I think many fail to appreciate that medical care only accounts for 12-15% of our health, probably less for adolescents and young adults who are mostly healthy and rarely need medical care. Yet, most of our investment is downstream in medical care and treatment, after people are already sick. Let's move upstream and start focusing on the quality of the water on which Goldie the goldfish swims.
Awesome piece Sandro. This reminds me of my learning when I was an undergraduate at Harvard and I was in class discussions on policy about the poor. I looked around the class and realized that the people who would make these policies, for the most part, had no direct experience with poverty.
And that those people who did, who were as close as the kitchen workers or maintenance crews all around us, would never have a say in these issues that affected their lives.
The assumption that education is the only access to intelligence, judgement or wisdom is pervasive in modern society.
This righteousness left the door wide open to populist and anti - intellectual thought that spread like wildfire.
Thank you for reclaiming the ground that supports actions for economic survival, as well as sound public health practices.
I often quote you, roughly, that the first front of public health is housing and jobs (and clean water!)
Thank you for always courageously telling the hard truths.
Thank you for this thoughtful comment, I agree and feel this captures well the blind spot in our perception, how in some ways, the nature of our education system, and the barriers that exist in gaining access to it, becomes another insulating bubble, and a veil between us and the world beyond it, which just happens to be the world of the majority of humans.
Excellent post. Always cheaper and more efficient to address the causes rather than focusing primarily on the outcomes, as Timothy notes. How society can best get intervention into marginalized communities at scale is our big challenge.
Another thing that jumps out at me when looking at that graph is the stark difference between men and women's experiences of the pandemic, particularly the mental health and finance bars. Anecdotally this makes sense to me based on many women's experiences of having to juggle work and remote school for their children which has fallen disproportionately on them. I believe the vast majority of jobs lost have also been jobs held by women. I think this is another angle worth considering when we look at this data.
At first, it seemed COVID would serve as a great equalizer, but we all saw how that turned out. Your recognition, Dean Galea, of how those of us in a certain knowledge class have perversely benefited from this tragic pandemic, and how this same group constitutes both the decisionmakers who are protected against many of the well-intended responses to preserve health + those who are simultaneously immune from its painful economic and social consequences, is an important convo. Today's WSJ book review of "We Need to Hang Out" begins with "Covid is a curse, yet some citizens have prospered during its grim visitation..." connects with another excellent line of inquiry in recent years, the effects of isolation and consequences of loneliness on health and community well-being. Looking forward to more of everyone's thoughts in this space.
I am inspired by your writing. With regard to last week's comments, there is ample evidence of the social health gradient in high income countries with universal health coverage (Canada and UK for example.) Universal coverage does not of course guarantee real equal access which is why the social gradient persists.
I think many fail to appreciate that medical care only accounts for 12-15% of our health, probably less for adolescents and young adults who are mostly healthy and rarely need medical care. Yet, most of our investment is downstream in medical care and treatment, after people are already sick. Let's move upstream and start focusing on the quality of the water on which Goldie the goldfish swims.
Agreed.
Awesome piece Sandro. This reminds me of my learning when I was an undergraduate at Harvard and I was in class discussions on policy about the poor. I looked around the class and realized that the people who would make these policies, for the most part, had no direct experience with poverty.
And that those people who did, who were as close as the kitchen workers or maintenance crews all around us, would never have a say in these issues that affected their lives.
The assumption that education is the only access to intelligence, judgement or wisdom is pervasive in modern society.
This righteousness left the door wide open to populist and anti - intellectual thought that spread like wildfire.
Thank you for reclaiming the ground that supports actions for economic survival, as well as sound public health practices.
I often quote you, roughly, that the first front of public health is housing and jobs (and clean water!)
Thank you for always courageously telling the hard truths.
Thank you Joan. I talk a bit about the need for financial support to address just some of these issues in this week's coming THG.
Thank you for this thoughtful comment, I agree and feel this captures well the blind spot in our perception, how in some ways, the nature of our education system, and the barriers that exist in gaining access to it, becomes another insulating bubble, and a veil between us and the world beyond it, which just happens to be the world of the majority of humans.
Excellent post. Always cheaper and more efficient to address the causes rather than focusing primarily on the outcomes, as Timothy notes. How society can best get intervention into marginalized communities at scale is our big challenge.
Yes. The challenge of course is how hard it is to act on those causes sometimes.
Another thing that jumps out at me when looking at that graph is the stark difference between men and women's experiences of the pandemic, particularly the mental health and finance bars. Anecdotally this makes sense to me based on many women's experiences of having to juggle work and remote school for their children which has fallen disproportionately on them. I believe the vast majority of jobs lost have also been jobs held by women. I think this is another angle worth considering when we look at this data.
At first, it seemed COVID would serve as a great equalizer, but we all saw how that turned out. Your recognition, Dean Galea, of how those of us in a certain knowledge class have perversely benefited from this tragic pandemic, and how this same group constitutes both the decisionmakers who are protected against many of the well-intended responses to preserve health + those who are simultaneously immune from its painful economic and social consequences, is an important convo. Today's WSJ book review of "We Need to Hang Out" begins with "Covid is a curse, yet some citizens have prospered during its grim visitation..." connects with another excellent line of inquiry in recent years, the effects of isolation and consequences of loneliness on health and community well-being. Looking forward to more of everyone's thoughts in this space.
I am inspired by your writing. With regard to last week's comments, there is ample evidence of the social health gradient in high income countries with universal health coverage (Canada and UK for example.) Universal coverage does not of course guarantee real equal access which is why the social gradient persists.
Thank you. Agreed.