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Friday, 7 September 2012

More health care doesn’t mean better health – an actuarial view that might stimulate change

For those in public health the Globe and Mail editorial is old news.  For something that is old news, it appears to be taking fire.

Wealthy people are healthier, and poorer people are sicker. Anyone who has visited this site enough will find the recurring theme of inequity in health.  Scan through the older posting, including what happens when economies fail and wealthy people become poor people.  Health inequities  - stop blaming the victim

Of course, it takes an actuary to write a piece that spending more money on health care actually won’t necessarily improve health – it has a high probability of making us less healthy.   It is a short piece, but based on the number of references circulating in the twitterverse and blogosphere, it would appear to be a revelation of astronomical proportions.   More health care - globe and mail.   

Dig a bit deeper, and the debates in the comments on the editorial are more entertaining and more likely to tweak a few nerves on those with either left or right leaning tendencies.  The debate itself and the diversity of ideologies reflect some of the real challenges faced by public health professionals in changing the current care dominated culture.

A dedicated reader forwarded a relevant study that even more clearly demonstrates how people’s pre-existing ideologies result in diametrically opposed reactions to the same information.  The study in case is a review of responses to social media based on US political alignment – which is about as polarizing an example as the world currently has to offer.   APHA Social media and communications

Just as we know that changing individual health behaviours often requires progression through steps such as the transtheoritical model of change, some evidence supports that community decision making on health supporting actions like smoking control bylaws go through similar steps.  

Likewise why would we not expect populations to also need to go through such steps.   Who better to take the social discourse from one of pre-contemplative acknowledgement that we have a health inequity problem, into one of contemplation that a member of the financial community speaking out that action is needed.  Thank you Mr. Brown.  

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