Investing in Lives

Healthcare, like many “public” services, is not equally available to everyone. It is true that there is some degree healthcare available to the population at large, but, due to the private sector, the quality is vastly different between groups. There are many things that factor in to the availability of quality healthcare. Things such as income, race, ethnicity, gender, age and others all play in to the healthcare a person receives. A complete list is covered in a report on health disparities published by the CDC  ( These factors ultimately come down to income and demographics. Preventive medicine deserves a larger amount of funding. If everyone does not have the same opportunity to protect their health, then should they be placed with the total responsibility of their own preventative medicine?

Education is a public service, but you can pay for better education; a higher level of learning to obtain a higher standard of living. Health care is also public, but again private healthcare is where the highest quality of care is generally found. Not because doctors are better, but because there are more resources and fewer patients. Preventative healthcare is no different in its access. There are many forms of public “prevention” that we may not even be aware of. Regulation of water, food, and air are a few things that prevent us from getting sick. For the US, these are the lowest level of prevention services provided. Beyond those things, availability of health prevention is not equal. In his argument Preventive Medicine, Brody states that “preventive medicine is most easily amenable to equal distribution”. At a basic level this is true, but to a greater extant preventative medicine is not equal.

One of the salient aspects in prevention is diet. It also happens to be one of the largest contributors to the prevalence of many chronic diseases in the US (WHO). Things such as food deserts and the limited influence and quantity of food stamps are directly related to income. When a family has a limited budget, and a bag of chips is cheaper then an apple, junk food trumps nutrition. Diet is an example of prevention that is not equal.

Like Brody mentions in Preventive Medicine, as a society we are more likely to fund life saving procedures then to invest in projects that will save lives before they are at risk. Nobody wants to pay you to keep them from getting sick. However, the cost of prevention is much less. Vaccines are a perfect example of how a small amount of money can save more lives if it is invested before those lives need to be saved.

With this information—of the cost benefits of acting early on health prevention and the disparity that currently exists in the US—can we raise the level of “basic” preventive medicine? Is it ethical that some people have the capacity to “protect” their own health through diet and other means, and others fall short? Why shouldn’t there be a larger public investment in preventative medicine, so that it may influence a larger population, ultimately saving money down the road?


WHO website

CDC Health Disparities & Inequalities Report (CHDIR)—Morbidity and Mortality Weekly Report (MMWR)


Book Title: Bioethics: Readings and Cases. 298-301. Prentice-Hall.1987

ISBN: 0130765228

8 thoughts on “Investing in Lives

  1. To further the discussion about your comment on raising the level of “basic” preventive medicine, I would like to bring up the topic of predictive health which is an upcoming area of study and is actually offered as a minor at Emory University. This model is similar to preventive health as both reject the idea of a reactionary approach to disease. In fact, in the context of predictive health, the disease and its progression is considered a major disappointment in the healthcare. Another advantage of this model is that it sees health as something we should maintain and take care of and therefore, anything that may cause disease in the future should be taken care of as soon as possible. The idea is to eliminate the risk factors for diseases, before the disease attacks the person. For example, genetic screening, when used as a predictive tool, can help detect if someone has a higher risk of acquiring certain disease. One such genetic test is an early detection of harmful mutation in BRCA1 and BRCA2 genes in women which can cause breast and ovarian cancer. If detected early enough, certain remedies can decrease the risk of cancer in these women. I really think that predictive model will soon rule the health world as it is considered cost effective in a long run. Especially, paying money to treat the underlying causes of disease (approximately $500- $4000 for genetic testing for BRCA1 and BRCA2 mutation) is much cheaper than treating the actual disease (approximately $20,000 to $100,000 thousands per Campbell and Ramsey 2009) once it has affected the body.

  2. I am definitely aware of the many issues that are occurring in society today that deal with unhealthy diets. It is even more sad these these diets are unhealthy and gluttonous while many, many, people are suffering with a lack of food and daily sustenance. I believe that there should be something done even earlier than trying to prevent unhealthy diets in the developed countries. I believe that the introduction of healthy foods, and also the redistribution of these foods will help to make more of society able to obtain enough healthy food to feed the family. Through this process, public health will be able to simultaneously reach those poorer families and countries by finding ways to provide them with sustenance, and also will help the more developed nations in regulating the amount of food they take, in order to ensure that they can move to healthier living. Through these initiatives taken on by both physicians and public health advocates, there will certainly be an decrease in diseases and illnesses.

  3. It is indeed sad that not everyone has the access of preventative medicine. Even the simplest thing – diet. Poorer families may only afford the junk food with low nutrition, even though they know that it is unhealthy for them. But what can poor people and health care do? Preventive medicine is to prevent disease from occurring. In order to do that, it’s not just about the technologies such as mapping the genes and vaccination but also has to consider the social aspects. For example, poor people may know the knowledge on healthy diet, but they just couldn’t afford to buy nutritional food. In order to prevent from diseases from occurring due to nutrition, people have to somehow solve the poverty issue, which is really hard.

  4. Though you mentioned that preventative medicine is not equal among societal groups and different ethnicities, I think you brushed over the concept too easily. This is the main issue. Preventative medicine is not one umbrella that covers the entire country, because it varies depending on the demographics and incomes of people. Those who are less fortunate and cannot afford preventative medicine like vaccines, do not have the same access to health care as someone who can afford these vaccines. The problem is that the country is almost divided into those who can afford health care and those who can’t. In this case, there are also those who are able to participate in this preventative medicine and those that can’t. For example, another part of preventative medicine is sanitation. There are many people in this country who do not have access to clean, running water, so as it is, they are a step behind those who do have these sanitary advantages in the steps towards preventative medicine. Bottom line, the fact that people cannot afford to engage in preventative medicine is not allowing us to reach the goal of public health that we want to reach.

  5. Sabrina, I agree- preventative medicine is very related to social inequality and it should be considered a major issue. However, preventative medicine is definitely not in the forefront of everyone’s mind- even in people that earn a middle or high income. This is the center of the healthcare problem in our country. We wait til the problem gets really, really bad and we have to treat it with expensive care that could have been avoided with a preventative measure. Like we mentioned in class, it is very difficult to set aside $5 a week for the rest of your life though you can end up with thousands in savings.The same goes with health- it is difficult to prevent a problem that progresses slowly over time and doesn’t become a problem until much later. Why eat healthy now if I enjoy eating fried greasy foods in the moment? Especially if you are living paycheck to paycheck, how can you possibly make healthy (read: expensive) meals a priority?

  6. I find it insightful that the CDC itself is aware and makes the public aware of health disparities. I also find interesting your articulation of the issue in terms of responsibility – “If everyone does not have the same opportunity to protect their health, then should they be placed with the total responsibility of their own preventative medicine?”. I agree that with an unequal foundation it should not be expected that the outcomes be considered fair! I find it interesting that the structure reveals deeper and deeper levels- health outcomes due to income and demographics mostly, and that due to diet mostly. But then, who is at fault for that? I can not help but say the government, for backing the subsidized foods that are making those who are vulnerable sicker, and by vulnerable I am referring to the people that did not get a fair start in the race to health!

  7. Georgia–I also focused on the statement about responsibility. The responsibility debate may never reach conclusion, but based on the ways theta our current healthcare system is moving, the government has to bear some of the responsibility. Since the passing of the Affordable Care act and the growing governmental involvement in the nations health, there needs to be some level of responsibility in the hands of the government. I think this form of responsibility comes in the form of accessibility and affordability. Preventative interventions need to first focus on making preventative materials, wether that be food options or information, are readily available, accessible, and affordable to all–especially marginalized members of society. I think as our nation begins to think of health options for all, accessibility and affordability need to be at the forefront of conversation. Then if the government bears this responsibility, then the final choice is in the hands of individual.

  8. While I do agree strongly that there should be a larger public investment in preventive medicine, I believe that it is often difficult to get the public to oblige with these investments. The medical model that has existed for years is one in which the body is viewed as a machine, to be fixed when broken. Although we have made tremendous progress in interdisciplinary medicine and straying away from this approach, the public is still fixated on the now. Consider if you were given the option to invest your tax money in cancer research and treatment or in bettering nutrition programs in public school. I believe that many people would choose to invest their money in cancer research and treatment, as it funds a current, widespread health challenge. However, as Ella mentioned, diet is actually one of the largest contributors to the prevalence of many chronic diseases in the US. Therefore, programs that improve diet of public school children may have an impact as beneficial, or even more beneficial than cancer research and treatment, on public health. Preventive health decisions encourage individuals to delve deeper into health challenges, and not just examine these challenges at face value.

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