With poverty and discrimination, job security decreases – and therefore no sick leave – and less secure work spaces, smaller homes, and more challenging access to healthcare: four factors – keys, or four. ” Social determinants of health », All public health experts mentioned.
But as journalist Amy Maxmine writes In a report The magazine published it on April 28 nature, “Although studies on social determinants of health have gained momentum for decades, real work to address the underlying causes is complex and politically risky and thus rare.”
The journalist has spent the past few months exploring these “social determinants”, among other things on the part of California farm workers – who are often Hispanic, poor and somewhat legal. When the epidemic began to take its toll there, there were many community organizations on the ground, distributing information about health measures and organizing screening campaigns – in addition to trying to explain why working conditions and housing had improved suddenly became more important than before.
“These types of social and economic interventions are what we really need to address health inequalities, but many researchers and policymakers are reluctant to press publicly for such measures.”
In other words, many of the experts interviewed for this report say it is not just an issue that falls to policymakers or health authorities. Medical experts should also talk, and not just about medical considerations: “We need to speak louder about things that are not in our field,” for example, says epidemiologist Mary Bassett.
A pandemic can have at least one good thing: It has shaped those warnings that have been part of the reality that public health experts have observed decades ago. Even for more than a century and a half, if we believe that in 1848, the Prussian physician Rudolf Virchow documented in his book Typhus Epidemic Report Four factors: hunger, illiteracy, poverty and depression. He wrote four basic social determinants for understanding the spread of the epidemic.
American sociologist WEB Du Bois added a layer at the beginning of the twentieth century by attacking the racial theories of the time, claiming that poverty was above all the question of premature deaths in black communities. . He was one of the first to develop indicators showing that changes in the death rate across a large city – Philadelphia – were primarily and ultimately a function of housing quality, education, type of work, and other variables, and that these measures were the same regardless of people’s skin color.
Today, everyone knows that life expectancy at birth is lower in poor countries. But many still ignore – or choose to ignore – that in their country, life expectancy at birth may vary depending on the zip code a person was born into. In some cases, as in the United States, the very vivid contrasts, documented in the 1980s, remain the same today. It is therefore not surprising that the epidemic has found factors more favorable to its spread to certain neighborhoods or provinces. And that the vaccination campaign will face more obstacles in some societies than others.
The solutions are also known: better education for the young and old, and improved access to healthcare for the most vulnerable. In the case of the United States, universal health insurance. But some solutions will vacillate most between those who control the money chains: impose better working conditions in industries. Most “are at risk Imposing better protection for workers with precarious status or immigrant backgrounds.
Connecting poverty to the epidemic is one thing, confronting the status quo is another. Notice Public health expert Ronald La Ponte, University of Ottawa. However, sooner or later experts from several disciplines will have to face this status quo, otherwise history will repeat itself.
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