In scientific circles, the “social determinants of health” is a common phrase used to describe how one’s zip code can have more impact on health outcomes than one’s personal health. This book plays off that title by describing how America’s political situation – whether one is part of a favored class or note – can influence health outcomes. It takes particular aim at health inequities in American history.
Daniel Dawes describes attempts in American history to provide a better, centrally organized healthcare system: namely, under Franklin Pierce and with the Freedman’s Bureau after the Civil War. Both attempts, sadly, did not induce lasting change. Harry Truman and Bill Clinton failed to produce Congressional legislation to pass into law.
In recent years, Barack Obama did succeed in passing the Affordable Care Act, more commonly known as Obamacare. That legislation imperfectly sought to address health inequities that might produce a less healthy workforce or extra, unnecessary expenditures on the system. Of course, Republicans sought to repeal and replace that legislation for the next decade, but largely failed in their efforts. Dawes concludes by describing the future of work in health inequities. This book preceded the second Trump administration and how research work in health inequities has been suppressed. Thus, the story of the political determinants of health is ongoing.
I appreciated a look at the politics surrounding healthcare. Make no mistake, though: This book is a work of political science more than public health. I would have liked to have heard more stories about how politics affected lives outside of Washington. That integrative work describing a transformation of American culture still awaits us – as does a lasting resolution to today’s health care debates. I’m not sure Obamacare represented as much of a long-term new paradigm as a first foray into health reform. Given that health has been considered a “third rail” of American politics, I believe continued bipartisan conversations about this issue are necessary for a better system. Perhaps only then can the “general welfare” of the American people’s health be realized in a less controversial and less passion-filled manner. I can only hope that health inequities will play a significant role in that resolution.
The Political Determinants of Health
By Daniel E. Dawes
Narrated by David Marantz
Text copyright (c) 2020
Johns Hopkins University Press
Audio copyright (c) 2020
Tantor Audio
ASIN B08HW26P72
Length: 7:37
Genre: Political Science
www.amazon.com