The authors include Paul E Farmer, Bruce Nizeye, Sara Stulac, Salmaan Keshavjee. Paul Farmer is a physician and anthropologist that is very active on this subject and has many different publications on the matter. Paul and the other authors are all involved with Partners in Health. All authors are doctors and very active in global health and efforts. Partners in Health focuses on developing healthcare in countries of need.
Emergency response isn't really addressed to the degree of the disaster discussed last week. The response discussed in this article isn't about immediate emergency response, triage or even fallout aftermath. The response discussed in this article was more about the analysis of social parameters on the spread of disease. The response in this case would be the need to better address these social influences on the spread of disease in certain populations.
This article utilized a study from the 90s that was performed in Baltimore. Statistics and studies performed in Haiti and Rwanda on the populations were also cited as arguments in the article. Publications and information provided by the PIH were also referenced and utilized to support the argument in the paper.
"The distribution and outcome of chronic infectious diseases, such as HIV/AIDS, are so tightly linked to social arrangements that it is difficult for clinicians treating these diseases to ignore social factors. Although AIDS is often considered a “social disease,” clinicians may have radically different understandings of what makes AIDS “social.”
"The impact of structural violence is even more obvious in the world's poorest countries and has profound implications for those seeking to provide clinical services there. "
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"We can begin to address this by “resocializing” our understanding of disease distribution and outcome. Even new diseases such as AIDS have quickly become diseases of the poor, and the development of effective therapies may have a perverse effect if we are unable to use them where they are needed most. "
I researched the statistics and numbers of HIV and and information about demographics as well as prevalence in areas such as Rwanda and Haiti. I also researched the PIH and its efforts globally while browsing their website and read about their Priority Programs, as well as countries they assist. I also researched the authors and took a look at the main author's other articles that he cited this paper in.
The authors support their argument many ways, one being how that the rates of HIV/AIDS are so positively linked and correlated with social arrangements that it is often referred to as social disease. HIV commonly effects those that are poor and disease rates are fueled by gender inequality, racism and poverty. The article discusses how structural violence has influenced HIV progression. The article cites that structural violence influences diagnosis rates, staging and treatment. The also article references a study done in Baltimore which reports racism and poverty forms of structural violence and the effects on excess mortality among African Americans without insurance- ultimately showing they were more likely to to be susceptible. The authors also used other historical data and research to support heir claims. Efforts through Partners in Health were made to prevent the spread and transmission of diseases in Haiti. The efforts made in Haiti and Rwanda were cited, both the positives and negatives. The article also discusses ways to incorporate more interventions to help eliminate any social influences of disease.
Many studies used as references for this article have to do with the biosocial aspects of diseases. Many of the articles trace the spread of disease in different populations and analyze the population's demographics. Health care utilization and social aspects are all themes that are seen in most of the references in this study. There are also many epidemiological studies. The dates of studies date back as early as the 80s and as recent as the year the article was written in 2006. This shows an extensive and thorough amount of research. The articles are also taken from reputable sources and journals and written by experts as well, showing a great deal of care and effort gone into research aspects of this article.
This article focuses on the fact that there not only biological aspects of disease and the spread of it, but also social factors that need more attention. The article cites that epidemic disease is linked with social conditions such as structural violence, education, income and more. The article addresses the fact that social conditions have an effect on disease prevention and many diseases quickly become diseases of the poor due to this. There are social conditions that effect patient's abilities to defend themselves against disease based off money, social condition, infrastructure, access to food etc. The concept of structural violence and its effects on disease spread within the poor community is discussed and analyzed. Overall, the main point to be driven home is the fact that disease spread can be decreased with the reconfiguration and addressing of social issues.
Paul Farmer cites this paper in some of his other studies and articles written after this. The article has also been cited in a book entitled "Social Medicine in the 21st Century" by Samuel Barrack. This article has also been cited in:
https://dash.harvard.edu/bitstream/handle/1/10612556/3585352.pdf;sequen…
http://opensample.info/blindness-survey-methods-response-from-sudan-stu…;