Can’t remember the last time I disagreed with Iona Heath and in this week’s BMJ she’s written an article which, yet again, I fully agree with. She’s writing about the connection between respect and health.
The evidence that poverty undermines health is now overwhelming, and the task for every member of any society worthy of the name is to transform that knowledge into some form of redress. Each of the dimensions of poverty—low income, inadequate education, unemployment, poor housing, social isolation, and even the carrying of knives—have a common core, which is the attrition of hope, opportunity, dignity, and respect. All four are intimately related, and the erosion of one damages each of the others.
If we are serious about trying to improve the health of the population we need to shift our focus from a disease-driven agenda to a health-driven one and that will require us to tackle inequalities. As Dr Heath says, the link between poverty and ill health is well proven and it is totally unreasonable to expect doctors to improve the health of the population by trying to ameliorate the effects of the diseases caused by inequality.
She’s also right when she concludes –
Respect means facing the reality and the effects of inequality and injustice, both within society as a whole and within the health service, rather than believing that they can simply be managed away.
The problems of ill health cannot be managed away. The solutions don’t lie in more drugs, faster operations or “health service reform”. They lie in rediscovering that health is an individual human experience and by a focus on “hope, opportunity, dignity and respect”.
Heroes Not Zombies 
Leave a comment