Viewpoint: It's time to address how power affects our health

A recent Health Affairs blog calls for healthcare stakeholders to begin examining power as a determinant of health and empowerment as a process to improve population health.

The authors grapple with how public health intersects — and how it fails to intersect —with current sociopolitical events, like the #MeToo movement, gerrymandering cases, inaction on gun control and riots around taking down Confederate statues. While these kinds of issues are not currently part of the public health discourse, they likely would be if the discussion of determinants of health were reframed around power, the authors suggest.

It is generally accepted among public health officials that socioeconomic status, social networks and stigmatization can affect health. Money, knowledge and prominence are also acknowledged as factors in health and the distribution of resources. However, all of these determinants point back to an even more fundamental concept — power.

Power could be considered "upstream of the upstream" factors that affect health and health equity, they write. It influences decision making, determines our national priorities and dictates what is socially acceptable. Sustained power imbalances can become baked into the foundation of systems and structures, creating systemic barriers to opportunities for growth of money, knowledge, prestige and ultimately, health.

While power is implicitly woven into discourse on health determinants, it should be explicitly discussed to broaden the events and issues public health encompasses, according to the authors. This means stakeholders need to talk about what power means, what it includes and how it can be measured. In this way, we can work to improve power imbalances that create health inequities, they write.  

"What is measured matters. Power matters," the authors conclude.  

Read the full essay here.

 

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