No sooner had I finished reading my colleague’s blog about taking a global view of health, than I found myself reading Jocalyn Clark’s analysis, which questions where the efforts for solutions to global health issues should be focussed. She states her case clearly: good health is interlinked with the economy and the “medicalisation of global health problems reinforces short term thinking.” She worries that the solutions to three global health concerns—mental health, non-communicable disease, and universal health coverage—are “tilted in favour of biomedical and technical definitions” to the detriment of social and political considerations.
Gavin Yamey responds, arguing that there is a place for both a “horizontal” and “vertical” delivery of strategy in healthcare, citing Mexico’s “diagonal approach” to reduce child mortality as an example. He also stresses the importance of innovation contributing to improved health outcomes, highlighting that countries which embrace technology promptly can see an “additional 2% per year decline in their child mortality rate.”
As we’re moving toward a general election in the UK, health will no doubt come to the front of the public consciousness. If the recent referendum in Scotland is anything to go by, people want to be well informed—and most importantly involved—in decisions that affect them.
Margaret McCartney, a GP from Glasgow, wants Scotland to “make Britain better” despite the divide in opinion on independence. She takes pride in the high turnout of voters, and wants the “shamefully wide differences in life expectancy across Glasgow” to motivate us “to narrow the income gap and tackle social inequalities.” So is this potentially a time to really engage people with health policy and shaping the future of the NHS?
As the political party conferences begin, health is already high in the priorities. As Adrian O’Dowd reported from the Labour Party conference, Ed Miliband has promised an increase in nurses, midwives, and care workers by 2020 if Labour are elected. It will be important to hear the ideas of the other parties, and it is possibly a time for the public, politicians, and healthcare professionals to think outside the constraints of health being delivered in a hospital or GP practice, and consider the wider implications of health on the population.
In the UK, policies such as HPV vaccination for boys in addition to girls are currently being debated. Globally, there is the ongoing Ebola outbreak, which current predictions suggest will affect 1.4 million people in Liberia and Sierra Leone by January. At a time when global health comes to the fore, I feel it is important to widen the view of what constitutes health and engage people to shape the service for everyone’s benefit.
Emma Parish is editorial registrar, The BMJ.