The choice between advocacy for long-run structural change versus implementing immediately remediable action that may fail to address underlying health determinants has been described as a choice between public health nihilism versus public health pragmatism.[i] Pragmatists emphasize immediate solutions to pressing public health problems such as education and behavioral modification strategies. Nihilists argue that these constitute band-aid solutions that fail to address the deeper, social and structural issues that give rise to health inequities such as economic and social inequalities in society.
Ideologically, it just makes sense. For Komen andPlanned Parenthood, women’s health is the priority. Funding the lifesaving care Planned Parenthood provides has always seemed like a “but of course” for Komen supporters. And yes, I may be biased a bit. But lest things seem muddier than they are, let me explain. I came to believe in the work of Planned Parenthood from a very logical examination of the work PP does as part of my own educational journey. It’s simply academic. There’s sound rational justification.
Folks – today is the 39th anniversary of Roe v. Wade. While the debates for the Republican Presidential primary continue to stoke the flames of dispute about the human right for universal healthcare, it’s time to pause and reflect on an important human right that was reaffirmed on this date, 39 years ago, in the historic ruling of Roe v. Wade – specifically the right to privacy regarding the medical decision whether or not to have an abortion. On January 22, 1973 the U.S. Supreme Court handed down its ruling in the landmark Roe v. Wade case. This historic ruling reiterated that individuals, not politicians, should have the right to make their own medical decisions – medical decisions are private decisions that should occur between the patient and doctor. More narrowly, the decision ensured that the right to privacy in the U.S. Constitution permits a woman to choose whether to continue…
The winter holiday season has arrived, and although Halloween is a bit more of a distant memory, I’m still chuckling at the display of anger and frustration exhibited by little munchkinsaround the US when their parents declared they had ostensibly eaten the candy of their little looters while they slept (Thanks, Jimmy Kimmel!). Little ones across the country were hollering in utter frustration when the unspoken rule of an American tradition – keeping one’s spoils after a hard night’s toil of “trick or treating” – appeared to have been broken. Folks – it’s rough to think we have had our candy stolen from us! This becomes abundantly clear in the war cries of stolen money sounded in the debates about our national debt – who has the money, who took it for their own purposes, who deserves it and for what purposes, etc.? Screams of violation reverberate across the country…
If someone offers you half of pie #1 or all of pie #2, the first thing you should ask is, “How big are the pies?” I don’t know when it started, but many Americans have forgotten to ask this question when they look at income inequality and the redistribution of wealth. The conventional wisdom is perhaps correct that wealth is now more concentrated, but that is relatively unimportant because the amount of wealth is not fixed. It is entirely possible for wealth to become more concentrated and for EVERYONE to be better off.
The national debt debate has uncovered a puzzling set of poor national priorities, where health access and equity for all doesn’t qualify as a need, but as a luxury that can be sacrificed in the name of balancing the budget. The debt crisis has forced us to think fundamentally about what the role of government is, because those essential tasks, those that are absolutely essential to our well being as people, cannot be sacrificed. What was supposed to be a discussion about how to make our government better equipped to act on behalf of its citizenry has descended into a debate for the sake of debate, as if there aren’t families who suffer when certain initiatives and programs are cut.
The neoliberal right has exploited the debt crisis, as it did the economic crisis, to further its agenda of retrenching the hard won health benefits of workers and the meek and apologetic left, only too happy to oblige, has shrunk from defending these rights. This tactic, described as the “the shock doctrine” by Naomi Klein in her New York Times best selling book, exploits public disorientation following collective shocks such as wars, terrorist attacks, or natural disasters to institute economic reforms that would ordinarily be too unpopular to pass democratically. Unfortunately, the neoliberal right is only too familiar with this thesis. Klein cites Milton Friedman, father of neoliberal economics, as saying, “only a crisis, actual or perceived, produces real change.” Worse still, the debt debate, as with the economic crisis, has reduced our choice set to two options: bad or worse. Either employees face mass lay-offs or they must accept…
By now, the facts of Tanya McDowell’s story are familiar to many in Connecticut and across the country– a mother wanting the best for her kindergarten-aged son, and a school district willing to charge the mother with a crime for illegally sending her son to a Norwalk school that clearly outperformed the options in Bridgeport, which was her last known residence. As awareness of the social determinants of health in the movement against health disparities are more recognized, education must be acknowledged as one of the most pivotal, and perhaps, the most actionable for policymakers and concerned communities wishing to change the trajectory of racial and ethnic health disparities.
Like my fellow contributors to Health Justice CT, I believe that racial and ethnic backgrounds have too much of an effect on health outcomes. Thedata in support of this belief is strong. Where I may disagree with my fellow contributors and others who care about this issue is how the problem is best solved. The best way to address racial and ethnic health disparities is through civil society, the institutions and relationships formed by the residents of Connecticut without the involvement of the state government. Unfortunately, many medical charities have stopped using their money to directly help people.Instead, they use the money they raise to lobby the government. Success at this gamble can turn thousands of dollars into millions.
The 20th century American theologian Reinhold Niebuhr once observed that “No man will ever be so intelligent as to see the needs of others as vividly as he recognizes his own . . .” This observations has been echoed in more recent descriptions of “empathy deficits,” which have been amplified by a political climate marked by growing selfishness, hostility, and personal animosity. Regardless of the characterization, the inability of our modern leaders to think beyond the next election has fueled a crippling shortsightedness that threatens the sustainability of public policies designed to foster shared security and prosperity.