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On a day to day basis as a healthcare professional, this isn’t very important outside of a teaching and understanding standpoint. A disease is, first and foremost, a disease, and needs to be treated accordingly. While healthcare professionals should educate their patients about risk factors that could lead to their increased likelihood of illness, as well as understand and appreciate why some populations are more vulnerable than others, it does not assist in direct disease treatment.

The entire study is focused on vulnerable populations – particularly those who due to racial or economic divides, do not have proper access to healthcare, or may be affected by factors such as poor housing and malnutrition.

The authors received no special funding for this article.

1. The study in Baltimore showed that with a reduction in the influence of socio-economic factors in patients receiving health care services. The studies showed that with their increased awareness and effort the socioeconomic disparities largely vanished. Unfortunately this is also underscored by the emergence of HIV which is resistant to multiple drugs. 

2. The use of the PIH model in Haiti was shown to have positive results there, so much so that it was adapted in Rwanda. The greater challenges faced by this group is water quality and gender inequality.

3. Another way the argument is supported is by discussing the ways that clinicians can help to intervene in structural violence. 

All data was collected through in field studies. They implemented a structure a tested to see how if affected the population.

Paul Farmer is the chair of the Department of GLobal Health and Social Medicine at Harvard Medical School. He is an expert in health care services and advocacy for those who are sick and in poverty. He doesn't appear to be situated in emergency response; he seems to be much more on the follow-up months or years later. Dr. Farmer has myriad publications of relevance to the Network, and his research foci are mostly regarding establishing high-quality health care in resource-poor environments. (http://ghsm.hms.harvard.edu/person/faculty/paul-farmer)

Bruce Nizeye works as the Chief of Infrastructure for PIH in Rwanda. It appears that his expertise is in physical constructs. I could not find how he was situated in emergency response, but it appears that he takes a role on the back side of disasters, much like Dr. Farmer. (http://www.pih.org/blog/the-voices-of-our-colleagues/)

Sara Stulac is an Associate Physician in the Division of Global Health Equity at BWH. She is also the Deputy Chief Medical Director for PIH. She seems to be an expert in pediatrics, specifically HIV care and prevention and oncology. Like her other authors mentioned on this page, she does not seem to be directly involved with emergency response. Her research foci are mostly not related to emergency response, but dealing with non-emergent pediatric care. (http://www.brighamandwomens.org/Departments_and_Services/medicine/servi…)

Salmaan Keshavjee is a professor at HMS and a physician at BWH. He has conducted research on post-Soviet Tajikistan's health transition and worked on an MDR-TB treatment program in Tomsk, Russia. Rather than emergency response, Dr. Keshavjee seems to be focused on epidemiology like his co-authors. He has a number of research foci including MDR-TB treatment and policy, health-sector reform in transnational societies, the role of NGOs in the formation of trans-border civil society, and "modernity, social institutions, civil society, and health in the Middle East and Central Asia. (http://ghsm.hms.harvard.edu/person/faculty/salmaan-keshavjee)

This article argues that when examining the spread of disease, fighting biosocial aspects are as important as fighting the biological aspects. The authors argue that structureal violence, which is introduced by inequality leads to premature death and disability. By "resocializing" we can prevent diseases such as TB and AIDS from staying diseases of the poor.

The authors support their argument by referencing a study that showed that race was associated with how quickly one received therapeutics. They also referenced that PIH was able to help in Haiti by introducing a model of care in which the patients chose someone to assist them by delivering drugs and supportive care in their home. This person would live nearby and was seen by some as a very effective way to remove barriers to care for AIDS and other chronic diseases in impoverished environments. They also say by removing issues like access to clean water that impoverished areas see, MTCT rates of HIV decreased.

Bruze Nizeye and Sara Stulac both work with Partners in Health (founded by Paul Farmer) while Salmaan Keshavjee is a physician and researcher whose expertise is in multi-drug resistant tuberculosis and global health. Farmer's and Keshavjee's anthropological research in particular is important to emergency response because it would allow for improved preparation of treatment to those communities. Their work in seeing the social causes of health epidemics would also allow for better prevention of disasters. 

The main argument was that there are "biosocial phenomena" or "structural violence" that lead to the tendency for certain diseases or lack of treatment in populations, particularly those in poverty. Their three major findings were: they can make structural interventions to "decrease the extent to which social inequities become embodied as health inequities", proximal interventions can reduce premature morbidity and mortality, and structural interventions "can have an enormous impact on outcomes.