Health

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Of all the forms of inequality, injustice in health is the most shocking and the most inhuman.  ~Dr. Martin Luther King Jr.

Creating and Developing Awareness

Why is health important to achieving social justice? The following paragraph from the World Health Organization (WHO) provides an excellent explanation:

Health has special meaning to individuals and communities at large. Good health is necessary for human well-being, providing intrinsic value for comfort, contentment and pursuit of the joys of life. But good health does more than that. It is important in allowing individuals to exercise a range of human rights – both civil and political (e.g. physical integrity, personal security, political participation), social and economic (e.g. employment, education and family life). Just as important, health is necessary for well-functioning societies. If a population does not have a decent level of health, it is very difficult to ensure economic prosperity, political participation, collective security and so forth. Source.

WHO describes the Social Determinates of Health:

[T]he condition in which people are born, grow, work, live and age, and the wider set of forces and systems shaping the conditions of daily life.”
WHO provides data on its 194 member states each year in a report covering 17 Sustainable Develop Goals (SDG) to reached by 2030. Health is one the central SDG’s which has 13 targets covering all major health related priorities which includes:

■ life expectancy and mortality ■ cause-specific mortality and morbidity ■ selected infectious diseases ■ health service coverage ■ risk factors ■ health systems ■ health expenditure ■ health inequities ■ demographic and socioeconomic statistics

The 17 SDGs are the result of an agenda adopted by the United Nations General Assembly in 2015 titled: Transforming our world: the 2030 agenda for sustainable development, with the intention to realize the vision a world that is rights based, equitable and inclusive.

The website, www.healthpovertyaction.org, sees the cause of poor health globally related to the political, social and economic injustices. This creates a circular situation because the people who must deal with health-related issues are less able to put energy nor have the resources to campaign for justice. The site lays out what determines good or poor health which does not necessary relate to access to health care and supports their statement linking poor health to political, social and economic injustices. The major determinants they list are:

• Where you live: is there clean and safe water and air? Is housing safe and not overcrowded? Is there good sanitation? What are levels of crime like? How safe are roads? Are there jobs with decent working conditions?
• Genetics: have you inherited greater likelihood of certain illnesses? How do you cope with stress?
• Income: unsurprisingly, higher income is linked with better health.
• Nutrition: can you regularly eat enough healthy food?
• Education: going to school can improve many other determinants of health.
• Relationships with friends and family: better support networks are linked with better health.
• Gender: men and women face different diseases at different ages. In many countries women also face many extra challenges that affect their health.
• Culture: customs, traditions and beliefs can all affect health for better or worse.
• Social status and social exclusion: people who are excluded, or on the margins of society have worse health chances.
• Access to and use of health services: are services available nearby to prevent and treat poor health?
• Personal behaviours: What do you eat? How much exercise do you do? Do you smoke or drink?

All these health determinants interact to create a complex set of health dynamics. But reducing poverty, providing livelihoods, increasing access to education and promoting gender equality are key parts of the puzzle. Source.

Educate, Inform and Create Inspiration

What This Looks Like in Real Life (Stories and Case Studies)

LEAD, WATER, RACE and ECONOMICS

In April 2014, Flint Michigan (a majority-black city with more 40% living in poverty), switched its water supply. The city intent was to save money by switching from its then current water provider (Detroit Water and Sewage Department - DWSD) to a company called Karegnondi Water Authority (KWA) in order to save $200 million over 25 years. When the DWSD found out, it cancelled the city’s contract.

The city decided to turn to the Flint River for water until it could connect with KWA. The city decided not to treat the water to prevent corrosion in the pipes which had been a source of water since 1960. Residents noticed the change in the water immediately and begin to complain about smell, color and taste of the water. City official denied for months there was a problem with the water.

In August, E.coli and total coliform bacteria was detected in the water. The city issued this statement:

In October, General Motors stopped using the Flint River water because it was corroding its machinery.

January, 2015, the state was found in violation of the Safe Drinking Water Act because of the high levels of disinfection byproducts.

In the next month, high levels of lead was detected in the water. Researchers found lead levels at 13,200 ppb in the water. Water is considered to be hazardous at 5,000 ppb.

It wasn’t until October of that year, that the water supply was switched to a safer source.

Lead Laced Water in Flint: A Step by Step Look at the Making of a Crisis: National Public Radion (NPR)

We talked about clean drinking water being vital for life and therefore a basic necessary for a person’s welfare and well-being, a quality of social justice. But this example points to other issues surrounding justice in our society.

Let’s look some of the other issues:

Lead Levels: Lead is both harmful to all humans, but is most dangerous to the development of children and to pregnant women. The Mayo Clinic lists the following effects of lead prisoning:

Signs and symptoms of lead poisoning in children include:
• Developmental delay
• Learning difficulties
• Irritability
• Loss of appetite
• Weight loss
• Sluggishness and fatigue
• Abdominal pain
• Vomiting
• Constipation
• Hearing loss
• Seizures
• Eating things, such as paint chips, that aren't food (pica)

Babies exposed to lead before birth might:
• Be born prematurely
• Have lower birth weight
• Have slowed growth

Although children are primarily at risk, lead poisoning is also dangerous for adults. Signs and symptoms in adults might include:
• High blood pressure
• Joint and muscle pain
• Difficulties with memory or concentration
• Headache
• Abdominal pain
• Mood disorders
• Reduced sperm count and abnormal sperm
• Miscarriage, stillbirth or premature birth in pregnant women

Nigeria's Fight Against Polio: New Internationalist

The battle against polio in Nigeria is being fought not only against the disease but against social mistrust and political violence. Yet, as Laura Jiménez Varo reports, the end could be in sight.

Issa’s right arm hangs slack along his little body. His mother takes his hand and lifts it to demonstrate; the arm falls limp. Then it’s grandma’s turn. She grabs the little boy’s hand, lifts it up and the arm falls again. At the third go, the child looks like he has had enough and squeezes the limb to show his strength. The amused audience claps inside the dark and gloomy room.

Issa’s arm is a state affair in Nigeria. Until 2016, he was the last known victim of polio in the country. His case was registered in July 2014 when he was two. One year later, the World Health Organization (WHO) certified that Nigeria had halted the transmission of the virus and removed the country from the ‘black list’. Africa was declared polio-free, and with Afghanistan and Pakistan the only remaining polio-endemic countries, the goal of global eradication by 2019 looked plausible.  Read the full article.

Skills Development and Activities

NOW with Bill Moyers: Learning about the Global Health Crisis. According to the World Bank, 110 million primary-school-age children in developing countries are not in school. Of these, 60 percent (66 million) are girls. More than a billion people in the world continue to live on less than $1 a day.  Poor economic conditions in developing countries often lead to the inability of governments to provide clean water, health care, public education, and other services. In addition, some countries sacrifice the rights of its laborers in its efforts to attract foreign investors and companies who can offer jobs. Such conditions, in turn, limit opportunities for the poor and make it even more challenging to meet their basic needs.

Public Television: Ebola Outbreak: Lesson Plans. The Ebola outbreak in Western Africa has already claimed the lives of thousands since its initial victim died in December 2017, and health organizations around the world fear that the number will only continue to rise. Use this mission-based lesson plan to help students learn basic concepts about epidemiology in the context of the current outbreak and apply what they’ve learned to design a strategy to control the epidemic. We have created an Ebola outbreak: mission instruction and resources – digital student guide webpage for students that guides them through their mission from start to finish. Learn More.

Global Health Care Course: University of Denmark. This course will provide you with an overview of the most important health challenges facing the world today. You will gain insight into how challenges have changed over time, we will discuss the likely determinants of such changes and examine future projections. Successful international strategies and programs promoting human health will be highlighted and global health governance structures will be mapped and the role of the key actors explored. Click here for more information.

Read the Book: Upstream Doctors by Dr. Rishi Manchanda. At the end of almost a decade spent in teaching hospitals and clinics, most (we hope all) physicians have honed their clinical acumen by focusing on the care of the patient who is right in front of them. Perhaps this is as it should be: as patients, we don’t want our doctors (or nurses or social workers) distracted by “outside” considerations such as the suffering or concerns of other patients not there in the exam room or, heaven forfend, by abstractions such as the extra-personal social forces that place people in harm’s way. We want the doctor focused on us, by bringing expertise and attention to our specific “illness episode” and even to our minor aches and pains. That’s what we want: laser-like focus, to use another term from the medical profession, on our own “chief complaint.”

Or do we? What if most of our aches and pains and many of our serious ailments come largely from those outside forces and abstractions? What if we want to prevent disease or complications of it by altering our risk of poor outcomes (not just death, but predictable or unforeseen complications of the chronic conditions and growing infirmity that most of us will one day endure)? What if we acknowledge that we live not only in bodies but in families, homes (mostly), neighborhoods, and cities? What if our lives outside of the clinic or hospital are often difficult and even, for some people and at some times, almost unendurable? What if our clinical diagnoses are not our chief complaints?  Learn More.

The Emerging Global Health Crisis: Non-Communicable Diseases in Low and Middle Income Countries.  Download PDF document from Council on Foreign Relations. Rates of heart disease, cancer, diabetes, and other noncommunicable diseases (NCDs) in low- and middle-income countries are increasing faster, in younger people, and with worse outcomes than in wealthier countries. In 2013 alone, NCDs killed eight million people before their sixtieth birthdays in developing countries.

In the short term U.S. leadership would have a significant effect on cardiovascular disease, tobacco control, liver cancer, and cervical cancer.

"Low-cost, prevention-based solutions exist for each challenge and the United States is in the position to help local governments implement them."

In the medium term U.S. leadership would make a tremendous difference to address diabetes and treatable and curable cancers, such as leukemia and breast cancer.

Health World. Health World's courses include materials such as digital health and safety instruction, student assignments, classroom activities, assessment and other valuable resources. Health World's curriculum is aligned with National Health Education Standards. Health World's educational resources are perfect for individual classrooms, large districts and are a homeschool friendly resource, as recognized by Home Educators Resource Directory (H.E.R.D).  Learn more.

First Lady Library: Lesson Plans on Exploring the Work of the World Health Organization. The curriculum is provided free of charge by the National First Ladies’ Library. You may download the plans and any related worksheets, etc. Learn more.

The Right to Health. The Universal Declaration of Human Rights defines “a standard of living adequate for the health and well-being...” as a right for all. According to the World Health organization (WHO) “health is a state of complete physical, mental and social well-being and not merely the absence of diseaseor infirmity.” This means that the right to health is more than just health care-equally important are general living conditions on which a person’s health depends. Click for a PDF.

How to Implement or Put into Action

Donate time or money to organizations whose mission is to improve health. Reference: www.guidestar.org/Home.aspx (lists various charity groups)

Stay aware of the work of the World Health Organization.  A recent report indicates a series of recommendaitons for the organization.  Here is a summary:

• The global community should come up with a strategy for strengthening health systems, including funding to help developing countries do so.
• The WHO should publicly commend countries that report disease outbreaks promptly and name and shame those that delay reporting. Financial incentives to compensate countries for losses linked to transparent disease reporting should be created.
• The WHO should set up a permanent outbreak response center with a guaranteed budget. It should report directly to the director general.
• The WHO should name a permanent emergency committee of experts to advise it on the threat posed by outbreaks. The committee should be able to convene itself and should consider adopting a graded system of warnings. Currently, emergency committees can only declare that something is or isn’t a global emergency.
• The UN should create an independent accountability commission that assesses response to major disease outbreaks.
• Governments, NGOs, the scientific community, and industry should develop rules for conducting research during an outbreak and a program for accelerating research between crises.
• Research funders should set up a facility to finance development of vaccines, drugs, disease tests, and other necessary medical equipment for diseases which the pharmaceutical industry won’t develop on its own.
• A global health committee should be set up as part of the UN Security Council to bring high-level attention to health issues and crises.
• The WHO should return its focus to its core functions, concentrating on efforts that only the WHO can undertake.
• The WHO’s executive board should establish a freedom of information policy; countries should stop earmarking the funding they provide the WHO; and countries should demand a WHO director general strong enough to stand up to the most powerful governments.

Support national emergency legislation when needed, as well as opportunities to strengthen international and local health systems overseas.

Ensure that research and development for new vaccines, drugs, diagnostics, and other health tools are prioritized in pandemic and emergency response strategies.

Support investments in health systems and partnerships with local health ministries in times of non-crisis.

Source Links

www.healthpovertyaction.org

http://www.who.int

http://www.un.org/en

https://hvousa.org/whoweare

http://www.who.int/workforcealliance/members_partners/member_list/ghec/en/