How should we make decisions in public health and who should be held responsible? Is it the individual or the society who is responsible for own their health? A person is responsible for their health to a certain extent. The doctor can only tell you so much and supply you with resources to aid you in the process. For example, if someone has a smoking habit, and they’re health is in cardiovascular danger. If the doctor has given them sources to help them, but they are not receptive to the treatment then they should be held responsible. Our society is made up of individuals, some who take care of their health and some who don’t. Public health focuses on the society as a whole.
One of the main issues in public health is that they are trying to fix issues quickly and directly. Sometimes in our society we wait on things to get bad, and then we want to fix it instead of increasing primary prevention. For example, “How can you expect me to be healthy if I can’t afford it?”. According to the Brody and Englehardt article, some third world countries are misguided in that they allot more financial aid for improving health as opposed to allocating money to the accumulation of the capitol. In my opinion, when money is given to the health fund, it is a more direct approach, but sometimes a different strategy is needed. As stated in the article, setting money aside for the capitol will help people get jobs and more money, which will increase health. This is a more indirect approach and may take a longer time to be effective, but I feel as though in the long run this may be the most impactful approach.
However, one can never be too sure on which approach to take, because some situations call for different approaches. Although, when one approach fails, the government should try to switch to an alternate method. The best method should be to attack the issues before they even fully develop into major problems. This method may seem unrealistic for issues that are unforeseeable and may contribute unforeseeable consequences. However, even if an issue is just beginning something can still be done to prevent the particular issue getting worse. For example in the article by Brody and Englehardt, it is stated that we would rather spend $100,000 on rescuing people from a trapped mine as opposed to investing in mine safety. Instead of letting a mine get to the point where it collapses, we should set money aside to help the damages in the mine before it gets out of hand.
When trying to fix the issues we also must think about who’s in power to fix these issues. The government has most of the power of where to distribute funds. They are the ones that decide which type of approach should be taken. According to the WHO website, there are 4 steps that need to be done to properly execute the public health approach: 1) Surveillance 2) Identify risk and protective factors 3) Develop and evaluate interventions 4) Implementation. These are good guidelines to follow, but we must be sure to execute each step in a cost effective and timely manner.
REFERENCES
Brody and Engelhard. “Preventative Medicine,” Bioethics: Readings and Cases
http://www.who.int/violenceprevention/approach/public_health/en/
http://healthyamericans.org/public-health-funding/
You make an interesting point about how public health crises can be addressed as they arise or in a preventative manner. Unfortunately, it is hard to concentrate on the future when there is the distraction of the present. We will always want to fix today’s problems first and tomorrow’s problems later because it seems more rational and hard to free up current resources in order to prevent futuristic problems. The issue is that we often think that once we can solve a current health problem, we can then concentrate on preventative measures; however, after solving the current problem, there is another immediate health problem that we need to attend to. We then act too late to prevent future health risks, and they eventually become yet another current problem that needs to be fixed immediately. It is a vicious cycle that, as you have stated, will take a huge effort to break.
I completely agree that there is a fine line in determining how to best deal with health. While we want to say that we will focus on issues before they happen, solve the problems early on – we cannot always guarantee that this is the case. Quite honestly it can even be impossible to know when this will be the case. However, I disagree with one point of the blog post:
Public health is trying to fix issues too quickly and directly: I disagree with the implication of this statement, that this method is a poor choice. While public health measures may try to address a problem in a direct way for many situations this is often the best method. Putting capital into a country can many times begin to build a healthcare system from the bottom up but without the public health knowledge, programs and basic health information the health of the nation will not improve for an extended about of time.
I completely agree with your point that it is almost impossible to know the balance. When can you tell which method is better? However, I do not think we can disregard the effects and positive outcomes that public health can have.
All accountable to some degree of public health- harm to population by smoking for example outweighs the benefit for one individual. That is why I agree with Emory’s efforts to ban smoking. At the same time however, there should be some available location where the smoker has access to exercise their right to smoke without hurting others.
I believe Geovonni’s point is best illuminating on the obstacle of those interested in public health- even those with good intentions, good ideas, and even efficient methods face administrative setbacks. But even after those, which are possibly solvable through policy reform, comes the obstacle that the intuition of problem solving helps immediate health threats first, and future ones as they come. The real solution that honors efficacy is one that prevents disease, not treats it. I believe we must jump at the first opportunity that comes where we are able to treat current problems and have enough resources to pour into preventative care. If this does not seem to come on its own, distribution of resources must be reevaluated manually.
Everyone living in a country has a right to health. This does not mean they have a right to be healthy but that a country must create conditions that allow everyone to be as healthy as possible. With is in mind, a developing country should focus their public health improvement funds on creating an environment as stated above. Respecting one’s right to health should be a top priority for any country. Rather than focusing totally on capitol, I think it’s important that these conditions for health are generated to maintain a population that can help a country grow successfully.
I think your argument brought up several important points. I definitely think it is necessary to implement prevention rather than allow for procrastination in health issues. Many people wait until the last minute to address a problem because laziness is characteristic of our society. Since health procrastination is more costly and dangerous than prevention is, it seems irrational for someone to wait until the last minute. However, prevention looks much more approachable in individual terms than in global terms.
When it comes to the government trying to improve the nation’s health, prevention as you stated sometimes seems impossible especially when issues are unforeseeable. I like your proposal of allocating more funds to increase jobs instead of directly putting money in a healthcare fund. The only downside to this is that we cannot guarantee that more jobs will cause the economically less fortunate to spend their money in a way that benefits their health. Sometimes people have questionable priorities or simply do not care about their health. In general, there is no specific action that the government can take in order to immediately improve national health, however; allocating funds to jobs and promoting prevention possibly through forms of media are definitely wise first steps.
I think a person should be held accountable for their own health. The smoking example is a great reason why one should take responsibility of their own health. If a person makes a conscious decision to do something detrimental to their health, it is their responsibility to suffer the consequences. I also agree that indirect approaches, such as preventative health, are much more effective and should be put into action. I think a lot of people have difficulty investing in the future when there are so many problems and health crises in the present that need to be addressed.
The only way to change people’s minds about public health is to shift culture’s perspective and approach to health in general. Health is much more than physical wellbeing. It is the food we eat, the relationships around us, and even our outlook on the world. Public health should not only focus on basic preventative measures, but also the many other factors that influence a person’s wellbeing. Policies that promote exercise and healthy eating habits in younger populations would most likely have the greatest success in changing the public’s mind about wellbeing. Over time, these fundamentals would be passed on to new generations. Preventative medicine is an encompassing issue that effects much more than just washing your hands.
Your post reminded me of the distinction between vertical and horizontal approaches used in global health. Each of these types of interventions have their benefits and place within health system, but ultimately, vertical interventions have the greatest impact in the longterm. These interventions may focus on a specific aspect of health, but mostly, these interventions deal with the determinants of health such as food quality, money, water, infastructure, safety, housing, etc. These types of interventions such as job creation or improving road ways have in direct benefits on health, that may end of saving more life than a health-oriented intervention. These vertical approaches tend to not only improve health an safety, but they also can improve the livlihood of people. For example, job creation: people have more money, they can spend money to keep themselves healthy and also spend money on pleasurable things. Thus, vertical interventions have the ability to improve quality of life beyond health, to other aspects of life and well being. Evaluating which type of intervention or health policy to put in place takes maturity and wisdom to look at the bigger longterm picture, rather than honing in on short term outcomes.
The society is more inclined to solve the problems when they are really bad, but the society often neglects the emerging problems. People feel like the money they pay is more directly used. However, what they didn’t really consider is cost effective. Preventative medicine can actually be more cost effective if the money is wisely used. For example, the small pox was eradicated due to the development of the vaccines. Today, people no longer have to deal with any problems such as death and the spread of the disease. Most importantly it provides lifelong protection and even herd immunity. In the beginning preventative medicine may seem ineffective because of the money used to research, but once there’s a solution, it is way more cost effective than any other measures to try curing the disease.
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