I recommend either full participation or at least a cursory review of literature provided in a free online course at Future Learn. Social Determinants of Health: What is Your Role? Much of the data integrated into real world evidence pulls from environmental and economic factors that have been demonstrated to impact health outcomes.
Do you find it impossible to envision a mono-therapeutic solution to a complex framework of chronic disease? Pathways of metabolic derangements nestled within a socioeconomic and political context don't seem amenable to a pharmaceutical panacea. Diseases of aging remind us of how little we know about healthy senescence and the pathology of age.
Consistent with the prevailing ideology of disease, adequate access to healthcare has long been identified as a credible goal for medicine. Not as much credence has been attributed to governance, social position, material circumstances, or social cohesion. Healthcare costs most specifically drug prices are being defended as the price we must pay for innovation. A recent article in Forbes presents a short-sighted view of drug industry pricing--described as a kerfuffle!? Here is where my thoughts land.
Innovation in healthcare and medicine is somewhat limited by biology at the interface of technology and trade-offs in quality of life. Instead of gargantuan investments in R&D or biotech company acquisitions--why don't we look at the real problems. If drug companies stop investing in "innovation" because their billion dollar collective bonuses are being slashed--what will be there new business model?
There is historical precedence for regulations and governance to help direct the "invisible hand" described in 1776 in the Wealth of Nations. Our modern society indeed has evolved into a holistic denial of social determinants of health and their impact on health inequities.
Innovation in healthcare and medicine is somewhat limited by biology at the interface of technology and trade-offs in quality of life. Instead of gargantuan investments in R&D or biotech company acquisitions--why don't we look at the real problems. If drug companies stop investing in "innovation" because their billion dollar collective bonuses are being slashed--what will be there new business model?
There is historical precedence for regulations and governance to help direct the "invisible hand" described in 1776 in the Wealth of Nations. Our modern society indeed has evolved into a holistic denial of social determinants of health and their impact on health inequities.
Unfortunately, discussions of investments in healthcare cluster around the medicalization of disease vs. preventative policy and oversight. Data presented by Yale Global Health Leadership Institute highlights the low investment in social service spending by the US. Interesting to note that we spend more on healthcare than any other nation, have the worst outcomes, and one of the smallest--if not the smallest--investment in social determinants of health.
The animals we eat--domesticated or wild--contain PCBs, hormone disruptors, and radioactivity, the fish has too much mercury, the tap water tastes of chlorine and contains copper, some tap water from fracking areas catches fire, buildings have toxic indoor air, we breathe in dust and nitrogen oxides, and there's too much ozone near the ground but tool little up in the stratosphere where it should be. The oceans are going acidic. Temperatures have gone off the charts. Forests are burning and fertile soil is getting depleted, eroded, or drought stricken. The entire atmosphere seems to have caught some kind of fever, which is gradually infecting the oceans. The lament and complaints over nature's disruptions go on and on. The earth and the sky have now become full of seemingly meaningless symptoms and suffering.-What We Think About When We Try Not to Think About Global Warming
This is the world we live in. But we are anxiously waiting for an even smaller cohort of a previously unsuccessful clinical trial ,(EXPEDITION, EXPEDITION2, and EXPEDITION3 (ongoing) in patients with mild Alzheimer's disease. Basically Eli Lilly seems to be looking for a problem--for its 25 year 3 billion dollar solution.
