Why are Some People Healthy and Others Not? (Social Institutions and Social Change) Book

Since the mid-1970s, a widely shared view that the determinants of health go well beyond medical care has emerged in the western democracies. What mattered in this newly-formed public health agenda were the more basic determinants of health: the work and physical environment; the genes one inherits; and the style of life one adopts. Yet despite nearly two decades of repeated intellectual efforts to redirect health policy away from curative medicine to more fundamental interventions, the task remains, largely undone. The purpose of this volume is to ask why, and to suggest answers and evidence about the determinants of population health that may help redirect national health policies. It is an unusual volume, in every sense a collaborative effort, growing out of the quarterly seminars and long-term research interests of the population Health Program of the Canadian Institute for Advanced Research (C.I.A.R.). Under the auspices of the C.I.A.R., participants distinguished in the social and the health sciences set out between 1988 and 1993 to probe the links between social hierarchy, the influence of "macroenvironmental" factors on illness patterns, the quality of the "microenvironment," and other such determinants of health. Their findings, reported as occasional papers and subsequently further revised and integrated, constitute separate chapters of this book. In addition to the specific viewpoints adopted and health fields explored here, the editors have provided both an extended introduction and a conceptual framework for the book that elaborates the scholarly group's philosophical and methodological premises. Though the picture presented of the future is not wholly optimistic, this volume will prove essential to an understanding of the underlying public health issues for the next several decades.Read More