Archive for December, 2006

Advocacy For Improvement In Community Health

Wednesday, December 6th, 2006

There is a short story called The Lottery that is a metaphor for our local community health care system. In this story members of a small town assign death by stoning to a randomly chosen citizen. The game becomes accepted annual tradition in the town. Although the townspeople appear saddened at losing their family members and neighbors, they never question the morality of a game that gambles with human life.

Our community health system in which sales, profits, convenience, and productivity are placed above healthcare seems like this fictional short story. Patients and health professionals suffer under the system because they are powerless to change what is seen as the destructive health habits of individuals.

We know that improvements in our healthcare system stem from a broader understanding of the economic, social, and environmental factors that determine health. We can change the system by working in our own communities to identify and challenge policies that have profound affects on individual health. For example, there is evidence that social determinants of health, such as poverty, lack of education and school nutrition have a greater influence on health than individual risk behaviors. Considering this, it may be possible with knowledgeable leadership to eliminate some health risks altogether.

Physicians can play a significant role in disease prevention as community health advocates. Some are now involved in community health programs. Let us add more voices and labor to their cause. Let us become involved in influencing community health policy. We can identify and describe the local economic, social, and environmental determinants of health relevant to the Houston area. By organizing physicians around community health issues such as tobacco control, air pollution, food policy, or advertising to children, we can become a voice for change and influence the public policy that influences health.

Aidan Kavanagh, Benedictine Monk, wrote in answer to the question;

Wednesday, December 6th, 2006

..what a professor of liturgics did?

No one can teach wisdom, least of all I. But what I can do in my own field of liturgical scholarship is to engage my students in an environment of facts, method and perspective in which wisdom may be learned by us all. In this regard my peculiar field is rich. What we study, ultimately, is not texts but ways in which people from time out of mind have regularly come together to express those values that they have found to serve them best in their own struggle to survive. I shall never live forever if I cannot make it through tomorrow morning. The strategic end is born in the tactics with which it is pursued. Little things like salt, smells, oil, bread and wine, singing and seed, dancing, laughter and tears, bodies and babies, and even thoughts and words form the tactical fabric of survival with which a liturgical scholar must deal.

A quote from Thomas Merton’s, The Silent Life, published in 1957:

Wednesday, December 6th, 2006

“…in our desire to be `as gods’…we seek…a relative omnipotence: the power to have everything we desire, to demand that all of our wishes be satisfied and that we should never be frustrated or opposed. It is the need to have everyone else bow to our judgment and accept our declarations as law. It is the insatiable thirst for recognition of the excellence which we so desperately need to find in ourselves to avoid despair. This claim to omnipotence, our deepest secret and our inmost shame, is in fact the source of all our sorrows, all our unhappiness, all our dissatisfactions, all our mistakes and deceptions. It is a falsity which rots our mortal life in its very roots because it makes everything we do more or less a lie. Only the thoughts and actions which are free from contamination of this secret claim have any truth or nobility or value in them….

Those whom we agree, among ourselves, to call `sane’ are those who keep their personal claim to absolute perfection and omnipotence repressed and disguised under certain accepted mental symbols, and who only assert their claim in actions which are rendered acceptable by apparent outward harmlessness and social utility.

There are many acceptable and `sane’ ways of indulging one’s claims to divine power. One can be, for example, a proud and tyrannical parent — or a tearful and demanding martyr-parent. One can be a sadistic and overbearing boss, or a nagging perfectionist. One can be a clown, or a dare devil, or a libertine. One can be rigidly conventional, or blatantly unconventional; one can be a hermit or a demagogue. Some satisfy their desire for divinity by knowing everybody else’s business; others by judging their neighbor, or telling him what to do. One can even, alas, seek sanctity and religious perfection as an unconscious satisfaction of this deep, and hidden, impurity of soul which is man’s pride.”