I recently came across this article, published last summer in the New York Times, about a program, Health Leads, that seeks to promote health by helping medical practitioners attend to the underlying social causes of illness:
The author states, “The health care system remains senselessly disconnected from the ‘social determinants of health.’ In this regard, the United States has fallen behind the rest of the world. If a politician in India announced a public health plan that neglected malnutrition, he would be ridiculed. Here, leaders make this kind of omission all the time. Almost all of the debate about the 2010 Affordable Care Act was consumed with questions about health care access and quality. But if we really want to improve the health of millions of people, we have to address the conditions that make them sick.”
What an intriguing idea: the conditions of health or lack of health.
Among the conditions addressed by this program: lack of nutritionally adequate food, insufficient heating in the winter, dilapidated housing, toxic housing materials, lack of transportation to medical facilities or grocery stores, language barriers. Volunteers help doctors “prescribe” ways to obtain more and better food, get the heat turned on, find transportation to a health provider or a store, get access to legal help to push a landlord to clean up a dangerous housing situation, find a translator.
The basic premise of this article is that lack of health has social causes. We cannot effectively promote health without attention to these causes, which typically extend beyond the reach – the expertise, time, and resources – of medical practitioners.
The solution suggested by Health Leads, an organization staffed by qualified volunteers that integrates into existing health clinics, not coincidentally, is social in nature. To solve socially caused health problems, we need a health care system that is more integrated, addresses the social aspects of medicine, and relies on a network of social groups to help bring about the basic conditions required to promote healthy lives. This is a remarkable framework for health care, because it contextualizes the ill individual in a social world that contributes to the possibilities of health or lack thereof. The causes of illness cannot be isolated within the body of the individual. Neither can health. In both cases, the individual body exists within a varied, extended web that includes social and economic circumstances and their material effects.
Sociality. A fundamental, underlying structural element of health?