Can health be a political commitment?

Absolutely....

although there hasn’t been much discussion focused on the repair of our “ailing national spirit” as a core component of our work as public health professionals. However, as Virchow once stated, “medicine is a social science, and politics is nothing but medicine on a grand scale.” It makes tremendous sense to view health in this manner; not only as a quality to be measured at either the individual or the population level, but as an essential component of our national philosophy and identity.

As public health professionals, we have the opportunity to effect change at many levels within our society, regardless of our scope of practice. As clinicians, we have the capacity to improve the lives of individuals suffering from physical, emotional or mental illness. We may also be able to reach across disciplines, educating providers and promoting community education. Beyond that, some public health professionals can foster coalitions, form networks, and work to change organizational practices at the corporate, city, county, state or federal level. Ultimately, the mobilization of communities in this manner can influence policy at county, state and federal levels of governance. Using this framework, it is easy to see how a focus on health policy can inspire and promote change.

If we accept that a focus on health is a central component of U.S. diplomacy that can bring resolution to long-standing international conflict, as is advocated by institutions like the UCSF Institute for Global Health (IGH), can we also accept the challenge to employ this approach in order to bring resolution to long-standing national strife? If health inequities can destabilize a region of the world, can they not also destabilize a city, a county, or a state?

I believe that diplomacy, focused on the health of the people in countries with whom we collaborate, can be a highly effective lever to improve international relations. However, I question why we do not think to employ such an approach here, within our own borders. We have already seen the evidence that health status is not equal across every population in the United States, and that level of income and educational attainment underlie existing health disparities.[1] It therefore may be reasonable to ask whether our national society would be greatly improved if we as public health professionals focused our attention beyond the health of populations with whom we work. If we focused our efforts on national diplomacy as a core component of our work in public health, might we see greater improvement in the population health? Such an approach may be just as important for our national security as for our international reputation.

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[1] McGinnis J.M., Williams-Russo P., and Knickman J.R. 2002. The case for more active policy attention to health promotion. Health Affairs. 21(March/April): 78-93.