Health inequities are growing globally, between and within countries. In the end, it is the poor who become tragic victims of this injustice.
“Our children have dramatically different life chances depending on where they were born. In Japan or Sweden they can expect to live more than 80 years; in Brazil, 72 years; India, 63 years; and in one of several African countries, fewer than 50 years… The poorest of the poor have high levels of illness and premature mortality…the lower the socioeconomic position, the worse the health.
It does not have to be this way and it is not right that it should be like this. Where systematic differences in health are judged to be avoidable by reasonable action they are, quite simply, unfair. It is this that we label health inequity” (WHO Commission on the Social Determinants of Health)
And this past week, PAHO/WHO Office of Programme Coordination in Barbados scheduled a meeting to talk about health leadership in the Caribbean, with a clear focus on the social determinants of health, and leadership initiatives in the Caribbean; the real purpose driving these talks was how to eliminate health inequalities through leadership; I participated in these sessions.
Dr. David Satcher was the keynote speaker at this meeting; President Bill Clinton appointed Dr. Satcher as the 16th Surgeon General of the United States in 1998; he is the Director of the Centre of Excellence on Health Disparities, and the Satcher Health leadership Institute Initiative at Morehouse School of Medicine in the USA.
I want to disseminate some of Satcher’s ideas on improving health equity globally, ideas that emanated from the meeting in Barbados.
On a lighter note, Satcher said that when people request his business card, instead of providing a business card, he gladly presents them with a prescription that would contribute to reducing inequities; here is Satcher’s prescription:
• “Moderate physical activity, at least five days a week, 30 minutes per day
• Eat at least five servings of fruits and vegetables a day
• Avoid toxins-tobacco, illicit drugs, and abuse of alcohol
• Responsible sexual behaviour: abstinence plus optimal protection when sexually active
• Daily participation in relaxing and stress reducing activities” (Satcher)
Satcher demanded that we focus on health equity globally; but that while we have to think globally, we may have to act locally.
And in developing health equity, it may be inappropriate to leave the emergence of leaders to chance; there must be unambiguous strategies for developing health leadership.
He spoke about leadership lessons. For him, leadership is: learning experience, listening experience; responding to opportunities, challenges, and crises; team sport that fosters cooperative leadership, where there is a sharing of the institution’s mission, and its history; not dependent on job status or designation; transforming communities, carrying a passion to change things for the better; requires a global perspective; and like a relay race. Satcher then alluded to the Healthy People 2010 goals: increase years and quality of healthy life; eliminate racial and ethnic health inequities; and support diversity goal. President Clinton, he noted, challenged each head of the Cabinet to make the diversity goal happen. Seemingly, Clinton was pushing for the inclusion of health policies in each sector of society, not merely retaining it within the Health and Human Services (or in local parlance, the Ministry of health).
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