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Activism 101 Public Health and Social Justice Martin Donohoe

Activism 101 Public Health and Social Justice Martin Donohoe. Perspective. The earth spins at 1,038 mph at the equator, between 700 mph and 900 mph at mid-latitudes The earth rotates around sun at 18.5 miles/sec The solar system orbits the center of the Milky Way Galaxy at 137 miles/sec

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Activism 101 Public Health and Social Justice Martin Donohoe

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  1. Activism 101 Public Health and Social Justice Martin Donohoe

  2. Perspective • The earth spins at 1,038 mph at the equator, between 700 mph and 900 mph at mid-latitudes • The earth rotates around sun at 18.5 miles/sec • The solar system orbits the center of the Milky Way Galaxy at 137 miles/sec • One rotation per 225 million years

  3. Perspective • The sun is one of hundreds of billions of stars in the Milky Way Galaxy • The Milky Way is one of over one hundred billion galaxies in the known universe • The universe may be one of an infinite number of universes

  4. The Planets

  5. Our Solar System

  6. Stars in the Milky Way Galaxy

  7. Stars in the Milky Way Galaxy

  8. Our Home

  9. Earth/Moon Seen by Voyager Spacecraft through Saturn’s Rings

  10. Am I Stoned? A 1999 Utah anti-drug pamphlet warns: “Danger signs that your child may be smoking marijuana include excessive preoccupation with social causes, race relations, and environmental issues”

  11. Harvey Cushing “A physician is obligated to consider more than a diseased organ, more even than the whole man. He must view the man in his world.”

  12. Martin Luther King, Jr. “Injustice anywhere is a threat to justice everywhere”

  13. Important Historical Figures in Medicine/Public Health and Social Justice • Florence Nightingale • Clara Barton • Margaret Sanger • Thomas Hodgkin • Albert Schweitzer • Rachel Carson • Lois Gibbs

  14. Important Historical Figures in Medicine/Public Health and Social Justice • Charles Dickens • Anton Chekhov • Upton Sinclair • George Orwell • William Carlos Williams

  15. Important Historical Figures in Public Health and Social Justice Dr. Thomas Hodgkin (abolitionist and opponent of British oppression of native populations in South Africa and New Zealand) Nurse Margaret Sanger (founder of the family planning movement in the US) Dr. Albert Schweitzer (won Nobel Peace Prize in part for developing a missionary hospital for the poor in Gabon, Africa)

  16. Important Historical Figures in Public Health and Social Justice Florence Nightingale (feminist, founder of the modern nursing profession, and advocate for hygienic hospitals) Dr. Salvador Allende (assassinated president of Chile and promoter of better living conditions for the poor and working classes). *The quiet and unknown*

  17. Rudolph Virchow • Founder of modern pathology • Thrombosis, pulmonary embolism, leukocytosis, leukemia • Member of state and local government for over 30 years • Founded journal Medical Reform

  18. Rudolph Virchow • Argued that many diseases result from “the unequal distribution of civilization’s advantages” • Advocated public provision of medical care for the indigent • Promoted universal education

  19. Rudolph Virchow • Worked to outlaw child labor • Improved water distribution and sewage system • Enhanced food inspection process • Published study of skull volumes to dispute myth of larger Aryan brains

  20. Rudolph Virchow • Passed hygiene standards for public schools • Set new standards of training for nurses • Improved local hospital system

  21. Rudolph Virchow “Doctors are natural attorneys for the poor … If medicine is to really accomplish its great task, it must intervene in political and social life…”

  22. Premature Deaths in the U.S. • 10% due to inadequate medical care • 60% due to behaviors, social circumstances, and environmental exposures

  23. Social Factors Responsible for Illness and Death • Deaths in 2000 attributable to: • Low education: 245,000 • Racial segregation: 176,000 • Low social support: 162,000 • Individual-level poverty: 133,000 • AJPH 2011;101:1456-1465

  24. Social Factors Responsible for Illness and Death • Deaths in 2000 attributable to: • Income inequality: 119,000 (population-attributable mortality – 5.1%) • Area-level poverty: 39,000 (population-attributable mortality – 1.7%) • AJPH 2011;101:1456-1465

  25. Social Factors Responsible for Illness and Death • Deaths in 2000 attributable to: • AMI – 193,000 • CVD – 168,000 • Lung CA – 156,000 • AJPH 2011;101:1456-1465

  26. The Role of Literature • Vicarious experience • Explore diverse philosophies • Promotes empathy, critical thinking, flexibility, non-dogmatism, self-knowledge • Encourages creative thinking • Allows for group discussion/debate

  27. Why Study Literature? “Why live? Life without literature is reduced to penury. It expands you in every way. It illuminates what you’re doing. It shows you possibilities you haven’t thought of. It enables you to live the lives of other people…It broadens you, it makes you more human. It makes life more enjoyable.” M.H. Abrams

  28. U.S. Health Care • Per capita expenditure on health care = $9,255 • Typical poor African/Asian country = $5-50 • 42 million uninsured • 48,000 deaths/yr • After PPACA – 36 million uninsured • Health outcomes poor

  29. Headline from The Onion Uninsured Man Hopes His Symptoms Diagnosed This Week On House

  30. Race and Access to Care Ernest J Gaines “The Sky is Gray” in Gray, Marion Secundy, ed. Trials,Tribulations, and Celebrations: African American Perspectives on Health, Illness, Aging and Loss. Yarmouth, Maine: Intercultural Press, 1992

  31. Racial Disparities in Health Care:African-Americans • Higher maternal and infant mortality • Higher death rates for most diseases • Shorter life expectancies • Less health insurance • Undergo fewer diagnostic tests / therapeutic procedures

  32. Racial Disparities in Health Care:African-Americans • Equalizing the mortality rates of whites and African-Americans would have averted 686,202 deaths between 1991 and 2000 • Whereas medical advances averted 176,633 deaths • AJPH 2004;94:2078-2081

  33. Poverty George Orwell “How the Poor Die” In Sonia Orwell and Ian Angus, eds. The Collected Essays, Journalism and Letter of George Orwell, IV; In Front of Your Nose, 1945-1950. New York: Harcourt, Brace and World, Inc: pp.223-233.

  34. Jacob Riis

  35. Dorothea Lange

  36. Poverty and Inequality in the U.S. • 22% of children live in poverty • Food insecurity common • Gap between rich and poor widening, largest of any industrialized nation

  37. Poverty Worldwide • 1.1 billion people lack access to safe, clean drinking water • 2.6 billion do not have adequate sanitation services • Hunger kills 18,000 people per day, most under age 5

  38. James Nachtwey

  39. Maldistribution of Wealth • Richest 1% (net worth of $800,000+) owns 48% of the world’s wealth • Over 500 billionaires worldwide • Top 85 billionaires worth $1.7 trillion, the combined income of bottom 3.5 billion people (1/2 of world’s population)

  40. Maldistribution of Wealth • U.S: Richest 1% of the population owns 50% of the country’s wealth -poorest 90% own 30%-widest gap of any industrialized nation

  41. Overconsumption (“Affluenza”) • U.S. = 4.5% of world’s population • Owns 50% of the world’s wealth • U.S. responsible for: • 25% of world’s energy consumption • 33% of paper use • 72% of hazardous waste production

  42. Income Inequality Lower life expectancy Higher rates of infant and child mortality Short height Poor self-reported health AIDS

  43. Income Inequality Depression Mental Illness Obesity Crime Diminished trust in people and institutions (↓ social cohesion/happiness)

  44. Maldistribution of Wealth is Deadly • 880,000 deaths/yr in U.S. would be averted if the country had an income gap like many Western European nations, with their stronger social safety nets • BMJ 2009;339:b4471

  45. Education • Medical advances averted a maximum of 178,000 deaths between 1996 and 2002 • Correcting disparities in education-associated mortality would have save 1.3 million lives during the same period • AJPH 2007;97:679-83

  46. Benefits of Education • For every $1 spent on early childhood education, up to $17 are saved from increased school achievement, improved health, reduced crime, and reduced reliance on public assistance • Income increases 11% for every year of education

  47. Benefits of Education • College graduates live 5 years longer than high school dropouts • Eliminating educational inequities would have saved 8X as many lives as medical advances from 1996-2002

  48. Declaration of IndependenceThomas Jefferson “All men are created equal”

  49. Care for All Equally “A society should be judged not by how it treats its outstanding citizens, but by how it treats its criminals” -Fyodor Dostoyevsky

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