Health Policy Approaches To Population Health: The Limits Of Medicalization
ABSTRACT Because of a strong tendency to "medicalize" health status problems and to assume that their primary solution involves medical care, policymakers often focus on increased financial and geographic access to personal health services in policies aimed at populations that are vulnerable to poor health. This approach has produced real public health gains, but it has neglected key social and economic causes of health vulnerability and disparities. Although access to care is a necessary component of population health, concerted policy action in income security, education, housing, nutrition/food security, and the environment is also critical in efforts to improve health among socially disadvantaged populations.
- SourceAvailable from: Hui Zheng
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- "Over the past 50 years, medical explanations have become increasingly dominant in discourses on health, illness and other human problems and behavior. The medical model of health and illness tends to marginalize social origins of disease (Waitzkin and Britt, 1989) and ''define[s] health problems as the result of individual failures of biology, hygiene, and behavior, with the implicit or explicit belief that the primary strategy for addressing these problems is through biomedical treatments delivered to individuals by physicians and other providers'' (Lantz et al., 2007: 1254). As this perspective won legitimacy, it fueled the growth of three major components of the health care system: investment in medical infrastructure; the size and specialization of the medical workforce; and the pharmaceutical industry. "
ABSTRACT: In the past 50years, the field of medicine has expanded dramatically in many Western societies. Despite substantial improvements in objective health measures, there has not been a commensurate increase in assessments of subjective health. We hypothesize that medical expansion may lower people's subjective health perceptions, leading to an increase in health care utilization, and, in turn, fueling further medical expansion. We use OECD (Organization for Economic Co-operation and Development) Health Data, World Development Indicators, the World Values Survey, and the European Values Study to fit a difference-in-differences model that removes unobserved cross-national heterogeneity and any period trend that is shared across nations. We find that three dimensions of medical expansion at the societal level (medical investment, medical professionalization/specialization, and an expanded pharmaceutical industry) negatively affect individual subjective health. These findings are robust to different model specifications. We conclude by discussing possible explanations for the adverse effect of medical expansion on subjective health, and how this effect may be related to other mechanisms through which medicine expands. Copyright © 2015 Elsevier Inc. All rights reserved.Social Science Research 01/2015; 52. DOI:10.1016/j.ssresearch.2015.01.006 · 1.27 Impact Factor
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- "Therefore, the client’s mental health would be ignored. Health related literature has identified this challenge as “medicalization”. "
ABSTRACT: Nurses and other members of health care team provide mental patients with health services through interprofessional collaboration which is a main strategy to improve health services. Nevertheless, many difficulties are evidently influencing interprofessional collaboration in Iranian context. This paper presented the results of a study aimed to explore the context. A qualitative study was conducted using in-depth interviews to collect data from 20 health professionals and 4 clients or their family members who were selected purposefully from the health centers affiliated with Isfahan University of Medical Sciences. Themes were identified using latent qualitative content analysis. Trustworthiness of the study was supported considering auditability, neutrality, consistency and transferability. The study lasted from 2010 to 2011. Some important challenges were identified as protecting professional territory, medical oriented approach and teamwork deficits. They were all under a main theme emphasizing professionals' divergent views. It could shed insight into underlying causes of collaboration gaps among nurses and other health professionals. The three introduced themes implied difficulties mainly related to divergences among health professionals. Moreover, the difficulties revealed the need for training chiefly to improve their convergent shared views and approaches. Therefore, it is worthwhile to suggest interprofessional education for nurses and other professionals with special attention to improving interpersonal skills as well as mental health need-based services.Iranian journal of nursing and midwifery research 02/2012; 17(2 Suppl 1):S171-7.
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- "The perceived scandal of Hurricane Katrina, Hemenway (2010: 1657) observes, was less the lack of " preventive measures (e.g., stronger levees) that would have averted the calamity and more the inadequate rescue efforts. " Many historical and cultural forces are behind the contemporary focus on medical care as the primary means to population health improvement (Lantz, Lichtenstein, and Pollack 2007). But the force of the " rescue principle " is clear: psychologically and emotionally, helping individual victims is much more compelling than preventing the tragedies and crises that produce them. "
ABSTRACT: Why is it so politically difficult to obtain government investment in public health initiatives that are aimed at addressing chronic disease? This article examines the structural disadvantage faced by those who advocate for public health policies and practices to reduce chronic disease related to people's unhealthy lifestyles and physical environments. It identifies common features that make it difficult to establish and maintain initiatives to prevent or reduce costly illness and physical suffering: (1) public health benefits are generally dispersed and delayed; (2) benefactors of public health are generally unknown and taken for granted; (3) the costs of many public health initiatives are concentrated and generate opposition from those who would pay them; and (4) public health often clashes with moral values or social norms. The article concludes by discussing the importance of a new paradigm, "health in all policies," that targets the enormous health and economic burdens associated with chronic conditions and asserts a need for new policies, practices, and participation beyond the confines of traditional public health agencies and services.Journal of Health Politics Policy and Law 12/2011; 37(2):181-200. DOI:10.1215/03616878-1538593 · 1.37 Impact Factor