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Thursday, 22 March 2012

Health inequity – Time to stop blaming the victim; Lessons from Greece

For years we have accumulated the evidence linking inequity with excess disease burden. Recently there have been honest efforts to try to reduce these disparities.  There are some detractors that espouse the survival of the fittest and there are those that would blame those affected for making poor choices.

What if there was a natural experiment?  One that randomly plucked members of society and stripped them of their social status?  One that threw large numbers of persons into poverty?  One that undermined the social fabric that was designed to keep the society cohesive and tended to the vulnerable?

So it is with Greece.  Until about 2007 Greece was a shining example of a European Union member, GDP growth at a healthy 4% per year and many aspects of its society given as examples of what to do, rather than what not to do.  In just a few years this noble and ancient land has been crushed by the economic tide.   Citizens thrown into unemployment and social services cut deeper than a bone, supposedly so that the “nation” can survive.  

Not surprisingly, the first reports are coming forth of the health chaos that is developing.  Malaria has had resurgence, tuberculosis is up, HIV transmission is becoming problematic again as sex trade and drug use increase. Greeks suffering resurgence in disease.   As better data is generated, perhaps we should expect that further declines in health status will be noted.  Many who have been thrown into distress were previously successful persons who through no fault of their own other than living in Greece, have been thrust into a dire and challenging situation. 

Should this not be enough evidence of the fragility of our societies to changing health equity? 
And Greece is unlikely to be the only EU member to crumble.  It is merely the forerunner and natural experiment in unmasking the inequities.

Of course, perhaps our memories are not so good.  Similar health declining reports came out of the Soviet republics after Perestroika.  Places like the Ukraine suffered greatly in the post-Soviet  era until economies were stabilized – and that was during a time of good economic  growth internationally.  

And really, who is benefitting from ensuring that the Greek nation does not default?  Is this not a question of following the money? And the trail likely ends at foreign investment firms who have lent from their deep pockets with reasonable knowledge of the risk.   Domestic investors have already had their savings bonds paid out at a fraction of their value as part of the required economic salvation package, this approach to devaluation was the typical approach when government funds became scarce and one should ask why is this not the route being taken to cope with the economic collapse?  

Just as with the banking industry bailouts, the damage is being shared amongst those that were not involved in taking the risk. Those who knowingly took the risks are not the ones on the street seeking a handout for their next meal. 

They are too often the ones who have spoken up to chide the very victims of social inequity. Perhaps it is time to blame the perpetrator and not the victim.  

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