PHA-Exch> Politics is nothing but medicine at a larger scale: reflections on public health's biggest idea

[Claudio Schuftan]

From: Ruggiero, Mrs. Ana Lucia (WDC) <ruglucia at paho.org>
crosposted from: EQUIDAD at listserv.paho.org


  *Politics is nothing but medicine at a larger scale:
reflections on public health's biggest idea*

*Prof. Johan P. Mackenbach, Department of Public Health
*Erasmus MC - University Medical Center Rotterdam - The Netherlands
*J Epidemiol Community Health 2009;63:181–184. doi:10.1136/jech.2008.077032*

*Abstract*<http://jech.bmj.com/cgi/content/abstract/63/3/181?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Mackenbach&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT>
*  *Website: http://jech.bmj.com/current.dtl

".......This essay retraces the historical origins and contemporary
resonances of *Rudolf Virchow's famous statement*
*"Medicine is a social science, and politics nothing but medicine at a
larger scale*".
Virchow was convinced that social inequality was a root cause of ill-health,
and that medicine therefore had to be a social science.
Because of their intimate knowledge of the problems of society, doctors
according to Virchow also were better statesmen.

Although Virchow's analogies between biology and sociology are out-of-date,
some of his core ideas still resonate in public health.
This applies particularly to the notion that whole populations can be sick,
and that political action may be needed to cure them.
Aggregate population health may well be different from the sum (or average)
of the health statuses of all individual members:
populations sometimes operate as malfunctioning systems, and positive
feedback loops will let population health diverge from t
he aggregate of individual health statuses.

There is considerable controversy among epidemiologists and public health
professionals about how far one should go in influencing
political processes. A "ladder of political activism" is proposed to help
clarifying this issue, and examples of recent public health
successes are given which show that some political action has often been
required before effective public health policies and
interventions could be implemented........"

*Commentaries*   *Virchow, a model for epidemiologists*
Rodolfo Saracci
J Epidemiol Community Health 2009; 63: 185. doi:10.1136/jech.2008.083204
[Extract] <http://jech.bmj.com/cgi/content/extract/63/3/185>    *Why is
epidemiology necessary to policy-making?*
Paolo Vineis and Paul Elliott
J Epidemiol Community Health 2009; 63: 186-187. doi:10.1136/jech.2008.082941
[Extract] <http://jech.bmj.com/cgi/content/extract/63/3/186>     *Is
epidemiology nothing but politics at a different level?*
Alfredo Morabia
J Epidemiol Community Health 2009; 63: 188-190. doi:10.1136/jech.2008.083162
[Extract] <http://jech.bmj.com/cgi/content/extract/63/3/188>
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