People Can’t Make Healthy Choices Without Healthy Options
Image credit: HSANet.org
Today’s blog by Andrey Ostrovsky, Coordinator of the HSAN Student Section and medical student at Boston University, explores the important role of students in health systems strengthening around the world
All I see around me are experts that have been researching health systems as a career, but the HSS movement is lacking the creativity and enthusiasm of students
With only a year of clinical experience under my belt, I’m already frustrated with treating chronic disease only to have the patient readmitted a few months later with the same problems. As a physician (in-training), I recognize the value of alleviating suffering on an individual basis. But what about preventing the situation that caused the problem in the first place?
I’m not even referring to preventative medicine through education, prophylaxis, or behavior change. Informing my diabetic patient about the value of exercise and healthy eating has its value. But he can’t make healthy choices without having healthy options. In other words, my patient with diabetes can’t choose to exercise if there is no option of safe parks to walk in. He can’t choose to eat healthy if there is no option of nearby fresh-food stores. Don’t take my word for it; listen to the experts: in a cross-sectional analysis of the OECD (developed) countries, the data “strongly suggest that environmental factors […] are more important than medical inputs in explaining variations in premature mortality.”1 The role of environment is even more pervasive in developing countries.
What if I could get the police department to scale-up surveillance to make it safe for my patient to go into the park? What if I could influence local tax codes to provide financial incentives for grocery stores to open in underserved areas?
During interviews with my diabetic patient, I often find myself thinking about these questions when I should instead be focusing on asking him whether he can feel his toes. In searching for a way to channel my “big-picture” inquiries, I stumbled upon the nebulous concept of health system strengthening (HSS). The more I learned about HSS, the more I was enthralled. Through several years of networking, I found a group of experts in HSS that shared my interest and showed me ways to impact health by influencing the system.
Now that I’m hooked into the system, all I see around me are experts that have been researching health systems as a career. But the HSS movement is lacking the creativity and enthusiasm of students. To try to fill that gap, I’ve helped to create a platform where students can learn about and contribute to HSS.
I hope the student section of the Health Systems Action Network (HSAN) can be a useful resource for those of you interested in the “big picture” of health (http://hsanet.org/pages/studentmain.aspx). And, I hope that we as students can find novel HSS approaches to give our patients healthy options for healthy choices.
Reference:
1) Or, Zeynep. Determinants of Health Outcomes in Industrialized Countries: A Pooled, Cross-country, Time-series Analysis. 2000. OECD Economic Studies: 30(1).