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90+ Strong Health Essay Topics And How To Handle Them

Haiden Malecot

Table of Contents

essay perspective health

You can write about healthy lifestyle, rehabilitation after traumas, childcare, common or rare diseases, global advances in health and medicine, environmental health issues, and more.

How to deal with essay on health?

Your essay will be the most impressive if you choose a topic that is familiar to you or you can write about something you have experience with. It will be easier for you to do a health essay paper and build a convincing argument. Another approach is choosing a topic which is not familiar to you but in which you are interested in. It would be a great opportunity for you to educate yourself.

If you pick an interesting essay topic idea which is too broad to cover in your essay, you should do additional keyword research and look for some specific aspects of this topic to narrow it.

Keep in mind that you should look for a narrow topic which has enough available resources that you can use for researching it.

Before you start writing, make sure you have found enough evidence and examples to support your argument. A good idea is to create a working outline or a mind map for your essay that will guide your writing and help you stay focused on your key points.

First, create a strong thesis statement and think about several main points to support it.

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Theoretical Perspectives on Health

Learning objectives.

Each of the three major theoretical perspectives approaches the topics of health, illness, and medicine differently. You may prefer just one of the theories that follow, or you may find that combining theories and perspectives provides a fuller picture of how we experience health and wellness.


According to the functionalist perspective, health is vital to the stability of the society, and therefore sickness is a sanctioned form of deviance. Talcott Parsons (1951) was the first to discuss this in terms of the  sick role : patterns of expectations that define appropriate behavior for the sick and for those who take care of them.

According to Parsons, the sick person has a specific role with both rights and responsibilities. To start with, she has not chosen to be sick and should not be treated as responsible for her condition. The sick person also has the right of being exempt from normal social roles; she is not required to fulfill the obligation of a well person and can avoid her normal responsibilities without censure. However, this exemption is temporary and relative to the severity of the illness. The exemption also requires  legitimation   by a physician; that is, a physician must certify that the illness is genuine.

The responsibility of the sick person is twofold: to try to get well and to seek technically competent help from a physician. If the sick person stays ill longer than is appropriate (malingers), she may be stigmatized.

Parsons argues that since the sick are unable to fulfill their normal societal roles, their sickness weakens the society. Therefore, it is sometimes necessary for various forms of social control to bring the behavior of a sick person back in line with normal expectations. In this model of health, doctors serve as gatekeepers, deciding who is healthy and who is sick—a relationship in which the doctor has all the power. But is it appropriate to allow doctors so much power over deciding who is sick? And what about people who are sick, but are unwilling to leave their positions for any number of reasons (personal/social obligations, financial need, or lack of insurance, for instance).

Conflict Perspective

Theorists using the conflict perspective suggest that issues with the healthcare system, as with most other social problems, are rooted in capitalist society. According to conflict theorists, capitalism and the pursuit of profit lead to the  commodification  of health: the changing of something not generally thought of as a commodity into something that can be bought and sold in a marketplace. In this view, people with money and power—the dominant group—are the ones who make decisions about how the healthcare system will be run. They therefore ensure that they will have healthcare coverage, while simultaneously ensuring that subordinate groups stay subordinate through lack of access. This creates significant healthcare—and health—disparities between the dominant and subordinate groups.

Alongside the health disparities created by class inequalities, there are a number of health disparities created by racism, sexism, ageism, and heterosexism. When health is a commodity, the poor are more likely to experience illness caused by poor diet, to live and work in unhealthy environments, and are less likely to challenge the system. In the United States, a disproportionate number of racial minorities also have less economic power, so they bear a great deal of the burden of poor health. It is not only the poor who suffer from the conflict between dominant and subordinate groups. For many years now, homosexual couples have been denied spousal benefits, either in the form of health insurance or in terms of medical responsibility. Further adding to the issue, doctors hold a disproportionate amount of power in the doctor/patient relationship, which provides them with extensive social and economic benefits.

While conflict theorists are accurate in pointing out certain inequalities in the healthcare system, they do not give enough credit to medical advances that would not have been made without an economic structure to support and reward researchers: a structure dependent on profitability. Additionally, in their criticism of the power differential between doctor and patient, they are perhaps dismissive of the hard-won medical expertise possessed by doctors and not patients, which renders a truly egalitarian relationship more elusive.

Symbolic Interactionism

According to theorists working in this perspective, health and illness are both socially constructed. As we discussed in the beginning of the chapter, interactionists focus on the specific meanings and causes people attribute to illness. The term  medicalization of deviance  refers to the process that changes “bad” behavior into “sick” behavior. A related process is  demedicalization , in which “sick” behavior is normalized again. Medicalization and demedicalization affect who responds to the patient, how people respond to the patient, and how people view the personal responsibility of the patient (Conrad and Schneider 1992).

An old engraving depicting “King Alcohol” is shown.

An example of medicalization is illustrated by the history of how our society views alcohol and alcoholism. During the nineteenth century, people who drank too much were considered bad, lazy people. They were called drunks, and it was not uncommon for them to be arrested or run out of a town. Drunks were not treated in a sympathetic way because, at that time, it was thought that it was their own fault that they could not stop drinking. During the latter half of the twentieth century, however, people who drank too much were increasingly defined as alcoholics: people with a disease or a genetic predisposition to addiction who were not responsible for their drinking. With alcoholism defined as a disease and not a personal choice, alcoholics came to be viewed with more compassion and understanding. Thus, “badness” was transformed into “sickness.”

There are numerous examples of demedicalization in history as well. During the Civil War era, slaves who frequently ran away from their owners were diagnosed with a mental disorder called  drapetomania . This has since been reinterpreted as a completely appropriate response to being enslaved. A more recent example is homosexuality, which was labeled a mental disorder or a sexual orientation disturbance by the American Psychological Association until 1973.

While interactionism does acknowledge the subjective nature of diagnosis, it is important to remember who most benefits when a behavior becomes defined as illness. Pharmaceutical companies make billions treating illnesses such as fatigue, insomnia, and hyperactivity that may not actually be illnesses in need of treatment, but opportunities for companies to make more money.

Key Takeaways

Introduction to Sociology: Understanding and Changing the Social World by University of Minnesota is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Essay On Sociological Perspectives On Health And Health Care

Type of paper: Essay

Topic: Sociology , Health , Canada , Medicine , Society , Policy , Wellness , Belief

Words: 1200

Published: 01/13/2020



I used to think that getting and maintaining health and wellness is just a personal matter. I did not totally recognize that it is a structural goal in any society. It makes sense to me while I grasped the topic in Chapter 2 of the Sociological Perspectives on Health and Health Care by Ivy Lynn Bourgeault (Raphael, Bryant & Rioux, 2006). It made me realize why the state is concerned with the health and well being of the people and why it promotes good health. Good health is actually linked with not just the sociological and political aspects of society. It is very well linked with the economic performance of a country. Hence, the topic of structural functionalism, as described in Chapter 2, really enlightened me on the said topic. Medical or health sociology is a very interesting topic because I am well aware of the concept in its totality (Raphael, Bryant & Rioux, 2006). Health and wellness is a social thing; it is not just rooted in the physical bodies of an individual. Thus, when one is ill, society frowns at the situation. Medical help is given urgently and people wish and expect people to get well sooner than later. This topic includes varied issues like the health care of the government, the doctor-patient relationship, behavior of a sick person, stress and coping mechanisms, the social distribution of health, medical professionalism, health care policy, and public health (Phellas, 2010). The social views on sickness are very diverse topic. It is also well rooted in the cultural beliefs of the people. Hence, one disease such as cancer may be conceived as a deadly disease in one social group while it may be a natural disease in another cultural community (or they may a totally different idea of what cancer is about). Another concept which is rooted on sociological belief is the concept of euthanasia. While it may be accepted in advances, western societies, it may still be considered as a sin in another society.


Structural functionalism suggests that the collective norms and values are important to society in order for it to function effectively as a whole. It treats medicine as a social institution that has an integral part in ensuring the stability of society. Structuralism also organizes the way that people’s behavior is arranged according to social rules and norms. On the other hand, functionalism holds the positive functionality of each parts of the social system like health or medicine. In modern perspective, structural functionalism is useful in understanding the issues related to welfare states and how medical systems and health care policies hold the society together. The issue of health and wellness is very well explained by the leadership which the state and its institutions are providing. Structural functionalism, as defined and discussed in the second chapter, depicted the issue with its various linkages to several social aspects that cannot be denied. For instance, it is linked with how the government arranges the health care system in the society and how it sees to it that the ill and the invalid are treated and made back to normalcy. It is also very important to explain the structure and the functions of medicine in society because medicine is not a sole scientific matter. In fact, it is interesting to note that many diseases in traditional societies find its cure in non-scientific ways. I really find it very fascinating. I believe that if mankind can only unlock the crucial balance between the health and wellness, incorporating both sociological, medical and anthropological methods and practices in medicine, the world may be relieved on even the most terminal diseases. Because men view medicine and health in different perspective, there are many ways by which the structural functionalism helps in understanding the function of social beliefs and norms in healing and treatment. The structural functionalism theory allows us to comprehend the richness and diversity of health. This theory also helps us appreciate the field of medical/health sociology. By knowing how society and its agencies are related to our health and our protection, we may begin to understand how various medical institutions and agencies work. We may appreciate it better or point out its flaws. We may also determine the most possible solutions for our present health and wellness problems. As explained in the book, the structural functional theory approaches medicine with how different societies create or develop their own collective belief systems and practices in health care and well being. It also explains how its members are socially bound by norms and values which guide the way they treat and consider ill people. This makes sense in governing societal practices of health problems such as drug addiction or AIDS problems. The way society reacts, in turn, regulate society and develop a sense of oneness in tackling the problems and concerns at a given time frame. With these insights and learning, I now conceive the health as a function of an advanced society. I now believe that the more advanced the social structures in one society, especially in health care practices, the more sophisticated is its perception of wellness and health.


Given that the sociological perspective aims to promote stability in health and the general society, the policy changes which I deem necessary to the improvement of the Canadian health policy is primarily on its resources. Just like the problems in the American health system, the allocation of resources is a crucial point in medicine. This includes expanding the abundant supply of resources such as financial, human, scientific and/or technological, educational, and managerial. The Canadian health sector must be reinforced in all these areas. According to medical practitioners Dr. Schippers, Dr. Pai and Dr. Swain (2008), the health system in Canada is not “well designed for patients and they have little voice.” For instance, it is usually difficult to find a doctor or receive new medicines for critical illnesses. The health system is also very centralized. Hence, it is bureaucratic. The main interest is to maximize and utilize resources but with a systemic perspective (Schippers, Pai & Swain, 2008). If state and its agencies want to maintain good health for all, it should maintain a comprehensive, patient focused health care. Its health features and provisions should be carefully positioned so as to be consistent with the Canada Health Act. However, the serious illnesses should have a different system altogether. This will ensure that whether the patient has a regular check up or a terminal treatment, the health care extended is satisfying and excellent. There is no service gap in the health care system.


Dr. Schipper, H., Dr. Pai, M. & Dr. Swain, H. (July, 2008). Putting people first: Critical reforms for Canada’s health care system. Retrieved on November 27, 2012 from, https://docs.google.com/viewer?a=v&q=cache:6vX3HdzM7_IJ:www.globalcentres.org/publicationfiles/Schipper%2520Pai%2520Swain%25200708.pdf+&hl=en&gl=ph&pid=bl&srcid=ADGEESjReuoZrn5aIIdVqFUnXY1yNPodwsnd74J9zt1GAj9wqI0dNra00xW1qKHCtLlVcAEiJzQmCpePkEd75OD4yIpOVdzAE-xgKC6QglE7VB1MXRsmYDVH4Du0tYFVmIe1Xz5z3AZn&sig=AHIEtbSSIAWPc2JSjIFwpNuEqq-jjEDgGg. Phellas, C. (2010). Sociological Perspectives of Health and Illness. Cambridge: Cambridge Scholars Publishing. Raphael, D., Toba, B. & Rioux, M. ed. (2006). Staying Alive: Critical Perspectives on Health, Illness, and Health Care. Canadian Scholar’s Press: Toronto.

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Essay Service Examples Sociology Sociological Perspective

Sociological Perspective on Global Health and Human Rights

1. Benetar describes the technological perspective operating with health care, to provide health care research, technological innovation, pharmaceuticals and evidence-based approaches to implementation. Current advances in medical practices have often been attributed to the implementation of a technological perspective.

In Canada for example, where healthcare has come under critique over its effectiveness, critiques of the need for healthcare reform use the technological perspective to justify the desire for more CT/MRI scans. They argue that the increased in technology will lessen wait times and decrease bottlenecks (Deber,2008). However, Deber (2008) demonstrates that although the technological perspective can find innovative ways to deal with health issues, often times they are costly and they lack equitable universality. This is because the ones that actually need the technology can hardly afford it. Also, Benetar (2011) notes that the use of evidence-based approaches to allow access to healthcare technology sometimes runs into a debate about the opportunity cost. Furthermore, he (2011) asks if healthcare organizations can find alternative solutions that don’t necessarily pose the use of a certain technology to cure/ diagnose a disease in order to ensure universality of healthcare access and support?

Benetar (2011) describes the economic perspective as positioning of medical care as a commodity. A model of this perspective of health care can be seen in the Americas for-profit health system. In America, large corporations and businesses compete to fund healthcare in the country. The economic perspective justifies the $9 892 (OECD, 2017), average American spends on healthcare. The main characteristic of the economic perspective is the use of money to achieving well-being and health; through the dispersion of healthcare and accumulation. This perspective is closely linked to the technological perspective because although in Canada bottlenecks occur- in relation to wait times for specialist appointments, in America your economic status determines how quickly you can or cannot receive a heart transplant.

The sociological perspective – built on sociological theories like Max Weber’s understanding of life chances and functionalism, views healthcare as a caring social institution. Benetar (2011) describes this perspective as, opportunities that each individual has to improve their quality of life. In relation to health care, hospitals and clinics should function as social institutions for achieving human potential- in a holistic form. Holistically looking at how income, race, class, education and gender- to name a few, affect health and well-being.

The bioethical perspective focuses on moral obligation and justification of healthcare interventions. For global health it would serve as the pretense for whether interventions are “our business”. This perspective is based on normative assumptions on how healthcare should and shouldn’t be administered. This perspective moves beyond measurement and comparison to provide a scope and mandate needed for health care.

Lastly, the existential perspective looks to identify the sanctity of humanity and anything that can potentially threaten humanity as a cause of concern. Similar to the sociological perspective, the existential perspective looks to move beyond the medicalization of disease and illness and narrate how it affects individual lives differently. This perspective illuminates the unequal balance between the vulnerability of the patient and the physician’s “promise to help” (Pellegrino, 1979).

2. The sociological perspective is the best way to approach the issue of mission and mandate for global health because unlike the technological, economic and bioethical perspective, – it provides a framework from which we can start to develop what our values and responsibilities for global health should be.

Unlike the technological perspective, the sociological perspective operates in global health through the use of the social determinants of health (SODH) to curate health research, innovation and intervention from the bottom up. This way practitioners ensure that interventions look at social conditions of the population that make achieving human potential inaccessible. One can argue that the issue of cost-effectiveness can only be applied in low-income countries. However, it is true that there is economic stratification in the west. Over 7% of the population own more than 90% of the world’s wealth (“Global Inequality”, 2018). Therefore, even within Canada we must start to move away from the primary emphasis on technology to solve health issues and look for other inexpensive ways, like advocating for fair wages in order to ensure individuals can afford universal healthcare coverage.

essay perspective health

Second, unlike the economic perspective, the sociological perspective is based on a social justice framework of equal opportunity. This perspective prioritizes health as a global public good. It even goes a step further to illuminate discrepancies in life opportunity and attempts to remediate that through the appropriate intervention. A global health example is illustrated through Cuba’s removal of medical school fees for individuals from low income countries. This has contributed to a physician-per-patient ratio of approximately 1:600, compared to the United States average of approximately 1:3200 (Demers, Kemble, Orris, & Orris,1993). As well as, prioritizing its admission for individuals from marginalized communities.

Although bioethics functions with a normative lens, it still concerned with the advancement of biology and medicine. Global health as a discipline must be that that -unlike modern science and medicine, encourages diverse perspectives of biology and medicine to those that are the recipients of global health work. The sociological perspective through the use of the SDOH understands that each individual in society develops their own meanings of illness and disease. Thereby ensuring that interventions do not impose biases on those that are the recipients of global health work in order to ensure sustainability. This is important, as seen through the effectiveness of contraceptives in rural areas in Nigeria and cultural assumptions and autonomy associated about childbearing in the country (Bamiwuye, Wet, & Adedini, 2013).

Lastly, the existential perspective although the most similar to the sociological perspective isn’t the best way to approach global health because it ignores the other factors that can threaten an individual’s existence. Health, well-being and ultimately existence are heavily influenced by socioeconomic status. The WHO (2018), has recognized the correlation and has adopted a SDOH framework that global health should closely implement.

3. The sociological perspective as an approach for remedying the issue of water management would identify- through the use of social determinants of health, water as essential for human existence’. Access to clean water is a right that should be mandated for all. However, it is also true that an individual interacts with the state and depending on normative assumptions, they may or may not have certain essential human rights- like water. Therefore, the sociological perspective, ensures governments mandate that all individuals have access to clean water, as a public good – free of cost.

Currently, the WHO (2010) identifies access to clean water as a global health issue. The WHO (2010) also acknowledges the need for access to clean water in its efforts to combat waterborne diseases and encourage healthy sanitation practices. However, if the sociological perspective was implemented properly the WHO would also consider the links between global political economy and health. Therefore, politicians would need to start having discourses on the privatization of a public good such as water and how that can affect equitable availability to clean water.

It has been the case that, in some developing regions big corporations often buy up water shares, ineffectively distribute water resources and make water unaffordable. Agyman (2007) mentions that in Ghana, since the implementation of a privatization scheme, it still hasn’t been able to reduce problems facing supply and in fact has not been able to provide clean water to even those in the low-income bracket. Water management policies should be designed to ensure social equity such as gender equity, public health and environmental equity

4. If the sociological perspective were adopted correctly- through a human rights framework, we would see a shift in the scope and the jurisdiction of global health policy and its practice. If human rights were understood as rights inherent to all human beings – regardless of race, sex, nationality, ethnicity, language, religion or any other status. While ensuring that they have the necessary conditions to lead a minimally good life. One can conclude that global health should then operate in a way, that it advocates and mandates the implementation of fundamental rights like clean water, food and shelter at the forefront of policy and interventions globally. What is directly implied is that, since the sociological perspective transcends global borders, the jurisdiction and scope of global health practice and policy becomes much broader because of globalization. For example, it is well known that the financial decisions of the developed region affect the developing world because of the deliberate reliance created through economic partnerships—Structural adjustment plans (SAP). Global health policies must then look at ways of promoting self-sufficiency in order to redistribute nation autonomy for developing regions affected by SAP’s.

Currently, work in global health has been functioning from us/them perspective. The sociological approach will attempt to move Global health from a position of “saviourism” for only developing countries to ensuring social justice for all. Global health must encourage developing worlds to rectify the inequalities that exist within their own countries. For example, the lack of clean water available to those in indigenous territories and the food desert marginalized communities- especially of racialized immigrant ancestry, face. Also to ensure universality global health must seek to standardize what the universal rights are and methods to ensure that they are internationally protected in all nations. This could possibly function through partnering with institutions like the Human Rights Council to ensure more political accountability and pressure. It is important for global health to move beyond idealism and ad hoc interventions into effective policy interventions through partnering with existing regulatory boards in order to demonstrate the importance of ensuring clean water, shelter and food as huge determinants for a person’s well-being and health.

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“Let’s create an AIDS/HIV-free generation”, which is not only a slogan that was proposed by President Obama but also a goal that I would like to achieve on my future career path. My practicum project at the Department of Health and Human Services was to generate dataset of new AIDS/HIV cases in Houston/Harris area required by the Center for Disease Control and Prevention, and then to use ArcGIS software to make a map describing the new diagnosed in Houston area. The final products can be spatially lined to other sources to enhance understanding of social determinants of health affecting populations impacted by HIV. This practicum experience let me realize that AIDS spreads so quickly is because most people have insufficient knowledge or misconception about the disease and prevention. Becoming a pharmacist to provide prevention service and educate people to improve their health and wellbeing is how I want to reach the goal of creating an AIDS/HIV-free generation.

There Are Those Who Say That Seeing Is Believing

"There are those who say that seeing is believing. I am telling you to believe in what you see" Neale Donald Walsh once said. This quote means that you have to see something that exists in order to believe it.This quote also means if you do not believe in what you are told, you might want or need to see it to know it actually occurs. I believe this quote is showing you that when you believe something you can see it, but when you see something you can believe it too. Seeing something that you never knew was true give you deeper details about what you saw or found out. You get to see something new, and the truth. Therefore, I believe that, seeing is believing.

Formulating Equations And Unbiased Opinion

It is important to see a situation from both sides when trying to understand people. You have to see it through their eyes, and “-climb into their skin and walk around in it.”(Lee, 39) It’s important when you are sympathizing for somebody and when you are trying to understand the reasoning behind someone’s actions. It’s of paramount importance to see through somebody’s eyes and then walk a mile in their shoes.

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Perspectives on the Concept of Mental Health

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Perspective on Health Care Essay

Perspective on Health Care Essay

There are a lot of issues that interested me in the health care. In the current essay I will review the positive and negative health outcomes linked to demographic indicators that intrigued me the most. I can say that I am interested in pursuing different areas of health care. I have always wanted to work in the health care field. I feel like no matter what you job title is, as you are always helping someone. I would love to be a nurse some day but that is not an option right now so I searched the other fields and began a degree in Science and Health Administration. United States have had a highly developed health care. “In 2008, U.S. health care spending was about $7,681 per resident and accounted for 16.2% of the nation’s Gross Domestic Product (GDP); this is among the highest of all industrialized countries. Total health care expenditures grew at an annual rate of 4.4 percent in 2008, a slower rate than recent years, yet still outpacing inflation and the growth in national income. ”, according to Health care costs (2010). The disadvantages of the health care in the United states are: “forced 32.5 million seniors and people with disabilities to pay higher premiums and other Medicare costs; dropped coverage for out-of-pocket expenses between $2,250 and $5,100; prevented the federal government from negotiating lower drug costs and does nothing to rein in soaring prescription drug prices; and threatened the employer-provided drug benefits of millions of retirees.”, according to What’s wrong with America’s health care (2003). Medical state programs cover a large portion of the population, their influence is not confined within these programs. As a fact, 95% of workers are paying taxes for social insurance, including earning the right to public health programs in old age. State support makes it possible to operate the health care system for people not only in adulthood. Health problems, including the organization of a system to provide health care, their financing, the development of medical science and technology are considered primarily in the context of human rights. Here are two important aspects: • The right of citizens to a quality life, a priority component of which is health; • The right of citizens to privacy. State assumes responsibility for the health sector that is either unprofitable of private medicine, or objectively in need of nationwide support. In the state’s activities in this area is clearly expressed the tendency to respect the interests of society as a whole, while the activities of major components of health care are aimed at maximizing profits. Herein lays one of the major contradictions of the American health care crisis in the generating elements of the medical system. Activities of States in the field of health management objective necessity, since there is, on the one hand, have the urgent need for compliance with national priorities in public health, and with another – the need to combine the real capacity of the state with the sometimes contradictory to each other the interests of individual layers and groups in society. Satisfying these objective needs of society is the essence of government in health care. The U.S. experience shows that in a market economy it is optimal to move to the state health insurance system. Introduction of medical care based on national insurance, it is appropriate and necessary to objectively measure in any country with a market economy. The principle of social responsibility of employers for maintaining the health of hired labor – is an indispensable condition for medical insurance in a civilized society. Moreover, there is a limited capacity of government to solve the problems of medical support by simply increasing the scale of funds. There is the need of an efficient organization of the health system in which there is the actual payment for medical services. It is imperative that the real price is in the first place, based on that balance supply and demand, and secondly, there is no someone else at monopoly position, distorting the real price. Public health insurance program Medicare – is an important mechanism to achieve social balance in society. Along with other government social programs, it serves as a stabilizer of society, the leveling of access to health care of different groups. Through this program not only improved access of aged and elderly to medical care, but also it improved its quality. Medicare – is the evidence of social responsibility of the U.S. government to its citizens. And although the state medical program Medicare does not solve all the problems in health care for the elderly, it has a great value: it provides Americans with a sense of confidence in the future and peace in the present. The program of Medicaid, with the socio-economic point of view, has the function of redistributing income in the country, as it is a tool not only for the equalization of opportunities for different categories of the population, but also to maintain the relative balance of different startup opportunities for its economic potential and development of staff. The latter characteristic distinguishes it from the program “Medicare.” Such a program of medical welfare could only appear to be of sufficiently advanced material and financial resources of the state as a whole, interested in maintaining socio-political status quo in the country. There are important social changes that have to be taken into consideration to create a high quality health care in the country. Today, life expectancy for women is 79 years and for men – 73 years, and it is predicted that persons whose age was 65 years old will live another 17 years. The most important issue of the health care in the United States – is the legal protection of the patient. All in all, health care has considerable perspectives for the successful development and improvements.


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Conflict Perspective On Health Care

Essay on raising the federal minimum wage.

A minimum wage increase from “$7.25 to $10.10 would result in a loss of 500,000 jobs”. ("The Effects of Minimum-Wage Increase on Employment and Family Income”) This claim is better because it shows how raising the minimum wage will decrease job growth instead of increasing it. But, the minimum wage should be increased because increasing will also increase economic activity and spur job growth, decrease poverty, and improvements in productivity and economic growth have outpaced increases in the minimum

Universal Health Care Argumentative Essay

Health care should not be considered a political argument in America; it is a matter of basic human rights. Something that many people seem to forget is that the US is the only industrialized western nation that lacks a universal health care system. The National Health Care Disparities Report, as well as author and health care worker Nicholas Conley and Physicians for a National Health Program (PNHP), strongly suggest that the US needs a universal health care system. The most secure solution for many problems in America, such as wasted spending on a flawed non-universal health care system and 46.8 million Americans being uninsured, is to organize a national health care program in the US that covers all citizens for medical necessities.

Four Reasons Not To Raise The Minimum Wage

People with government care would also no longer qualify because of their profit. Increasing the minimum wage would not have any good effects but instead have more negative because all the sales will increase as

Minimum Wage Should Not Be Raised

A controversial topic often debated between liberals and conservatives is the minimum wage issue. While many liberals advocate for raising it, a number of conservatives are persistent on keeping the rate constant; however, studies show that raising minimum wage would not alleviate this country’s poverty issue and would, in fact, increase the unemployment. For these reasons, the minimum wage should not be raised. Increasing the minimum wage would cause economic strain in many ways to workers already living in poverty. According to James Sherk’s article: ‘Raising the Minimum Wage Will Not Reduce Poverty’, raising minimum wage to seven dollars and twenty five cents would cause an estimated eight percent of current workers to lose their jobs.

Persuasive Essay On Minimum Wage

If America raises the minimum wage to $9.00, it will help people in need or in poverty, but it also won’t hurt people in the workforce. If you increase the minimum wage to $15.00 it will make unemployment rates go high up. Which in the process, makes the homelessness rates go up in the country and in your community. If you keep the minimum wage at $7.25 people will stay in poverty and homeless or on the verge of homelessness.

Minimum Wage Should Be Increased

Many of the minimum wage workers who had been functioning in poverty would still be functioning in poverty because the cost of living would be elevated too. In the past when the national minimum wage was raised there was virtually no effect to people living in poverty. Some people might say that the talk about higher minimum wage is sparking hope in the workers. If a worker has a chance to earn more wages then they will work better so that they do get that raise; however, more people will lose their jobs because not as many people will get to work if others are making higher wages.

Minimum Wage In Texas

Minimum wage would raise the wages of many workers and increment benefits what disadvantaged workers. An estimated 6.9 million workers would receive an incrementation in their hourly wage if the minimum rage were raised to $10.15 by 2015. Due to the spill over effect the 10.5 million workers earning up to a dollar above minimum wage would withal be liable to benefit from an incrementation. Women are the most astronomically immense group of beneficiaries from a minimum wage increase. Sixty percent of workers who would benefit from an incrementation are women.

Single Payer Universal Healthcare System

In addition to the dismay of many healthcare professionals, patients, and citizens who are uninsured, several flaws about the current healthcare system show the necessity for reform. The three flaws that exacerbate the current healthcare crisis are: the tax code and tax breaks, the lack of preventable care and adequate care of chronic diseases, and administrative costs. A single payer, universal healthcare system can resolve the major flaws of the

Disparities In Health Care Essay

Many Americans were led to believe that the introduction of the Patient Protection and Affordable Care Act in 2009 would put an end to disparities in health care access. While it did improve the situation for a small percentage of the population there are still many Americans who lack access to good quality health care. Health care access in America is determined by money and those in lower socioeconomic groups frequently tend to miss out on adequate care. In a recent health care report by the national health research foundation Kaiser Family Foundation, it was noted “health care disparities remain a persistent problem in the United States, leading to certain groups being at higher risk of being uninsured, having limited access to care, and experiencing poorer quality of care” (Kaiser Family Foundation). The current health care

Essay On Increase In Minimum Wage

However, in the long run, many employers will not be able to maintain to stay in business due to the significantly high wages. An increase in minimum wage would cause millions to lose their jobs and put them further in poverty. It would even make it harder for them to obtain jobs after the increase due to the increase of competition in the job market, and most importantly an increase in minimum wage would cause increase in the price level and it will reduce significantly consumption due to the lack of purchasing power that is cause by the higher inflation rate. The minimum wage should not increase because it is unsustainable economically. Another approach of help guide people out of poverty can be a push for an increase in education and knowledge capital instead of continuously increasing the minimum

Pros And Cons Of Raising The Minimum Wage

First, one main reason that the minimum wage should be raised is because the economy will prosper. “Economic Policy Institute stated that a minimum wage increase from the current rate of $7.25 an hour to $10.10 would inject $22.1 billion net into the economy and create about 85,000 new jobs over a three-year phase-in period” (ProCon). This quote shows that the economy will flourish from the increase of the minimum wage and that unemployment will decrease. Another quote that shows how raising the minimum wage will affect employment is “To the extent that through these contour effects it affords as much as 70 percent of the workforce greater purchasing power, it effectively increases aggregate demand for goods and services, which should ultimately lead to the creation of more jobs” (Challenger 19). Bryan Covert supports raising the minimum wage by

Persuasive Essay On Health Care

Healthcare is something everyone needs and should be able to get, but right now that is not happening. In America there are millions of people who don’t have healthcare insurance. This is because some can’t afford the insurance plan. There are also millions more who have health insurance, but can’t afford using it. This means that they are paying for an insurance plan, but the deductibles are so high they can’t afford to go to the doctor.

Raising Minimum Wage Research Paper

So, raising the minimum wage by 5 dollars is going to end poverty. Though many people argue that by raising it, is just going increase the unemployment rate. While I do acknowledge and take into consideration, this act takes care for those families

Argumentative Essay: Raising The Minimum Wage

We do not know how the rise of minimum wage will affect us in the future here in California, but in Seattle, Washington the minimum wage is now $11.00. The money it is not making a difference. A study in my fourth source “Jacob Vigdor, an economist at the University of Washington and one of the authors of the report...leading the researchers to conclude that the minimum wage reduced the number of hours worked quarterly by 3.2, roughly 15 minutes each week. Those figures do not include workers without jobs… Workers employed by thriving businesses who did not lose any hours could have enjoyed welcome gains.

Argumentative Essay On Minimum Wage

The people who make minimum wage very clearly express their theory that higher pay will benefit them and show many valid points on why it should be increased. Minimum wage workers work hard and "[s]ince the 1970s, productivity has risen dramatically... [y]et middle- and low-wage workers ' incomes have barely changed" (Dorn). These circumstances make it hard for low wage workers to stay above the poverty line when the average low wage worker makes only $15,000 annually (Dorn). Before inflation, the minimum wage was surprisingly much higher, "in 1968, the minimum wage was close to $10 per hour in today 's dollars" (Dorn).

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Free Examples and Ideas That Can Help You Write an Essay on Health

Medicine is a fast-growing field today. There is scope for writing a large number of essays, research papers, dissertations, and more. However, with so much information available to a broad audience, it is difficult to understand all contradicting findings and theories. When you write an essay on health, you should rely on credible data, approved by the academic community. Choose scientific articles and relevant medical textbooks as sources. Outline the issues you're going to write about. Moreover, checking out a good health essay example on a similar topic would be helpful.

You can find a lot of free health essay samples in our open-access directory. We have collected only the best examples that you can use to your advantage. Each health essay sample is written by a professional in the field and based on reliable sources. Use our essay examples as a source of the best writing practices and as a model to follow.

There is also an opportunity for you to get a 100% unique essay with minimal effort – just entrust your paper to experienced writers at WePapers.com.

Free Essay On Google Inc.

According to Google.com (2015c), Google Inc. was founded in 1988 in California by Sergey Brin and Larry Page. In 2004, the company issued its Initial Public Offer (IPO). The company’s revenue was US$ 59,825 million by the end of 2013. It is primarily renowned for its leading search engine which provides global access to information. This firm purposes to organize global information into useful and accessible units. It specializes in web searches and online advertising, android operating system, commerce, hardware and enterprise products. Catalan (2014) asserts that by the end of December 31st 2013, Google had 47, Continue reading...

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By Francesca Colombo , Head, Health Division, Organisation for Economic Co-operation and Development (OECD) and Helen E. Clark , Prime Minister of New Zealand (1999-2008), The Helen Clark Foundation

The COVID-19 crisis has affected more than 188 countries and regions worldwide, causing large-scale loss of life and severe human suffering. The crisis poses a major threat to the global economy, with drops in activity, employment, and consumption worse than those seen during the 2008 financial crisis . COVID-19 has also exposed weaknesses in our health systems that must be addressed. How?

For a start, greater investment in population health would make people, particularly vulnerable population groups, more resilient to health risks. The health and socio-economic consequences of the virus are felt more acutely among disadvantaged populations, stretching a social fabric already challenged by high levels of inequalities. The crisis demonstrates the consequences of poor investment in addressing wider social determinants of health, including poverty, low education and unhealthy lifestyles. Despite much talk of the importance of health promotion, even across the richer OECD countries barely 3% of total health spending is devoted to prevention . Building resilience for populations also requires a greater focus on solidarity and redistribution in social protection systems to address underlying structural inequalities and poverty.

Beyond creating greater resilience in populations, health systems must be strengthened.

High-quality universal health coverage (UHC) is paramount. High levels of household out-of-pocket payments for health goods and services deter people from seeking early diagnosis and treatment at the very moment they need it most. Facing the COVID-19 crisis, many countries have strengthened access to health care, including coverage for diagnostic testing. Yet others do not have strong UHC arrangements. The pandemic reinforced the importance of commitments made in international fora, such as the 2019 High-Level Meeting on Universal Health Coverage , that well-functioning health systems require a deliberate focus on high-quality UHC. Such systems protect people from health threats, impoverishing health spending, and unexpected surges in demand for care.

Second, primary and elder care must be reinforced. COVID-19 presents a double threat for people with chronic conditions. Not only are they at greater risk of severe complications and death due to COVID-19; but also the crisis creates unintended health harm if they forgo usual care, whether because of disruption in services, fear of infections, or worries about burdening the health system. Strong primary health care maintains care continuity for these groups. With some 94% of deaths caused by COVID-19 among people aged over 60 in high-income countries, the elder care sector is also particularly vulnerable, calling for efforts to enhance control of infections, support and protect care workers and better coordinate medical and social care for frail elderly.

Third, the crisis demonstrates the importance of equipping health systems with both reserve capacity and agility. There is an historic underinvestment in the health workforce, with estimated global shortages of 18 million health professionals worldwide , mostly in low- and middle-income countries. Beyond sheer numbers, rigid health labour markets make it difficult to respond rapidly to demand and supply shocks. One way to address this is by creating a “reserve army” of health professionals that can be quickly mobilised. Some countries have allowed medical students in their last year of training to start working immediately, fast-tracked licenses and provided exceptional training. Others have mobilised pharmacists and care assistants. Storing a reserve capacity of supplies such as personal protection equipment, and maintaining care beds that can be quickly transformed into critical care beds, is similarly important.

Fourth, stronger health data systems are needed. The crisis has accelerated innovative digital solutions and uses of digital data, smartphone applications to monitor quarantine, robotic devices, and artificial intelligence to track the virus and predict where it may appear next. Access to telemedicine has been made easier. Yet more can be done to leverage standardised national electronic health records to extract routine data for real-time disease surveillance, clinical trials, and health system management. Barriers to full deployment of telemedicine, the lack of real-time data, of interoperable clinical record data, of data linkage capability and sharing within health and with other sectors remain to be addressed.

Fifth, an effective vaccine and successful vaccination of populations around the globe will provide the only real exit strategy. Success is not guaranteed and there are many policy issues yet to be resolved. International cooperation is vital. Multilateral commitments to pay for successful candidates would give manufacturers certainty so that they can scale production and have vaccine doses ready as quickly as possible following marketing authorisation, but could also help ensure that vaccines go first to where they are most effective in ending the pandemic. Whilst leaders face political pressure to put the health of their citizens first, it is more effective to allocate vaccines based on need. More support is needed for multilateral access mechanisms that contain licensing commitments and ensure that intellectual property is no barrier to access, commitments to technology transfer for local production, and allocation of scarce doses based on need.

The pandemic offers huge opportunities to learn lessons for health system preparedness and resilience. Greater focus on anticipating responses, solidarity within and across countries, agility in managing responses, and renewed efforts for collaborative actions will be a better normal for the future.

OECD Economic Outlook 2020 , Volume 2020 Issue 1, No. 107, OECD Publishing, Paris

OECD Employment Outlook 2020 : Worker Security and the COVID-19 Crisis, OECD Publishing, Paris

OECD Health at a Glance 2019, OECD Publishing, Paris


OECD (2020), Who Cares? Attracting and Retaining Care Workers for the Elderly, OECD Health Policy Studies, OECD Publishing, Paris

Working for Health and Growth: investing in the health workforce . Report of the High-Level Commission on Health Employment and Economic Growth, Geneva.

Colombo F., Oderkirk J., Slawomirski L. (2020) Health Information Systems, Electronic Medical Records, and Big Data in Global Healthcare: Progress and Challenges in OECD Countries . In: Haring R., Kickbusch I., Ganten D., Moeti M. (eds) Handbook of Global Health. Springer, Cham.

2. Improving population health and building healthy societies in times of COVID-19

By Helena Legido-Quigley , Associate Professor, London School of Hygiene and Tropical Medicine

The COVID-19 pandemic has been a stark reminder of the fragility of population health worldwide; at time of writing, more than 1 million people have died from the disease. The pandemic has already made evident that those suffering most from COVID-19 belong to disadvantaged populations and marginalised communities. Deep-rooted inequalities have contributed adversely to the health status of different populations within and between countries. Besides the direct and indirect health impacts of COVID-19 and the decimation of health systems, restrictions on population movement and lockdowns introduced to combat the pandemic are expected to have economic and social consequences on an unprecedented scale .

Population health – and addressing the consequences of COVID-19 – is about improving the physical and mental health outcomes and wellbeing of populations locally, regionally and nationally, while reducing health inequalities.¹ Moreover, there is an increasing recognition that societal and environmental factors, such as climate change and food insecurity, can also influence population health outcomes.

The experiences of Maria, David, and Ruben – as told by Spanish public broadcaster RTVE – exemplify the real challenges that people living in densely populated urban areas have faced when being exposed to COVID-19.¹

Maria is a Mexican migrant who has just returned from Connecticut to the Bronx. Her partner Jorge died in Connecticut from COVID-19. She now has no income and is looking for an apartment for herself and her three children. When Jorge became ill, she took him to the hospital, but they would not admit him and he was sent away to be cared for by Maria at home with their children. When an ambulance eventually took him to hospital, it was too late. He died that same night, alone in hospital. She thinks he had diabetes, but he was never diagnosed. They only had enough income to pay the basic bills. Maria is depressed, she is alone, but she knows she must carry on for her children. Her 10-year old child says that if he could help her, he would work. After three months, she finds an apartment.

David works as a hairdresser and takes an overcrowded train every day from Leganés to Chamberi in the centre of Madrid. He lives in a small flat in San Nicasio, one of the poorest working-class areas of Madrid with one of the largest ageing populations in Spain. The apartments are very small, making it difficult to be in confinement, and all of David’s neighbours know somebody who has been a victim of COVID-19. His father was also a hairdresser. David's father was not feeling well; he was taken to hospital by ambulance, and he died three days later. David was not able to say goodbye to his father. Unemployment has increased in that area; small local shops are losing their customers, and many more people are expecting to lose their jobs.

Ruben lives in Iztapalapa in Mexico City with three children, a daughter-in-law and five grandchildren. Their small apartment has few amenities, and no running water during the evening. At three o’clock every morning, he walks 45 minutes with his mobile stall to sell fruit juices near the hospital. His daily earnings keep the family. He goes to the central market to buy fruit, taking a packed dirty bus. He thinks the city's central market was contaminated at the beginning of the pandemic, but it could not be closed as it is the main source of food in the country. He has no health insurance, and he knows that as a diabetic he is at risk, but medication for his condition is too expensive. He has no alternative but to go to work every day: "We die of hunger or we die of COVID."

These real stories highlight the issues that must be addressed to reduce persistent health inequalities and achieve health outcomes focusing on population health. The examples of Maria, David and Ruben show the terrible outcomes COVID-19 has had for people living in poverty and social deprivation, older people, and those with co-morbidities and/or pre-existing health conditions. All three live in densely populated urban areas with poor housing, and have to travel long distances in overcrowded transport. Maria’s loss of income has had consequences for her housing security and access to healthcare and health insurance, which will most likely lead to worse health conditions for her and her children. Furthermore, all three experienced high levels of stress, which is magnified in the cases of Maria and David who were unable to be present when their loved ones died.

The COVID-19 pandemic has made it evident that to improve the health of the population and build healthy societies, there is a need to shift the focus from illness to health and wellness in order to address the social, political and commercial determinants of health; to promote healthy behaviours and lifestyles; and to foster universal health coverage.² Citizens all over the world are demanding that health systems be strengthened and for governments to protect the most vulnerable. A better future could be possible with leadership that is able to carefully consider the long-term health, economic and social policies that are needed.

In order to design and implement population health-friendly policies, there are three prerequisites. First, there is a need to improve understanding of the factors that influence health inequalities and the interconnections between the economic, social and health impacts. Second, broader policies should be considered not only within the health sector, but also in other sectors such as education, employment, transport and infrastructure, agriculture, water and sanitation. Third, the proposed policies need to be designed through involving the community, addressing the health of vulnerable groups, and fostering inter-sectoral action and partnerships.

Finally, within the UN's Agenda 2030 , Sustainable Development Goal (SDG) 3 sets out a forward-looking strategy for health whose main goal is to attain healthier lives and wellbeing. The 17 interdependent SDGs offer an opportunity to contribute to healthier, fairer and more equitable societies from which both communities and the environment can benefit.

The stories of Maria, David and Ruben are real stories featured in the Documentary: The impact of COVID19 in urban outskirts, Directed by Jose A Guardiola. Available here. Permission has been granted to narrate these stories.

Buck, D., Baylis, A., Dougall, D. and Robertson, R. (2018). A vision for population health: Towards a healthier future . [online] London: The King's Fund. [Accessed 20 Sept. 2020]

Wilton Park. (2020). Healthy societies, healthy populations (WP1734). Wiston House, Steyning. Retrieved from https://www.wiltonpark.org.uk/event/wp1734/ Cohen B. E. (2006). Population health as a framework for public health practice: a Canadian perspective. American journal of public health , 96 (9), 1574–1576.

3. Imagine a 'well-care' system that invests in keeping people healthy

By Maliha Hashmi , Executive Director, Health and Well-Being and Biotech, NEOM, and Jan Kimpen , Global Chief Medical Officer, Philips

Imagine a patient named Emily. Emily is aged 32 and I’m her doctor.

Emily was 65lb (29kg) above her ideal body weight, pre-diabetic and had high cholesterol. My initial visit with Emily was taken up with counselling on lifestyle changes, mainly diet and exercise; typical advice from one’s doctor in a time-pressured 15-minute visit. I had no other additional resources, incentives or systems to support me or Emily to help her turn her lifestyle around.

I saw Emily eight months later, not in my office, but in the hospital emergency room. Her husband accompanied her – she was vomiting, very weak and confused. She was admitted to the intensive care unit, connected to an insulin drip to lower her blood sugar, and diagnosed with type 2 diabetes. I talked to Emily then, emphasizing that the new medications for diabetes would only control the sugars, but she still had time to reverse things if she changed her lifestyle. She received further counselling from a nutritionist.

Over the years, Emily continued to gain weight, necessitating higher doses of her diabetes medication. More emergency room visits for high blood sugars ensued, she developed infections of her skin and feet, and ultimately, she developed kidney disease because of the uncontrolled diabetes. Ten years after I met Emily, she is 78lb (35kg) above her ideal body weight; she is blind and cannot feel her feet due to nerve damage from the high blood sugars; and she will soon need dialysis for her failing kidneys. Emily’s deteriorating health has carried a high financial cost both for herself and the healthcare system. We have prevented her from dying and extended her life with our interventions, but each interaction with the medical system has come at significant cost – and those costs will only rise. But we have also failed Emily by allowing her diabetes to progress. We know how to prevent this, but neither the right investments nor incentives are in place.

Emily could have been a real patient of mine. Her sad story will be familiar to all doctors caring for chronically ill patients. Unfortunately, patients like Emily are neglected by health systems across the world today. The burden of chronic disease is increasing at alarming rates. Across the OECD nearly 33% of those over 15 years live with one or more chronic condition, rising to 60% for over-65s. Approximately 50% of chronic disease deaths are attributed to cardiovascular disease (CVD). In the coming decades, obesity, will claim 92 million lives in the OECD while obesity-related diseases will cut life expectancy by three years by 2050.

These diseases can be largely prevented by primary prevention, an approach that emphasizes vaccinations, lifestyle behaviour modification and the regulation of unhealthy substances. Preventative interventions have been efficacious. For obesity, countries have effectively employed public awareness campaigns, health professionals training, and encouragement of dietary change (for example, limits on unhealthy foods, taxes and nutrition labelling).⁴,⁵ Other interventions, such as workplace health-promotion programmes, while showing some promise, still need to demonstrate their efficacy.

essay perspective health

The COVID-19 crisis provides the ultimate incentive to double down on the prevention of chronic disease. Most people dying from COVID-19 have one or more chronic disease, including obesity, CVD, diabetes or respiratory problems – diseases that are preventable with a healthy lifestyle. COVID-19 has highlighted structural weaknesses in our health systems such as the neglect of prevention and primary care.

While the utility of primary prevention is understood and supported by a growing evidence base, its implementation has been thwarted by chronic underinvestment, indicating a lack of societal and governmental prioritization. On average, OECD countries only invest 2.8% of health spending on public health and prevention. The underlying drivers include decreased allocation to prevention research, lack of awareness in populations, the belief that long-run prevention may be more costly than treatment, and a lack of commitment by and incentives for healthcare professionals. Furthermore, public health is often viewed in a silo separate from the overall health system rather than a foundational component.

Health benefits aside, increasing investment in primary prevention presents a strong economic imperative. For example, obesity contributes to the treatment costs of many other diseases: 70% of diabetes costs, 23% for CVD and 9% for cancers. Economic losses further extend to absenteeism and decreased productivity.

Fee-for-service models that remunerate physicians based on the number of sick patients they see, regardless the quality and outcome, dominate healthcare systems worldwide. Primary prevention mandates a payment system that reimburses healthcare professionals and patients for preventive actions. Ministries of health and governmental leaders need to challenge skepticism around preventive interventions, realign incentives towards preventive actions and those that promote healthy choices by people. Primary prevention will eventually reduce the burden of chronic diseases on the healthcare system.

As I reflect back on Emily and her life, I wonder what our healthcare system could have done differently. What if our healthcare system was a well-care system instead of a sick-care system? Imagine a different scenario: Emily, a 32 year old pre-diabetic, had access to a nutritionist, an exercise coach or health coach and nurse who followed her closely at the time of her first visit with me. Imagine if Emily joined group exercise classes, learned where to find healthy foods and how to cook them, and had access to spaces in which to exercise and be active. Imagine Emily being better educated about her diabetes and empowered in her healthcare and staying healthy. In reality, it is much more complicated than this, but if our healthcare systems began to incentivize and invest in prevention and even rewarded Emily for weight loss and healthy behavioural changes, the outcome might have been different. Imagine Emily losing weight and continuing to be an active and contributing member of society. Imagine if we invested in keeping people healthy rather than waiting for people to get sick, and then treating them. Imagine a well-care system.

Anderson, G. (2011). Responding to the growing cost and prevalence of people with multiple chronic conditions . Retrieved from OECD.

Institute for Health Metrics and Evaluation. GBD Data Visualizations. Retrieved here.

OECD (2019), The Heavy Burden of Obesity: The Economics of Prevention, OECD Health Policy Studies, OECD Publishing, Paris.

OECD. (2017). Obesity Update . Retrieved here.

Malik, V. S., Willett, W. C., & Hu, F. B. (2013). Global obesity: trends, risk factors and policy implications. Nature Reviews Endocrinology , 9 (1), 13-27.

Lang, J., Cluff, L., Payne, J., Matson-Koffman, D., & Hampton, J. (2017). The centers for disease control and prevention: findings from the national healthy worksite program. Journal of occupational and environmental medicine , 59 (7), 631.

Gmeinder, M., Morgan, D., & Mueller, M. (2017). How much do OECD countries spend on prevention? Retrieved from OECD.

Jordan RE, Adab P, Cheng KK. Covid-19: risk factors for severe disease and death. BMJ. 2020;368:m1198.

Richardson, A. K. (2012). Investing in public health: barriers and possible solutions. Journal of Public Health , 34 (3), 322-327.

Yong, P. L., Saunders, R. S., & Olsen, L. (2010). Missed Prevention Opportunities The healthcare imperative: lowering costs and improving outcomes: workshop series summary (Vol. 852): National Academies Press Washington, DC.

OECD. (2019). The Heavy Burden of Obesity: The Economics of Prevention. Retrieved here .

McDaid, D., F. Sassi and S. Merkur (Eds.) (2015a), “Promoting Health, Preventing Disease: The Economic Case ”, Open University Press, New York.

OECD. (2019). The Heavy Burden of Obesity: The Economics of Prevention. Retrieved from OECD.

4. Why e arly detection and diagnosis is critical

By Paul Murray , Head of Life and Health Products, Swiss Re, and André Goy , Chairman and Executive Director & Chief of Lymphoma, John Theurer Cancer Center, Hackensack University Medical Center

Although healthcare systems around the world follow a common and simple principle and goal – that is, access to affordable high-quality healthcare – they vary significantly, and it is becoming increasingly costly to provide this access, due to ageing populations, the increasing burden of chronic diseases and the price of new innovations.

Governments are challenged by how best to provide care to their populations and make their systems sustainable. Neither universal health, single payer systems, hybrid systems, nor the variety of systems used throughout the US have yet provided a solution. However, systems that are ranked higher in numerous studies, such as a 2017 report by the Commonwealth Fund , typically include strong prevention care and early-detection programmes. This alone does not guarantee a good outcome as measured by either high or healthy life expectancy. But there should be no doubt that prevention and early detection can contribute to a more sustainable system by reducing the risk of serious diseases or disorders, and that investing in and operationalizing earlier detection and diagnosis of key conditions can lead to better patient outcomes and lower long-term costs.

To discuss early detection in a constructive manner it makes sense to describe its activities and scope. Early detection includes pre-symptomatic screening and treatment immediately or shortly after first symptoms are diagnosed. Programmes may include searching for a specific disease (for example, HIV/AIDS or breast cancer), or be more ubiquitous. Prevention, which is not the focus of this blog, can be interpreted as any activities undertaken to avoid diseases, such as information programmes, education, immunization or health monitoring.

Expenditures for prevention and early detection vary by country and typically range between 1-5% of total health expenditures.¹ During the 2008 global financial crisis, many countries reduced preventive spending. In the past few years, however, a number of countries have introduced reforms to strengthen and promote prevention and early detection. Possibly the most prominent example in recent years was the introduction of the Affordable Care Act in the US, which placed a special focus on providing a wide range of preventive and screening services. It lists 63 distinct services that must be covered without any copayment, co-insurance or having to pay a deductible.

essay perspective health

Whilst logic dictates that investment in early detection should be encouraged, there are a few hurdles and challenges that need to be overcome and considered. We set out a few key criteria and requirements for an efficient early detection program:

1. Accessibility The healthcare system needs to provide access to a balanced distribution of physicians, both geographically (such as accessibility in rural areas), and by specialty. Patients should be able to access the system promptly without excessive waiting times for diagnoses or elective treatments. This helps mitigate conditions or diseases that are already quite advanced or have been incubating for months or even years before a clinical diagnosis. Access to physicians varies significantly across the globe from below one to more than 60 physicians per 10,000 people.² One important innovation for mitigating access deficiencies is telehealth. This should give individuals easier access to health-related services, not only in cases of sickness but also to supplement primary care.

2. Early symptoms and initial diagnosis Inaccurate or delayed initial diagnoses present a risk to the health of patients, can lead to inappropriate or unnecessary testing and treatment, and represents a significant share of total health expenditures. A medical second opinion service, especially for serious medical diagnoses, which can occur remotely, can help improve healthcare outcomes. Moreover, studies show that early and correct diagnosis opens up a greater range of curative treatment options and can reduce costs (e.g. for colon cancer, stage-four treatment costs are a multiple of stage-one treatment costs).³

3. New technology New early detection technologies can improve the ability to identify symptoms and diseases early: i. Advances in medical monitoring devices and wearable health technology, such as ECG and blood pressure monitors and biosensors, enable patients to take control of their own health and physical condition. This is an important trend that is expected to positively contribute to early detection, for example in atrial fibrillation and Alzheimers’ disease. ii. Diagnostic tools, using new biomarkers such as liquid biopsies or volatile organic compounds, together with the implementation of machine learning, can play an increasing role in areas such as oncology or infectious diseases.⁴

4. Regulation and Intervention Government regulation and intervention will be necessary to set ranges of normality, to prohibit or discourage overdiagnosis and to reduce incentives for providers to overtreat patients or to follow patients' inappropriate requests. In some countries, such as the US, there has been some success through capitation models and value-based care. Governments might also need to intervene to de-risk the innovation paradigm, such that private providers of capital feel able to invest more in the development of new detection technologies, in addition to proven business models in novel therapeutics.

OECD Health Working Papers No. 101 "How much do OECD countries spend on prevention" , 2017

World Health Organization; Global Health Observatory (GHO) data; https://www.who.int/gho/health_workforce/physicians_density/en/

Saving lives, averting costs; A report for Cancer Research UK, by Incisive Health, September 2014

Liquid Biopsy: Market Drivers And Obstacles; by Divyaa Ravishankar, Frost & Sullivan, January 21, 2019

Liquid Biopsies Become Cheap and Easy with New Microfluidic Device; February 26, 2019

How America’s 5 Top Hospitals are Using Machine Learning Today; by Kumba Sennaar, February 19, 2019

5. The business case for private investment in healthcare for all

Pascal Fröhlicher, Primary Care Innovation Scholar, Harvard Medical School, and Ian Wijaya, Managing Director in Lazard’s Global Healthcare Group

Faith, a mother of two, has just lost another customer. Some households where she is employed to clean, in a small town in South Africa, have little understanding of her medical needs. As a type 2 diabetes patient, this Zimbabwean woman visits the public clinic regularly, sometimes on short notice. At her last visit, after spending hours in a queue, she was finally told that the doctor could not see her. To avoid losing another day of work, she went to the local general practitioner to get her script, paying more than three daily wages for consultation and medication. Sadly, this fictional person reflects a reality for many people in middle-income countries.

Achieving universal health coverage by 2030, a key UN Sustainable Development Goal (SDG), is at risk. The World Bank has identified a $176 billion funding gap , increasing every year due to the growing needs of an ageing population, with the health burden shifting towards non-communicable diseases (NCDs), now the major cause of death in emerging markets . Traditional sources of healthcare funding struggle to increase budgets sufficiently to cover this gap and only about 4% of private health care investments focus on diseases that primarily affect low- and middle-income countries.

In middle-income countries, private investors often focus on extending established businesses, including developing private hospital capacity, targeting consumers already benefiting from quality healthcare. As a result, an insufficient amount of private capital is invested in strengthening healthcare systems for everyone.

essay perspective health

Why is this the case? We discussed with senior health executives investing in Lower and Middle Income Countries (LMIC) and the following reasons emerged:

Notwithstanding these barriers, healthcare, specifically in middle-income settings, could present an attractive value proposition for private investors:

Based on the context above, several areas in healthcare delivery can present compelling opportunities for private companies.

To fully realize these opportunities, government must incentivise innovation, provide clear regulatory frameworks and, most importantly, ensure that health priorities are adequately addressed.

Venture capital and private equity firms as well as large international corporations can identify the most commercially viable solutions and scale them into new markets. The ubiquity of NCDs and the requirement to reduce costs globally provides innovators with the opportunity to scale their tested solutions from LMICs to higher income environments.

Successful investment exits in LMICs and other private sector success stories will attract more private capital. Governments that enable and support private investment in their healthcare systems would, with appropriate governance and guidance, generate benefits to their populations and economies. The economic value of healthy populations has been proven repeatedly , and in the face of COVID-19, private sector investment can promote innovation and the development of responsible, sustainable solutions.

Faith – the diabetic mother we introduced at the beginning of this article - could keep her client. As a stable patient, she could measure her glucose level at home and enter the results in an app on her phone, part of her monthly diabetes programme with the company that runs the health centre. She visits the nurse-led facility at the local taxi stand on her way to work when her app suggests it. The nurse in charge of the centre treats Faith efficiently, and, if necessary, communicates with a primary care physician or even a specialist through the telemedicine functionality of her electronic health system.

Improving LMIC health systems is not only a business opportunity, but a moral imperative for public and private leaders. With the appropriate technology and political will, this can become a reality.

6. How could COVID-19 change the way we pay for health services?

John E. Ataguba, Associate Professor and Director, University of Cape Town and Matthew Guilford, Co-Founder and Chief Executive Officer, Common Health

The emergence of the new severe acute respiratory syndrome coronavirus (SARS-Cov-2), causing the coronavirus disease 2019 (COVID-19), has challenged both developing and developed countries.

Countries have approached the management of infections differently. Many people are curious to understand their health system’s performance on COVID-19, both at the national level and compared to international peers. Alongside limited resources for health, many developing countries may have weak health systems that can make it challenging to respond adequately to the pandemic.

Even before COVID-19, high rates of out-of-pocket spending on health meant that every year, 800 million people faced catastrophic healthcare costs ,100 million families were pushed into poverty, and millions more simply avoided care for critical conditions because they could not afford to pay for it.

The pandemic and its economic fallout have caused household incomes to decline at the same time as healthcare risks are rising. In some countries with insurance schemes, and especially for private health insurance, the following questions have arisen: How large is the co-payment for a COVID-19 test? If my doctor’s office is closed, will the telemedicine consultation be covered by my insurance? Will my coronavirus care be paid for regardless of how I contracted the virus? These and other doubts can prevent people from seeking medical care in some countries.

In Nigeria, like many other countries in Africa, the government bears the costs associated with testing and treating COVID-19 irrespective of the individual’s insurance status. In the public health sector, where COVID-19 cases are treated, health workers are paid monthly salaries while budgets are allocated to health facilities for other services. Hospitals continue to receive budget allocations to finance all health services including the management and treatment of COVID-19. That implies that funds allocated to address other health needs are reduced and that in turn could affect the availability and quality of health services.

Although health workers providing care for COVID-19 patients in isolation and treatment centres in Nigeria are paid salaries that are augmented with a special incentive package, the degree of impact on the quality improvement of services remains unclear. The traditional and historical allocation of budgets does not always address the needs of the whole population and could result in poor health services and under-provision of health services for COVID-19 patients.

In some countries, the reliance on out-of-pocket funding is hardly better for private providers, who encounter brand risks, operational difficulties, and – in extreme cases – the risk of creating “debtor prisons” as they seek to collect payment from patients. Ironically, despite the huge demand for medical services to diagnose and treat COVID-19, large healthcare institutions and individual healthcare practitioners alike are facing financial distress.

Dependence on a steady stream of fee-for-service payments for outpatient consultations and elective procedures is leading to pay cuts for doctors in India , forfeited Eid bonuses for nurses in Indonesia , and hospital bankruptcies in the United States . In a recent McKinsey & Company survey, 77% of physicians reported that their business would suffer in 2020 , and 46% were concerned about their practice surviving the coronavirus pandemic.

COVID-19 is exposing how fee-for-service, historical budget allocation and out-of-pocket financing methods can hinder the performance of the health system. Some providers and health systems that deployed “value-based” models prior to the pandemic have reported that these approaches have improved financial resilience during COVID-19 and may support better results for patients. Nevertheless, these types of innovations do not represent the dominant payment model in any country.

How health service providers are paid has implications for whether service users can get needed health services in a timely fashion, and at an appropriate quality and an affordable cost. By shifting from fee-for-service reimbursements to fixed "capitation" and performance-based payments, these models incentivize providers to improve quality and coordination while also guaranteeing a baseline income level, even during times of disruption.

Health service providers could be paid either in the form of salaries, a fee for services they provide, by capitation (whether adjusted or straightforward), through global budgets, or by using a case-based payment system (for example, the diagnostics-related groups), among others. Because there are different incentives to consider when adopting any of the methods, they could be combined to achieve a specific goal. For example, in some countries, health workers are paid salaries , and some specific services are paid on a fee-for-service basis.

Ideally, health services could be purchased strategically , incorporating aspects of provider performance in transferring funds to providers and accounting for the health needs of the population they serve.

In this regard, strategic purchasing for health has been advocated and should be highlighted as crucial with the emergence of the COVID-19 pandemic. There is a need to ensure value in the way health providers are paid, inter alia to increase efficiency, ensure equity, and improve access to needed health services. Value-based payment methods, although not new in many countries, provide an avenue to encourage long-term value for money, better quality, and strategic purchasing for health, helping to build a healthier, more resilient world.

7. L essons in integrated care from the COVID-19 pandemic

Sarah Ziegler, Postdoctoral Researcher, Department of Epidemiology and Biostatistics, University of Zurich, and Ninie Wang, Founder & CEO, Pinetree Care Group.

Since the start of the COVID-19 pandemic, people suffering non-communicable diseases (NCDs) have been at higher risk of becoming severely ill or dying. In Italy, 96.2% of people who died of COVID-19 lived with two or more chronic conditions.

Beyond the pandemic, cardiovascular disease, cancer, respiratory disease and diabetes are the leading burden of disease, with 41 million annual deaths. People with multimorbidity - a number of different conditions - often experience difficulties in accessing timely and coordinated healthcare, made worse when health systems are busy fighting against the pandemic.

Here is what happened in China with Lee, aged 62, who has been living with Chronic Obstructive Pulmonary Disease (COPD) for the past five years.

Before the pandemic, Lee’s care manager coordinated a multi-disciplinary team of physicians, nurses, pulmonary rehabilitation therapists, psychologists and social workers to put together a personalized care plan for her. Following the care plan, Lee stopped smoking and paid special attention to her diet, sleep and physical exercises, as well as sticking to her medication and follow-up visits. She participated in a weekly community-based physical activity program to meet other COPD patients, including short walks and exchange experiences. A mobile care team supported her with weekly cleaning and grocery shopping.

Together with her family, Lee had follow-up visits to ensure her care plan reflected her recovery and to modify the plan if needed. These integrated care services brought pieces of care together, centered around Lee’s needs, and provided a continuum of care that helped keep Lee in the community with a good quality of life for as long as possible.

Since the COVID-19 outbreak, such NCD services have been disrupted by lockdowns, the cancellation of elective care and the fear of visiting care service . These factors particularly affected people living with NCDs like Lee. As such, Lee was not able to follow her care plan anymore. The mobile care team was unable to visit her weekly as they were deployed to provide COVID-19 relief. Lee couldn’t participate in her community-based program, follow up on her daily activities, or see her family or psychologists. This negatively affected Lee’s COPD management and led to poor management of her physical activity and healthy diet.

The pandemic highlights the need for a flexible and reliable integrated care system to enable healthcare delivery to all people no matter where they live, uzilizing approaches such as telemedicine and effective triaging to overcome care disruptions.

Lee’s care manager created short videos to assist her family through each step of her care and called daily to check in on the implementation of the plan and answer questions. Lee received tele-consultations, and was invited to the weekly webcast series that supported COPD patient communities. When her uncle passed away because of pneumonia complications from COVID-19 in early April, Lee’s care manager arranged a palliative care provider to support the family through the difficult time of bereavement and provided food and supplies during quarantine. Lee could even continue with her physical activity program with an online training coach. There were a total of 38 exercise videos for strengthening and stretching arms, legs and trunk, which she could complete at different levels of difficulty and with different numbers of repetitions.

Lee’s case demonstrates that early detection, prevention, and management of NCDs play a crucial role in a global pandemic response. It shows how we need to shift away from health systems designed around single diseases towards health systems designed for the multidimensional needs of individuals. As part of the pandemic responses, addressing and managing risks related to NCDs and prevention of their complications are critical to improve outcomes for vulnerable people like Lee.

How to design and deliver successful integrated care

The challenge for the successful transformation of healthcare is to tailor care system-wide to population needs. A 2016 WHO Framework on integrated people-centered health services developed a set of five general strategies for countries to progress towards people-centered and sustainable health systems, calling for a fundamental transformation not only in the way health services are delivered, but also in the way they are financed and managed . These strategies call for countries to:

Whether due to an unexpected pandemic or a gradual increase in the burden of NCDs, each person could face many health threats across the life-course.

Only systems that dynamically assess each person’s complex health needs and address them through a timely, well-coordinated and tailored mix of health and social care services will be able to deliver desired health outcomes over the longer term, ensuring an uninterrupted good quality of life for Lee and many others like her.

8 . Why access to healthcare alone will not save lives

Donald Berwick, President Emeritus and Senior Fellow, Institute for Healthcare Improvement; Nicola Bedlington, Special Adviser, European Patient Forum; and David Duong, Director, Program in Global Primary Care and Social Change, Harvard Medical School.

Joyce lies next to 10 other women in bare single beds in the post-partum recovery room at a rural hospital in Uganda. Just an hour ago, Joyce gave birth to a healthy baby boy. She is now struggling with abdominal pain. A nurse walks by, and Joyce tries to call out, but the nurse was too busy to attend to her; she was the only nurse looking after 20 patients.

Another hour passes, and Joyce is shaking and sweating profusely. Joyce’s husband runs into the corridor to find a nurse to come and evaluate her. The nurse notices Joyce’s critical condition - a high fever and a low blood pressure - and she quickly calls the doctor. The medical team rushes Joyce to the intensive care unit. Joyce has a very severe blood stream infection. It takes another hour before antibiotics are started - too late. Joyce dies, leaving behind a newborn son and a husband. Joyce, like many before her, falls victim to a pervasive global threat: poor quality of care.

Adopted by United Nations (UN) in 2015, the Sustainable Development Goals (SDG) are a universal call to action to end poverty, protect the planet and ensure that all enjoy peace and prosperity by 2030. SDG 3 aims to ensure healthy lives and promote wellbeing for all. The 2019 UN General Assembly High Level Meeting on Universal Health Coverage (UHC) reaffirmed the need for the highest level of political commitment to health care for all.

However, progress towards UHC, often measured in terms of access, not outcomes, does not guarantee better health, as we can see from Joyce’s tragedy. This is also evident with the COVID-19 response. The rapidly evolving nature of the COVID-19 pandemic has highlighted long-term structural inefficiencies and inequities in health systems and societies trying to mitigate the contagion and loss of life.

Systems are straining under significant pressure to ensure standards of care for both COVID-19 patients and other patients that run the risk of not receiving timely and appropriate care. Although poor quality of care has been a long-standing issue, it is imperative now more than ever that systems implement high-quality services as part of their efforts toward UHC.

Poor quality healthcare remains a challenge for countries at all levels of economic development: 10% of hospitalized patients acquire an infection during their hospitalization in low-and-middle income countries (LMIC), whereas 7% do in high-income countries. Poor quality healthcare disproportionally affects the poor and those in LMICs. Of the approximately 8.6 million deaths per year in 137 LMICs, 3.6 million are people who did not access the health system, whereas 5 million are people who sought and had access to services but received poor-quality care.

Joyce’s story is all too familiar; poor quality of care results in deaths from treatable diseases and conditions. Although the causes of death are often multifactorial, deaths and increased morbidity from treatable conditions are often a reflection of defects in the quality of care.

The large number of deaths and avoidable complications are also accompanied by substantial economic costs. In 2015 alone, 130 LMICs faced US $6 trillion in economic losses. Although there is concern that implementing quality measures may be a costly endeavor, it is clear that the economic toll associated with a lack of quality of care is far more troublesome and further stunts the socio-economic development of LMICs, made apparent with the COVID-19 pandemic.

Poor-quality care not only leads to adverse outcomes in terms of high morbidity and mortality, but it also impacts patient experience and patient confidence in health systems. Less than one-quarter of people in LMICs and approximately half of people in high-income countries believe that their health systems work well.

A lack of application and availability of evidenced-based guidelines is one key driver of poor-quality care. The rapidly changing landscape of medical knowledge and guidelines requires healthcare workers to have immediate access to current clinical resources. Despite our "information age", health providers are not accessing clinical guidelines or do not have access to the latest practical, lifesaving information.

Getting information to health workers in the places where it is most needed is a delivery challenge. Indeed, adherence to clinical practice guidelines in eight LMICs was below 50%, and in OECD countries, despite being a part of national guidelines, 19-53% of women aged 50-69 years did not receive mammography screening.4 The evidence in LMICs and HICs suggest that application of evidence-based guidelines lead to reduction in mortality and improved health outcomes.

Equally, the failure to change and continually improve the processes in health systems that support the workforce takes a high toll on quality of care. During the initial wave of the COVID-19 pandemic, countries such as Taiwan, Hong Kong, Singapore and Vietnam, which adapted and improved their health systems after the SARS and H1N1 outbreaks, were able to rapidly mobilize a large-scale quarantine and contact tracing strategy, supported with effective and coordinated mass communication.

These countries not only mitigated the economic and mortality damage, but also prevented their health systems and workforce from enduring extreme burden and inability to maintain critical medical supplies. In all nations, investing in healthcare organizations to enable them to become true “learning health care systems,” aiming at continual quality improvement, would yield major population health and health system gains.

The COVID-19 pandemic underscores the importance for health systems to be learning systems. Once the dust settles, we need to focus, collectively, on learning from this experience and adapting our health systems to be more resilient for the next one. This implies a need for commitment to and investment in global health cooperation, improvement in health care leadership, and change management.

With strong political and financial commitment to UHC, and its demonstrable effect in addressing crises such as COVID-19, for the first time, the world has a viable chance of UHC becoming a reality. However, without an equally strong political, managerial, and financial commitment to continually improving, high-quality health services, UHC will remain an empty promise.

1. United Nations General Assembly. Political declaration of the high-level meeting on universal health coverage. New York, NY2019.

2. Marmot M, Allen J, Boyce T, Goldblatt P, Morrison J. Health equity in England: the Marmot review 10 years on. Institute of Health Equity;2020.

3. National Academies of Sciences, Engineering, and Medicine: Committee on Improving the Quality of Health Care Globally. Crossing the global quality chasm: Improving health care worldwide. Washington, DC: National Academies Press;2018.

4. World Health Organization, Organization for Economic Co-operation and Development, World Bank Group. Delivering quality health services: a global imperative for universal health coverage. World Health Organization; 2018.

5. Kruk ME, Gage AD, Arsenault C, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. The Lancet Global Health. 2018;6(11):e1196-e1252.

6. Ricci-Cabello I, Violán C, Foguet-Boreu Q, Mounce LT, Valderas JM. Impact of multi-morbidity on quality of healthcare and its implications for health policy, research and clinical practice. A scoping review. European Journal of General Practice. 2015;21(3):192-202.

7. Valtis YK, Rosenberg J, Bhandari S, et al. Evidence-based medicine for all: what we can learn from a programme providing free access to an online clinical resource to health workers in resource-limited settings. BMJ global health. 2016;1(1).

8. Institute of Medicine. Best Care at Lower Cost: The Path to Continuously Learning Health Care in America . Washington, DC: National Academies Press 2012.

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Lay perspectives: advantages for health research


Although involvement of the consumer is increasingly being advocated in health related research, it is not welcome universally. Furthermore, the underlying rationale is rarely made explicit. Policy makers, health care professionals, and researchers need to be clear about the benefits and ways of including lay perspectives and the criteria for evaluating these. Examples of lay involvement in setting research agendas, 1 2 3 4 methodological debate, 5 and specific projects 4 6 4 are accumulating, but little clear evidence about the benefits and costs of different ways of incorporating lay input into health services research is available.

We outline two basic reasons for incorporating lay perspectives into research and discuss some common objections. A framework is offered to help clarify the dimensions of lay involvement in health research. We use the term “lay” to mean people who are neither health care professionals nor health services researchers, but who may have specialised knowledge related to health. This includes patients, the general public, and consumer advocates.

The origins of lay involvement

The current interest in incorporating lay perspectives into health services research reflects broad social and political trends and developments in health care that have involved some breaching of the boundaries between medical professionals and others. The assumptions that the “experts”–doctors and biomedical researchers—are the best judges of what research is needed and should be exempt from democratic accountability are questioned. In addition, theoretical and empirical work on the philosophy and sociology of science has shown that the culture and values of those involved can influence research and the knowledge derived from it. 8 The relevance of much research that has been driven by narrow professional and academic interests is increasingly being questioned. 9 10

Summary points

Including lay people in health services research has been mandated politically and could improve the quality and impact of research

Patients and …

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How to Choose a Health Essay Topic?

When writing about health, there is a lot to say, that’s why it’s so hard to find the right topic for you. As a general reference, you can choose one of two types of topics:

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How to write Essay about Health?

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Medical Perspectives on Death and Dying

Several states have begun to consider legislation that would legalize active voluntary euthanasia.

Several states have begun to consider legislation that would legalize active voluntary euthanasia. To address some of the ethical issues raised by such legislation, the Center for Applied Ethics sponsored a symposium entitled Legalizing Euthanasia: Ethical Perspectives on Medicine and Dying . Principal speakers were Derek Humphry, founder and president of the Hemlock Society, and author of the current best-seller, Final Exit , a suicide manual for the terminally ill; and Richard Gula, S.S., Ph.D., a professor of moral theology at St. Patrick's Seminary in Menlo Park, California. The symposium was funded in part by the California Council for the Humanities, a state program of the National Endowment for the Humanities. The following excerpts highlight the remarks of Mr. Humphry and Father Gula.

Derek Humphry Let me explain how I became involved with the subject of euthanasia. In 1974 my first wife, Jean, was dying of bone cancer. Thrombosis had set in, her bones were cracking and she was losing control of her bowels. One day, after a very close brush with death, she sat up in her hospital bed and said to me, "Will you help me die?" That is when I first encountered the issue of euthanasia; from across my late wife's hospital bed.

After she made her request, I asked myself, "What if I were sitting in that hospital bed? What if I had had two years of pain and agony? What if I faced an imminent death? What if I was losing control of my bowels and my bones were cracking and so-forth?" I realized then that I would be asking her to help me to die. That, ladies and gentlemen, is my simple reason for what I did. It was an act of love.

Jean had been a good wife to me for 22 years. She stood by me in good times and bad. And when she was experiencing a bad time, I felt it was my duty to support her in her decision. I am not a Christian. I am an atheist. So, for me there was no question of consulting any god. It was a matter of situational ethics.

In 1980, five years after Jean's death, I helped to establish the Hemlock Society. This organization seeks to change certain laws regarding suicide. We want the government to decriminalize the actions taken by physicians in the assisted suicides of terminally ill patients.

We believe that a mentally competent adult who is dying should be able to submit a written request to their doctor that would state, "I've had all I can take. The pain and suffering are too much. I wish to die. Help me."

The physician, according to the Hemlock movement's prepared law, would have to obtain the opinion of a second doctor. They would both have to agree that the person is dying. The first doctor could then end the life of the patient with an oral or intravenous drug overdose, without the threat of prosecution or lawsuit. Our laws also state that the doctor could elect not to assist the patient with such an action.

There are those who agree with what the Hemlock movement is saying at the present time, but are fearful that such an ideology would result in a system of euthanasia similar to that used by Nazi forces. It is true that the Nazis introduced a program which they called euthanasia. They murdered about 100,000 people who were physically or mentally handicapped. No senior citizens or terminally ill people were allowed to voluntarily end their own lives.

But how can you say to a person who is dying of throat cancer today that they cannot have voluntary euthanasia because of what the Germans did in 1940 and 1942? I think that the person would respond, "It's not relevant. It's me. It's my body. It's my liberty. It's my life. And it's my death. Let me have control."

I would claim that this is the ultimate civil liberty. If we cannot go to our deaths in the manner of our own choosing, what liberty do we have?

Richard Gula Most of the focus on euthanasia so far has been dominated by what I'm going to call the paradigm of individual case analysis. My position is that euthanasia is not primarily an individual issue; it's a societal one. So discussion about euthanasia should not be governed primarily by individual case ethics, but by societal ethics.

The sanctity of life principle is probably the common ground principle. There are two extreme positions that can give sanctity of life as a principle a bad name. One extreme is what I call vitalism, and that is the extreme that tries to absolutize physical life making an idol out of biological existence. This principle says no cost is too great to keep this biological life going. The other extreme interpretation leads to what I'm calling a utilitarian perspective, which values life for its usefulness. This is the interpretation that says only the strongest and the fittest ought to survive. The danger here is the abuse of undertreatment.

I want to think about the sanctity of life from the middle position. This is the interpretation of the principle that recognizes we have limited dominion over life. It's the interpretation that says we are stewards of life, that we ought to care for life and promote it and enhance it in order to allow our lives to flourish and to achieve our potential. This is the interpretation that wants to respect life in all its forms and in all its stages. Interpreting sanctity of life in this way entails two obligations: a positive one--to nurture and support life„and a negative obligation not to harm life. Therefore, to appeal to sanctity of life in a discussion of euthanasia is to create a presumption in favor of life.

The second principle is the principle against the prohibition of killing. I want to look at three ways of interpreting this principle. The first says there is no moral difference between killing and allowing to die -- that once you decide that life no longer needs to be sustained, because the use of treatment would be futile, then it makes no difference whether you actively intervene or simply withhold or withdraw treatment.

The second interpretation is that there is a qualified moral difference. That qualified moral difference is that the distinction holds but gives way at a certain point. Some will say when the person has gone beyond the reach of human care, when there is no longer the capacity to receive love, or to receive comfort, then the distinction dissolves. Others will say when the person is in intractable pain and there's nothing more that can be done to relieve the pain, then the distinction between killing and allowing to die dissolves. Others would say when the patient is overtaken by the dying process -- that is to say, once you have decided that nothing more needs to be done, that life has reached its limits, then it makes no difference whether you withhold treatment or intervene, because in that condition, you are not usurping the dominion that is not yours. Then there's the third position that says the distinction holds all the way through.

The next principle is the principle of autonomy, which is probably going to be at the core of this discussion of whether euthanasia ought to be legalized. In our culture, we interpret autonomy as the right to self determination. The prevailing interpretation of autonomy in our culture is that autonomy is there to maximize self-interest. That means that we are able to pursue our own goals and life plans without external constraints. When we interpret autonomy this way, we answer the question "whose life is it anyway?" in favor of the one whose life is in question. This is solid ground for supporting euthanasia.

Can the principle of autonomy be used to challenge euthanasia? Some argue that the very interpretation of autonomy that says that you have the freedom to have another person intervene to take your life is a contradiction of what autonomy means -- that actually what you're doing is giving away your freedom. The other way of looking at it is to say that euthanasia is not primarily a private affair. It's a public or societal action that involves others, and therefore it is something that ought to be treated as a form of public action.

The third principle is the principle of the common good. To show that euthanasia ought to be sanctioned as a public practice, we need to be able to show that we can justify it in more than the individual case. This is the principle that says that when we establish a policy, we are sanctioning actions as a common practice. When we apply that principle to euthanasia, we need to ask, "how does the goal of my own private killing contribute towards making society the context in which human life can flourish?"

Now let's turn to the perspective of virtue. Virtue asks whether or not a policy on euthanasia creates the right kind of relationship between the physician and the patient, and would a policy on euthanasia create the right kind of community in which health care is delivered. The perspective of virtue asks that the physician deliver compassionate care within the limits of the physician's role. The trust that we extend to the medical profession to heal and protect life is something that we would want to sustain and the perspective of virtue asks whether that kind of trusting relationship would be enhanced or hindered if euthanasia became part of the options that are available to the physician. The perspective of virtue looks on ourselves as a community of interdependents in which we are partners to one another. It sustains the community of trust and care by promising not to abandon anyone, and it tries to be realistic about accepting the limits about what it means to be human. We recognize that life will not be free of suffering, that life will be burdensome, and there will be tragedy. The perspective of virtue tries to be realistic about accepting that. It encourages us to construct structures of support which will enable us to raise those who suffer into the network of the supportive, caring community.

Ultimately we cannot convert individual cases into public policy without having something remaining. The common good resists the temptation. How do the burdens to one individual compare to the burdens and the benefit on society as a whole? I think all of this ultimately is going to turn not on the basis of principles we argue with, but on the kind of people we are. Are we a virtuous people that creates a community of caring or are we going to compromise that in the way we allow euthanasia to become a practice in our healing society?

Videotapes of the symposium are available for $16.50 by writing to the Center for Applied Ethics, Santa Clara University, Santa Clara, CA 95053.

This article was originally published in Issues in Ethics - V. 5, N. 2 Fall 1991

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