PHM-Exch> Politics, primary healthcare and health: was Virchow right?

[Claudio Schuftan]

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


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*Politics, primary healthcare and health: was Virchow right?

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*Barbara Starfield**

*Primary healthcare
**Editors' note Just as this issue was going to press, we learned that
Barbara Starfield MD, MPH, died suddenly and unexpectedly while swimming. Dr
Starfield was a world-renowned scholar and tireless advocate for primary
care and health inequalities research. She made an enormous impact in both
of these fields and her contributions will be greatly missed by our research
community.
We thank Normalie Barton for checking the proofs on behalf of Dr Starfield

**

*J Epidemiol Community Health 2011;65:653-655 doi:10.1136/jech.2009.102780

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Website: http://bit.ly/pTuxH3

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“…..In this issue of JECH, authors from both the People's Health Movement 1
and WHO 2 agree that primary healthcare makes a considerable contribution to
reducing the adverse impact of social inequalities on health.

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That is, primary healthcare is a ‘health equity-producing’ social policy.
Both groups of authors agree that health systems do not exist in isolation
from other social systems. Both provide examples of how the market
orientation of neo-liberal globalisation has worked against improvements in
general and equity in health specifically. The role of world trade
agreements in compromising nutritional status of socially disadvantaged
populations provides a powerful case for the importance of inter-sectoral
approaches in health policy activities.

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Both papers speak of ‘primary health care’ rather than of ‘primary care’.
The distinction between the two is at the heart of achieving greater equity
in health through societal actions. Both clinical practices and system
policies need consideration. 3

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The literature on *‘primary care’* is largely clinical, having to do with
the behaviour of health services professionals and their interactions with
people and, increasingly, the subpopulations for whom they provide services.
Within the last two decades there has been increasing clarity about which ‘*
behaviours*’ are most important to adequacy of primary care: first contact
accessibility and use, identification with a regular source of care that is
person (rather than disease) focused care over time, comprehensiveness of
services available and provided, and coordination (when care from other
places is required).

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*Issue – content: http://bit.ly/o87RK4

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*Related Articles:

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*Primary health care and the social determinants of health: essential and
complementary approaches for reducing inequities in health *

Kumanan Rasanathan, Eugenio Villar Montesinos, Don Matheson, Carissa
Etienne, Tim Evans****

J Epidemiol Community Health 2011;65:656-660 Published November 2009
doi:10.1136/jech.2009.093914

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*Revitalising primary healthcare requires an equitable global economic
system - now more than ever *

David Sanders, Fran E Baum, Alexis Benos, David Legge****

J Epidemiol Community Health 2011;65:661-665 Published December 2009
doi:10.1136/jech.2009.095125

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