The main arguement is that there needs to be a larger emphasis on the biosocial understanding of medical phenomina, to help prevent or reverse disease infection in low income, diverse, or war strikin communities.
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.
When community factors such as transportation and insurance status were minimized as factors preventing HIV/AIDs care, the playing field was leveled within a few years. No longer were those issues much more often seen in the patients that did not survive, rather, they were seen more evenly in those that did and did not survive.
Combining clinic treatments with home-visits and prescription drug deliveries has been found to be most effective for treating all people, regardless of social factors, in places from rural Africa to Boston, MA.
Mutli-faceted approach in rural areas were most effective and able to dramatically reduce Mother-to-Infant-Transmission of HIV. This requires more resources and organization, but it takes care of the issue most efficiently in areas that are very poor and have very rudimentary infrastructure, even worse than in poor cities.
Paul E. Farmer is a Harvard research professor and physician and focuses on global health. I was unable to find anything on Bruce Nizeye besides that he was a student at Harvard. Sara Stulac is a Physician at Bigham Womens Hospital with a focus on HIV studies. Salmaan Keshavjee is affiliatted with Harvard Medical School and has written many papers.
"Does our clinical practice acknowledge what we already know—namely, that social and environmental forces will limit the effectiveness of our treatments?"
"This means working at multiple levels, from “distal” interventions—performed late in the process, when patients are already sick—to “proximal” interventions—trying to prevent illness through efforts such as vaccination or improved water and housing quality."
"Yet risk has never been determined solely by individual behavior: susceptibility to infection and poor outcomes is aggravated by social factors such as poverty, gender inequality, and racism."
Paul E Farmer, Bruce Nizeye, Sara Stulac, Salmaan Keshavjee are listed as the authors of this paper. They work with the health workers in suffering countries, like Haiti. Farmer is a co-founder of Partners in Health, as well as a physician and anthropologist. Stulac is an MD, MPH, specializing in pediatrics, and is also associated with PIH. Keshavjee is an MD, PhD, professor at Harvard of Global Health and Social Medicine. They are all professionals in the field of medicine, and through the PIH, they are well acquainted with responding to global health issues.
They researched a lot into tuberculosis/HIV and the social issues that were discussed. Articles on asthma were also reviewed and used, despite asthma not being directly discussed, as well as lead poisoning. This could indicate that more diseases are affected by social issues than discussed in the article, or maybe those diseases didn't show any correlation.
This is a problem that needs to be emergently disscussed, but it doesn't reference emergency response.
This article is more based on the response to disease spread, rather than response to a single emergency event.
A great number of the references from the articles bibliography reference many of Farmers other research papers. This article also researches many data collections in regards to the data which supports the push to a heavier emphasis on biosocial solutions.