The health of the whole

Recently Archimedes attended the 18th World Conference on Health Promotion and Health Education, a major meeting of minds in an area about which most of us have little knowledge. In one of the most interesting papers, Tunisian human rights activist and University of Paris XIII Associate Professor of Public Health, Moncef Marzouki argued there are three approaches to health.

The first he calls the bio-technological model, which is at the heart of Western medicine. Health problems are the result of a malfunction in the body which must be hunted down and rooted out. The social model is favoured by those involved in preventive medicine. The emphasis moves from the individual to the community, investigating ecological, cultural, socio-economic and political factors. The third model Marzouki calls ‘human rights’. The Universal Declaration of Human Rights specifies a right to health, including adequate food, clothing, housing and medical care. It also contains related rights such as rights to life, physical safety, work, leisure and culture. ‘These are the basis of the … most important field of intervention,’ he said, ‘that of health promotion.’

Health promotion transcends immediate boundaries—its use as a tool for peace in Israel, for instance. Then there are issues such as the health of the world’s 200 million indigenous people, and the impact of dominant cultures. What about the social problems caused by HIV? How are we to counter obesity, the world’s biggest growing problem even in non-industrialised nations?

Archimedes was interested in the link between mental health and migrants. In an analysis of lover 150 studies of schizophrenia, Dr John McGrath of the University of Queensland found that, immigrants were five times more likely to suffer from the condition. There were several pointed papers on the problem of migrant mental health, giving pause to those, like Archimedes, who are opposed to the present Federal policy of indefinite detention of asylum seekers.

Australian environmentalist and science commentator, Professor Ian Lowe, raised the question of whether resources for health promotion have been hijacked by ‘the war on terror’. As a health risk, he argues, terrorism is almost negligible.

‘The Bali bombing shocked us because about 100 Australians, most of them young people, were killed and hundreds more injured. But every three weeks about 100 Australians, most of them young people, are killed and hundreds more injured on our roads. This is so depressingly predictable we call it “the road toll”, as if it were the inevitable price of using roads. About every two days, 100 Australians die from the effects of smoking tobacco. The industry still shamelessly targets the young to replace older smokers as they die or quit.

‘No amount of military spending will provide protection from terrorism if we ignore its causes … More than a billion people don’t have clean drinking water, about 2.4 billion don’t have sanitation. Several billion live on less than the public subsidy of each European cow. Mortality rates for children under five have actually increased in the last decade for several countries in sub-Saharan Africa.’

Recent experiences with SARS and bird flu have illustrated the need for nations to work together. In our tightly-linked world, any group suffering from a communicable disease could trigger a worldwide problem. In such a world, health promotion plays an increasingly important role. Any increase in the health of our neighbour, is an increase in our own health.

Tim Thwaites is a freelance science writer.



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