Transcript Purdue University School of Health Sciences HSCI 101: Introduction to the Health Science Professions Health and Social Justice F.S.

Purdue University School of Health Sciences
HSCI 101: Introduction to the
Health Science Professions
Health and Social Justice
F.S. Rosenthal, Ph.D.
[email protected]
December 6, 2011
Why this lecture is important…
• Social Justice is essential in caring for the sick
and improving health of people.
• Health professionals have opportunities and
obligations to consider social justice issues in
their work.
• Social Justice should be a concern of all
members of society.
What is Social Justice?
• Social justice generally refers to the idea of
creating an egalitarian society or institution that is
based on the principles of equality and solidarity,
that understands and values human rights, and
that recognizes the dignity of every human
en.wikipedia.org/wiki/Social_justice
• The fair and proper administration of laws
conforming to the natural law that all persons,
irrespective of ethnic origin, gender, possessions,
race, religion, etc., are to be treated equally and
without prejudice.
http://www.businessdictionary.com/definition/social-justice.html
•
• Social justice means moving towards a society
where all hungry are fed, all sick are cared for, the
environment is treasured, and we treat each other
with love and compassion. Not an easy goal, for
sure, but certainly one worth giving our lives for!
http://www.reachandteach.com/content/index.php?topic=socialjustice
Social Justice
• Equality and fairness
• Human rights and dignity
• Fulfillment of human needs
What are the goals of Health
Professionals?
• Care for the sick
• Reduce illness through prevention, diagnosis
and treatment.
• Increase human health, longevity,
productivity, potential and well-being.
How do the goals of health
professionals and social justice relate?
Health Professionals
Social Justice
• Care for the sick
• Reduce illness
? • Fairness and equality
through prevention,
  • Human rights and
diagnosis and
dignity
treatment.
• Fulfillment of human
• Increase human
needs
health, longevity,
productivity, potential
and well-being.
Statement by the National Association
of County and City Health Officials
“We embrace social justice as the cornerstone of
our work…We advocate for comprehensive
strategies that attend to the root determinants
of health such as standard of living, quality of
housing and education…”
Topics
• Social Injustice
– Health Indicators
– Unequal access to healthcare
– Environmental Justice
– Effects of war on health
• What Health Professionals (and Students) Can
Do
Factors Influencing Infant Mortality
• Poor nutrition
• Poor housing
• Lack of access to prenatal and infant healthcare
services
• Lack of access to preventive health information
• Low birthweight and pre-term births
• Infant mortality is considered an indicator of the
general health of a population
U. S. rate = 6.8
http://en.wikipedia.org/wiki/Infant_mortality
Infant Mortality Rates in the U.S.
Deaths (< age 1 y) per 1,000 live births
Non-Hispanic White 5.7
Non-Hispanic Black 13.4
Hispanic
5.3
Total
6.8
http://www.statehealthfacts.org/profileind.jsp?ind=48&rgn=1&cat=2
Unhealthy housing
• Defined by conditions such as rodents recently
seen, leaks in preceding 12 months, peeling
paint, no working smoke alarm, etc.
• Increase in unhealthy housing compared to
white population
– Blacks -- 30% …
– Hispanics -- 10% …
– American Indians/Alaskan natives -- 60% …
Centers for Disease Control, Health Disparities and
Inequalities Report, 2011 (data from 2009)
Coronary Heart Disease Deaths for
Men per 100,000 population
Age
45-54
55-64
65-74
75-84
>85
White
86.2
221.7
483.8
1456.9
3396.0
Black
130.9
340.1
704.9
1275.5
2656.7
Centers for Disease Control, Health Disparities and
Inequalities Report, 2011 (data from 2006)
Unhealthy air quality
Percent of Population Living in Areas with Air
Pollution Levels Exceeding EPA standards
Fine
Race/Ethnicity
Particulate
Ozone
White
9.7
32.0
Black
15.2
40.0
Asian
26.2
50.2
Amer Indian
8.2
18.6
Hispanic
26.6
48.4
Centers for Disease Control, Health Disparities and
Inequalities Report, 2011 (data from 2006-2009)
Inadequate Health Insurance
Percent, Aged 18-64 Without Health Insurance
White
Black
Hispanic
14.6
22.1
41.6
Nonpoor1
Near-poor2
Poor3
8.9
30.5
37.0
Income Level
1 > 3 times Federal Poverty Level (FPL)
2 1.0 – 2.9 times FPL
3 < FPL
Centers for Disease Control, Health Disparities and
Inequalities Report, 2011 (data from 2008
Study by Woolf et al in the American Journal of
Public Health (2008)…
• “…For 1991 to 2000, we contrasted the number
of lives saved by medical advances with the
number of deaths attributable to excess mortality
among African Americans. Medical advances
averted 176,633 deaths, but equalizing the
mortality rates of Whites and African Americans
would have averted 886,202 deaths. Achieving
equity may do more for health than perfecting
the technology of care.
Woolf, SH, et al. The Health Impact of Resolving Racial Disparities: An Analysis of US
Mortality Data Steven H. Woolf, MD, Am. J. Pub. Health, 2008.
Effects of War on Health and the
Environment
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Civilian casualties
Environmental destruction and contamination
Huge needs for care of returning veterans.
Effects on families and social health (PTSDs,
divorce, homelessness, drug addiction, suicide).
• Carbon “footprint” of military activities
• Depletion of funds needed for social progams.
“Every gun that is made, every warship launched,
every rocket fired signifies, in the final sense, a theft
from those who hunger and are not fed, those who
are cold and not clothed. This world in arms is not
spending money alone. It is spending the sweat of
its laborers, the genius of its scientists, the hopes of
its children. “
-- Dwight Eisenhower
34th President of the U.S.
5-star General
Supreme Commander of the Allied
Forces in Europe (WW II)
Social Justice – What Health Professionals
(and Students) Can Do…
• Work in underserved areas
• Work with professional and health advocacy
organizations.
• Advocate for government programs that
address health inequities.
• Promote social and economic justice in all
areas of society.
http://phsj.org/activism-and-education
Worked to outlaw child labor.
Worked for improvements in sewage
systems and food inspections.
Advocated for free medical care for
the poor.
Rudolph Virchow
1821 - 1902
German Physician, Scientist
Founder of Modern
Pathology
Identified Role of cells in
disease.
Considered a founder
of “Social Medicine” –
based on the idea that
health and disease
largely arise from social
conditions.
• “A physician is obligated to consider more
than a diseased organ, more even than the
whole man - he must view the man in his
world.”
• Harvey Cushing, MD (1869-1939), American
Neurosurgeon
• “Every article I wrote in those days, every speech
I made, is full of pleading for the recognition of
lead poisoning as a real and serious medical
problem. “
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Alice Hamilton, MD (1869- 1970)
Physician
Activist
Social Reformer
Some Organizations…
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Center for prisoner health and human rights
http://www.prisonerhealth.org/
Grassroots soccer
http://www.grassrootsoccer.org/
Doctors without borders
http://www.doctorswithoutborders.org/
Physicians for Social Responsibility
http://www.psr.org/
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IU-Kenya Partnership AMPATH
http://medicine.iupui.edu/kenya/
Hoosiers for a Commonsense Health Plan
http://www.hchp.info/
Illinois Physical Therapy Association
http://www.ipta.org/?SocialResponsibility
• Maquiladora Health and Safety Support Network
• http://mhssn.igc.org/
• The end
• Acknowledgement. Some material was
adapted from a slide show by Martin Donohoe
(see: http://phsj.org/biography/)