gregggonsalves ,
@gregggonsalves@med-mastodon.com avatar

Nice piece by CDC Director Mandy Cohen in NEJM on Integrating Public Health & Health Care. However, the relationship between public health & healthcare isn't that simple. First, a piece on the medicalization of public health and the consequences of that move. 1/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791244/

gregggonsalves OP ,
@gregggonsalves@med-mastodon.com avatar

Now, along with public health being essentially taken over by physicians and slated as a poor relative of biomedicine, we've seen the rise of the financialization of medicine. This piece by the great Don Berwick, puts it bluntly. 2/ https://jamanetwork.com/journals/jama/fullarticle/2801097

gregggonsalves OP ,
@gregggonsalves@med-mastodon.com avatar

And let's face it, medicine is vastly, vastly more well supported than public health. This creates a problem that isn't just solved by "partnerships." The late Elizabeth Fee described this 20 years ago. We simply do not invest in public health. 3/ https://www.healthaffairs.org/doi/full/10.1377/hlthaff.21.6.31

gregggonsalves OP ,
@gregggonsalves@med-mastodon.com avatar

So, yes, we need to talk about the relationship between public health & healthcare, but if you do not talk about the role of politics, money & power that are central to how both fields are constructed in this country, this is just happy talk. There are structural problems we need to face now. end/

NoOneSpecial1 ,
@NoOneSpecial1@mastodon.social avatar

@gregggonsalves In the US, if the healthcare you need doesn't produce a profit for someone, you don't get it. We don't "invest" in public health because hedge funds and/or others can't make a quick profit. The whole stinking system is morally bankrupt. Only when we value health will we, as a society, change.

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