It matters to public health greatly because without it, hospitals could refuse to provide critical treatment until they were satisfied that the patient could pay, which can result in death from delay or refusal of care.
1) Factors affecting disease (HIV/AIDS) outcome in different biosocial settings are radically different despite similar, established “risk-factors” in lifestyles/behaviors for individuals. This is because biosocial factors play an important role that is far often overlooked by current medical systems and policies.
2) mother-to-child transmission (MTCT) of HIV, antiretroviral therapy (ART) and infant formula (preventing pediatric aids transmission through mother). MTCT of HIV is driven through universal breastfeeding being mainly pushed by the existing medical structures of the local and international healthcare policy makers. They claimed that the difficulty giving access to infant formula in rural areas and stigma around signing up for an HIV project doomed it to failure; however the projects in Rwanda and Haiti proved otherwise, when the structural “violence” was addressed. This was done mainly by giving both distal and proximal support and care as well as addressing the other social-economic barriers to good medical care in these communities.
3) When locals, who are much more aware of the areas biosocial setting, implications and problems, are utilized in the medical system, the results are multifold. Proximal care provided by an accompagnateur not only reduces barriers to care such as traveling to a hospital for basic medicine, but also creates jobs that contribute to raising the quality of life which is another major factor when examining structural “violence”.
Virtually all of the references include in their title “social”, “structural violence”, a mention of poverty or underdeveloped country/community, or gender/social-status/race. The nature of the references concur with the nature of the article and references mainly other research articles which portray some aspect of the authors’ argument.
While most hospitals would provide stabilizing, lifesaving treatment to those that needed it, there were some that did not. This act really helps the good hospitals (the majority of them) that were already doing what this policy made law, but there were enough instances and examples of hospitals that were not, so the legislature acted. It is also important to note that this act was part of a larger bill (COBRA) that dealt with national healthcare and social security policy.
The article: “Structural Violence and Clinical Medicine” is about the social structures that play into “violence” (anything that causes harm physically, socially, or otherwise). The research seeks to establish the importance of biosocial understanding in the medical field when trying to understand medical problems.
University of Washington: http://www.washington.edu/omad/ctcenter/projects-common-book/mountains-beyond-mountains/explaining-difference/
The Society Pages: https://thesocietypages.org/sexuality/2010/01/18/thinking-about-haiti-structural-violence-through-the-lens-of-m-l-k/
Race in a Bottle: The Story of BiDil and Racialized Medicine in a Post-Genomic Age by Jonathan Kahn
This policy applies to all persons residing (regardless of legal status) in the U.S. and any of its territories as well as the District of Columbia who require medical screening examinations as outlined in the act or treatment for an emergency medical condition.
The article: “Structural Violence and Clinical Medicine” was written by Paul E Farmer, Bruce Nizeye, Sara Stulac, and Salmaan Keshavjee. Paul Farmer is an anthropologist and physician who works professionally as a humanitarian healthcare worker in impoverished nations, physician at Brigham and Women’s Hospital Division of Social Medicine and Health Inequalities, Professor at Harvard University, and cofounder of Partners In Health. Bruce Nizeye is a Director of the Program on Social and Economic Rights. Sara Stulac is a Director of Pediatric Programs at Inshuti Mu Buzima, in Rwanda, and Partners In Health’s deputy chief medical officer. Salmaan Keshavjee is also a physician at Brigham and Women’s Hospital, an instructor at Harvard’s Department of Medicine, and a specialist at Partners In Health on tuberculosis.
It is important to understand the work of Partners in Health (PIH) is to assist underdeveloped countries build high quality healthcare systems, when talking about the authors’ work.
This act was a win for all individuals in EMS as no EMT, nurse, or doctor would have to send a patient in critical need away because there was no one to foot the bill. This was a horrible position that put medical workers in the position of moral culpability for policy formed by higher-ups who never had to deal with the reality of their decisions.
The article seeks to broaden the vision of the current medical system and structures by acknowledging and delivering care with the knowledge of biosocial effects.