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The Political Determinants of Health.doc

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Health Studies
Scott Sams

The Political Determinants of Health –Lecture 2 Monday Sep17, 2012 Purpose: To introduce the political dimensions of health and review the state of scholarship on it. How is health political?  Allocation of resources- the amount of money spent on health. Some people get more resources than others. Certain services get covered and not others. Who benefits from healthcare.  Shaped by action or inaction- social determinants of health are imendible to political. (governments can choose to do something about health issues or ignore them  Right to health?- UN says we have a right to good, health but good health is an act of citizenship  Embedded in wider economic, social & political system- power exercised over health, health is one art of how these three systems are structured. In order to change system you need an awareness. In order th change the system you will have political struggle. Way to change something is through politics  Evidence of political influence on health outcomes- evidence political variables have an impact of health outcomes. Why is there a paucity of literature on health politics? “Medicine is a social science and politics nothing but medicine on a grand scale” – Rudolf Virchow  Politics of health underdeveloped & marginalized- people don’t talk about it because  Result of: o Reduction of health to health care- media= healthcare( debates over privatization, the organization or delivery of health systems)-  Absence of disease  Health is commodity: economic • Specific to individual not society • Product your lifestyle • Individual factors such as genetics • Result of individuals failing to make the right lifestyle choices or misallocation of health care products o Narrow popular definition of politics  1. Politics has government—activities of the state • most prevelant which places restrictive boundaries and what politics is and who can participate • top-down • through healthcare there is a role for the state • but health inequalities isn’t what the government does  2. Politics has public life—conduct and management of community affairs  3. Politics has conflict resolution- come together compromise, negotiate and find solutions to problems  4. Politics has power- who decides who gets resources • compared to 1) –everything is political and anyone can engage in politics • in this narrow definition, healthcare is when states role is significant. Major industries of state is healthcare o Political science approaches  Haven’t studied health  Generally concerned with insitututions and processes of government  Only interested in health to apply theories  PS see health as domain of other disciplines • Soci, PH and medicine o Medicalization  Transfer of power responsibility of individuals, public and individual life  Docs, drug corporations  Health is something docs are responsible  Don’t acknowledge own power over own life o More politics than science o Funding of public health research  People in medicine and biology  Statisticians and epi—research • Politics is avoiding by these groups • Forbidden subject • Who funds health research—government o Sources that are accountable for their research o Limited conception of the public policy process
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