Health as if everybody counted blog
Understanding social determinants of health: A good-news story
In an earlier posting, I commented on how difficult it is to get many colleagues to understand that conditions of daily life like not getting enough to eat, or having to spend four hours a day commuting to work while dropping off and picking up the kids at school and daycare, might not be good for your health. When you have that kind of day, some of life's less healthy diet choices look awfully attractive.
|On a tight schedule and a tight budget,
healthy eating options are not always feasible.
The bad news is that it's still difficult. The good news, showing that an increasing number of people are beginning to 'get it,' comes from two medical journal articles that appeared around the time of the UN High-level Meeting on Non-communicable diseases in September, 2011. That's the meeting where, as reported in the Canadian Medical Association Journal, our own government helped to water down a proposed action plan on NCDs.
"The challenges [of NCDs] are much farther upstream and multisectoral than other health challenges; what presents as a health issue has its origins in a variety of determinants, and the solutions must incorporate agriculture, the food and beverage industry, and the built environment, among others."
And in the European Journal of Cancer, two UK-based authors warned against a "zero-sum" approach in which cancer control is viewed as competing with other prevention priorities, and made a remarkably clear statement of the case for intersectoral action, also the topic of an earlier posting:
"One of the critical failings time and time again is the development of public policy and actions around inequality and cancer outcomes that are completely dissociated from the actual lifestyles and concepts of individual responsibility that give rise to the situation in the first place. Before even setting the policy agenda for the social determinants of cancer there needs to be an explicit political mechanism that stitches cancer into the various vertical political silos of social policy – for example education and urban planning."
There are people out there who get it. Unfortunately, so far as I can tell neither of these articles is available on an open access basis, so if you don't have access through a university or hospital, make friends with someone who does. Meanwhile, the question becomes: Why don't more people get it? And what can we do to change all that?
Useful opportunities for discussing this question in the specific context of NCDs will no doubt arise at the Fourth Pan-Canadian Conference on Chronic Disease Prevention in Ottawa next month.