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Health in Black and White

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by HM2VikingRN HM2VikingRN, RN (Member)

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if you were america's health disparities "czar," backed by unlimited funding, what would you do first?

i would take actions that would improve educational opportunities, employment opportunities, improve the quality of residential environments, develop environments that make it easier for individuals to make the right choices in terms of health.

i would want to see medical care that is accessible to all, and medical care that is more proactive and preventive in orientation. medical care as currently practiced does not play a large role as a determinant of health in the united states -- but it could. cuba is a good example. they spend a tiny, a miniscule, fraction of what we spend on health care in this country, and have better outcomes than we do on a range of health status indicators. and they don't have the high tech or all the latest procedures and diagnostic tests. what they do have is a greater emphasis on public health.

if we can emphasize procedures in medicine that are more preventive, we can actually achieve more out of our health care dollars. some research suggests that health care quality in the united states is poor for all persons. there is a gap in health care quality by race and by socioeconomic status -- but even for the advantaged, we're not doing well.

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on the one hand, we know a lot about the magnitude of disparities and trends in disparities. we know which policy areas should be priorities -- like education, living conditions, housing, work environments. at that level, the answers are clear.

what we honestly don't know: what are the levels at which we should intervene -- state, federal, local? we don't know which strategies are likely to have the biggest payoff. we don't know which specific interventions would be the most successful for society.

there are some areas where we have good data, like early childhood interventions. we know that investment in early childhood has a good payoff, and that it's cost-effective. but in many other areas, the data just aren't there. even in areas of society where we have made interventions, we have frequently not assessed the health impact. we haven't assessed the health impact of non-health policy, such as the earned income tax credit, the social security system, living wage ordinances. what impact do these have on the health of communities? i would argue that, given what we know about social determinants of health, the factors that are the largest drivers of the health of the population are outside of what we traditionally define as the health care sector.

http://prospect.org/cs/articles?article=health_in_black_and_white

 

 

 

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clee1 specializes in Hospice, Med/Surg, ICU, ER.

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The first line of this "article" shows it to be wishful, and therefore practically useless, thinking.

There is no such thing as "unlimited funding".

Better we should eliminate programs that have had limited or no success, and redirect those resources to areas that might have some legitimate, broad-based public good.

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979 Posts; 8,155 Profile Views

I can't get that page. Who is it who thinks in terms of being a czar? Let me know so I can vote against them.

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1 Article; 5,758 Posts; 32,496 Profile Views

My thoughts about public health in US is that no one has figured out a way to get rich from it. If no one can get rich from it than it just does not float.

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4,700 Posts; 38,043 Profile Views

I can't get that page. Who is it who thinks in terms of being a czar? Let me know so I can vote against them.

Its an interview with a PhD who has done a lot of public health research. Some of the things that he is talking about have been tested abd shown to have a positive preventative effect. (Early childhood intervention is his prime example.) It was a "blue sky" type of question.

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1,301 Posts; 11,093 Profile Views

My thoughts about public health in US is that no one has figured out a way to get rich from it. If no one can get rich from it than it just does not float.

Oramar, I agree with you 100%. Prevention and primary care will not get backing as long as no money can be gleaned from it. However, more companies are trying to get on the wellness bandwagon in an effort to reduce health care costs. We have yet to see the longterm ROI from wellness.

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