Advocacy For Improvement In Community Health

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.

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