I've been traveling a lot recently, both a faculty development workshop focusing on working with underserved communities and to the world conference of family doctors (WONCA) conference. As a result, I have a number of ideas bouncing around in my head as to how I can act to improve medical students' willingness and ability to provide care to marginalized communities but also how to work to provide care to all who need it--in the US and abroad. Realizing that my direct impact will never be as great as I might like, it's still necessary to keep trying.
As a result, I'm posting 2 links here that will probably influencing a lot of my thinking over the next few weeks:
--The first link shows the interplay of individual factors that affect health with social and community impacts and broader socioeconomic factors. Each circle/level is acted upon by the levels outside of it, meaning that one can never fully address the health of the individual without also addressing the broader societal factors that lead to poor health outcomes. How can we effectively target diabetes or high blood pressure when patients live in communities with poor access to nutritious foods, regular exercise, good education and jobs that provide for their individual and family health and well-being?
--This second link opens a table describing a new way to conceive of health care, as a social justice issue, not a market based issue. If we agree with this new description of health (which really doesn't seem new at all, but rather a return to essential precepts of health and health care), then it would call for significant changes in our health care system: more primary care, more wellness and preventive care, but also more action on the broader societal determinants of health referenced above.
2 thought-provoking ideas. I hope that they take hold, as I feel our patients, our nation, and our world will be better off if these became our standard-operating procedure.