Lecture highlights social determinants of health

The Institute of Community and Public Health at Birzeit University held the second of its series of annual “Public Lectures,” on February 10, 2018. The lecture, entitled “Social Determinants of Health and Primary Health Care,” was delivered by visiting professor Dr. John Macdonald from the University of Western Sydney.

Dr. Macdonald, who has been a friend of Birzeit University and a visiting scholar delivering some of its lectures for the past 33 years, began his lecture by praising Palestinian resolve and will to survive, saying “I believe in your struggle and I respect that. Remember that you are not forgotten, neither is your cause.”

Dr. Macdonald then moved to the main topic of his lecture, social determinants of health and primary healthcare, and began by discussing the concept of health. He said, “The concept of health does not just comprise the absence of disease and access to medical treatment, but also access to agriculture, education, and housing. Without those, there is no health.”

“The WHO,” added Dr. Macdonald, “started exploring the social determinants of health in 2003, and while that is a long time ago now, it was still a bit late. Social determinants, such as culture, collective history, wholesome physical environment, early childhood, family of origin, basic needs, access to healthcare and education, work security and satisfaction, political stability, and social gradient have a very noticeable effect on health and well-being.”

“Take, for instance, the Aboriginal peoples from Australia. Their land was taken, their language deconstructed, and their children abducted at young ages. As a result, the life expectancy of the Aboriginal population is usually 10 years shorter than that of other Australians. These are all effects of social determinants.”

Another example by Dr. Macdonald was the people of Japan. The Japanese population, he said, is one of the healthiest in the world, not just because of their healthcare, but because of the narrow gap between the rich and the poor – the social gradient. The US and the UK also have great healthcare facilities, but the pay gap between the poorest and the richest is getting wider with each passing day, further affecting well-being, he noted.

“Health, in my opinion, is the interaction between people and their total environments. Negative interactions, as such, affect health negatively. The children of Aboriginals and the children of Gaza, for example, were both negatively affected by their environments. Aboriginal children were taken from their homes and raised in foreign environments with little or no care to their culture and heritage, resulting in a negative interaction with their environment which negatively affected their health. Children in Gaza, similarly, saw their homes bombed and their neighborhoods leveled to the ground – a severely negative interaction with their total environment, which negatively affected their health,” said Dr. Macdonald.