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Daniel Dawes Discusses His Just-Published, "The Political Determinants of Health"

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As you note. the medical division Attempted to provide a medical care for five of the five million freed. Slaves Post Civil. It was reauthorized annually. And then you know discussions shutdown eventually not long after eighteen seventy two So effectives Sally but short lived and then. Your Book Discusses And then there's crisis long pause and then you discuss. This comes back for example in your discussion of hill. Burton under Truman There's a national school lunch program or act that Ronald Reagan looked at favorably President Carter and eighty had a mental health systems act so there's other like legislation between then and now let's let's go to the specifics of Applicable terminates and then we'll get to a context current context and you know three primary portable determines That you not discuss. Can you identify those and give a brief overview of why you not those three primary absolutely so so in in the book you know? I explore all the things That contribute to health and survival in this country for our most vulnerable populations including three major aspects voting government and policy. Right and the reason I did that is because as I kept thinking about these multiple interacting determinants of health right and their impact on our overall health and what what scientists researchers have have shown us over the last few years in terms of what really plays an outsized role in our overall health. They've looked at the social determinants of health. The behavioral health determinants and so forth and and and they stopped there and I found it very interesting because you know underlying every single one of these. Social determinants is a political determining political accident accident. So we need to zoom out even further to understand those pieces and and as I think about the political determinants of health you know I see it as involving Systematic process of structuring relationships distributing resources and administering power operating simultaneously in ways a mutually reinforced or influence one another to save opportunities that either advance health equity or exacerbate health inequities. So the way I look at. This is through the Lens of okay. Let's see how voting impacts health. What are the challenges and opportunities there right? How can we use voting? Which is usually deemed. The frontline how can we use that? That part of the process to to bypass government for instance. Right if we have a government that is not Receptive to this health equity agenda. How might you be able to bypass them to get your policy agenda through and so we talk about ballot augmentation and the book In the world. Can you work with the government and that is keen on Shredding you know whatever P- public policy agenda you might have into pieces. How can you work with them in such a situation? And then with the policy piece right which we know concretizes these decisions by by Government Officials how can we ensure that they are taking an equity Lens To their work so I think one of the things that's really interesting about today You know it's really interesting especially as we discuss These issues two days after the tenth anniversary CHARAC being signed into law which I deem as the most comprehensive and inclusive health law that we've ever had passed at the federal level here in the United States There are certainly lessons to be learned from that but what we have now is the perfect storm for disaster right a serious health crisis going on an equitable method of health. Delivery millions of uninsured people in on even politically charged approach to dealing with this pandemic. That we're in an upcoming election. And and some of the most vulnerable people on the frontlines keeping our country. Going all of these things leave us vulnerable and they shine a huge spotlight pot. Light on the holes and the gaps in the the shortfalls in our current system. And so I found it very necessary to to actually single them out from voting. What has happened there that we can leverage or the challenges there right when we talk about you know structuring relationships looking at redistricting redistricting process and how that is used to structure relationships? Right administering power how gerrymandering has been used For such causes and and distributing resources right especially as we look at. What's happening with this pandemic today with with access the To the test right and access hopefully to treatments once that's created the vaccines and so forth. So these are things that are being magnified today that I think The book really does a line and and showing how we can tackle some of these issues.

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