We know that pandemics, natural disasters, wars, and other crises magnify the burden of disease among people who experience poverty and other marginalized groups. With the COVID-19 pandemic, the flaws in our health care system and social safety net have been unmasked, highlighting how inequities in education, income, and housing can cripple a nation’s response to a crisis. Also laid bare is the reality that this pandemic is likely to deepen the consequences of inequality, especially in communities of color. At the same time, it offers a timely exercise in understanding how policies and politics influence health and survival for our country’s most vulnerable populations.
In The Political Determinants of Health, Daniel Dawes, director of the Satcher Health Leadership Institute at the Morehouse School of Medicine, explores the political decisions and drivers underlying the social determinants of health. The US, Dawes observes, has struggled to apply the doctrines of equal protection and general welfare to its laws and policies for more than 225 years. As a result, implicit biases are so baked into our political system that even in the most dire health emergencies, our actions tend to help or favor some groups over others. Consider how policy decisions have differentially affected those experiencing opioid addiction, mental illness, or HIV infection, for example. (author introduction)
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