'll need to change power dynamics. We'll need political parties that support family friendly wages, educational for all, and health coverage for all as a given!

Senator Obama on Health Care Reform

Senator Obama said that he was a supporter of Universal Health Care but the obstacles that had to get out of the way were control of the White House and control of the Congress....

Sound familiar? Watch Obama say he is a Single Payer supporter on this Bill Moyers special.

More on Inequality

The debate on health care often skips talking about inequality. It has become hard to keep up with all the changes in direction.

If you take into account that one out of four children in NM lives in poverty we see that things like health care are important to flourishing. Not just for the children but for the parents. Unhealthy parents will obviously have a much harder time raising healthy children.

There is a lot of talk about working to end violence, obesity, drop-outs, and other problems with youth. But the reality of our inequality is often ignored. Not just that "kids in China don't have shoes" type of inequality, but the type that attacks your senses, often without you knowing it. There is a lot of interesting information in the video link above.

Here are some facts about NM Inequality. One of the important things is the NM is 6th in greatest inequality between rich and poor. And the site mentions some specific strategies to reduce that.

Need to Keep Organizing

Here are a couple of good short posts from Wellstone.



Grassroots vs Astroturf


"If it wasn't before, it's obvious now that the right still knows how to organize. And with powerful channels of message dissemination (see: Fox News) sending misinformation, anti-reformers are riling up a small but vocal group that could dismantle the best shot at real reform we've ever had.

That's why it's not enough for progressives to just dismiss the vocal minorities we're seeing in the news and wait for the political backlash. We have to turn our anger and frustration into action. So, don't just get mad--get organized."

Same Day Registration Increases Youth Vote

"The Center for Information and Research on Civic Learning and Engagement (CIRCLE) just published a report on election law reform and its connection to youth voter turnout. More specifically, they found election day registration (EDR) is key to increase the youth vote.

In the nine states that currently have EDR, youth are 41% more likely to vote than youth in other states. In addition, five of the eight states with the highest youth vote, Minnesota, Iowa, New Hampshire, Wisconsin, and Maine, all have EDR. Although CIRCLE acknowledges that EDR is not beneficial for all ages or even all youth, it is an important step in encouraging youth to be active citizens."

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La Raza Unida will be encouraging people to support the "Public Option" and push for Universal Health Care as the follow-up!

Is Inequality Killing Americans?

Thom Hartman had a great segment where he pointed out that societies where inequalities were higher had worse health outcomes. The outline of his show are on his website. He used information from EqualityTrust.org.uk for the information and there is even a video there for those who prefer watching to reading.

Here is a quote from the EqualityTrust:

"Great inequality is the scourge of modern societies. We provide the evidence on each of eleven different health and social problems: physical health, mental health, drug abuse, education, imprisonment, obesity, social mobility, trust and community life, violence, teenage births, and child well-being. For all eleven of these health and social problems, outcomes are very substantially worse in more unequal societies."

The US does close to the bottom in almost every area. And Thom talked about even within the US states that are more unequal also have worse outcomes for these public health issues. Until we have strong parties that stand on this as basic policy we will continue to get the fights that we get for decent wages, health policy, and more.

Register Raza Unida in NM by placing "LRU" in box 5 of your voter registration form!

Policy Changes for Drop Off

One of the things La Raza Unida has been doing is supporting the policy changes for how the Metropolitan Detention Center (MDC) drops people off. Often people are released in the middle of the night into downtown Albuquerque. Whether they are disabled, having mental health problems, or substance abuse issues.

Kalpulli Izkalli and Young Women United have been doing great work around this. And it is paying off!

Health and Health Care Reform

Women in Japan living the longest. Most of these news stories don't mention why people live longer in different countries. They sometimes talk about what an individual did to live so long, but don't mention the larger picture.

Health and public health professionals are talking about the need to change the dynamics of power ton improve health. It is very interesting. Vicente Navarro and others are taking a strong stand on the importance of politics and health.

Universal Health Care? Not Yet (5/13/09)

Well on the Ed Shultz show yesterday there was talk about how Obama was holding hands with corporations to continue screwing the people out of Universal Health Care. It was depressing and looking at the news it seems accurate. And Congressman Kucinich has introduced a Universal Health Care bill!

Physicians for a National Health Plan have lots of information from a doctor's point of view. I think it is safe to say that Single Payer is off the table. Exclusion is normal in a society with corporate sponsored political parties. I like where the video shows the person talking about "pay to play." I think Vicente Navarro does a good job at pointing out "why this situation persists." He even talks about solutions. He talks about the nature of the problem in the US (pdf) and does something that is not mentioned in the media. He actually looks at life expectancy and infant death rates and looks to see if the health system of a country makes a difference.

Instead of sadly comical news about terrorist doctors like the US. I think the final note in this article says more than just fear mongering of particular news stations.

Improving Health (3/17/09)

There are places where social inequalities have been reduced and the health of the population improved. Two of these regions have been studied extensively because they are a region within a country and not the entire country. Mostly showing how inequality reduction supports public health.

These areas are the state of Kerala India and the northeastern regions of Italy. Over the last 40 or so years these areas have improved the health of the population and reduced social inequalities for their regions. What they have in common? They have parties that intentionally implement policies of equity.

Because we often have such a negative view of parties and politicians in the US we lose sight of this. This is not to say that the corporate friendly parties that we have in charge don't disappoint. In fact, in almost all countries people's expectations of parties and politicians lead to a lack of engagement.

Political parties are important because they the policies they implement when in government determine the level of equalities and inequalities in a society and relates to the health of the population as a whole. If you look at the social democratic countries (Sweden, Finland, Norway, Denmark, and Austria) the labor movements and their related parties have been very strong.

What does this look like? Social democratic parties are in power at least half the time. The percentage of people in unions is about 60-80%. In the US? About 13% Social security expenditures are high, taxes are higher, public employment in health, education, and welfare are higher. And importantly women's participation in the workforce are higher.

Besides the fact that it pays to be union, parties can make a difference as well. Worker oriented parties also work at full-employment policies. This leads to lower unemployment. Universal social policies. Things like universal health care, paid time off for all workers, and childcare available for all families. These fit together very well also.

One quick example. For universal health care to work there would need to be an increase in health care workers. This would require increasing support for education to build the work force needed. And that requires more teachers to train the work force. By expanding the work force in a wide variety of ways more people are employed in general and also more women.

There is so much more. But really quickly let's look at the reasons for inequalities in a country. Three major areas of policy are involved. One is the amount of money that goes to capital versus labor. Even our stimulus has gone mainly to corporations and focused on credit versus wages. A second the wage disparities within the labor force. Again worker friendly governments have the lowest wage disparities within the work force. The distributive effect of state interventions. Changes in disposable income as a result of taxation system.

We can easily see in the US that these three policies which work in "corporate friendly" countries are most corporate friendly here. How can we change this? Only through a lot of hard work done by all of us. We have to take the caring we have and the responsibilities that come with it to form a strong stand for the entire population. Our government has been serving mainly the top 5% for a long time.

Working together we can change that. Working together can make the incremental changes that will lead toward strong communities. We can have freedom from want, freedom from intrusion, and freedom to thrive by taking a strong and caring stand together!