Thinking Citizen Blog — Three Images: Upstream/Downstream Parable, The Determinants v Spending Graphic, The Heckman Curve
Thinking Citizen Blog: Thursday is Health, Health Care, and Global Health Policy Day
Today’s Topic: Three Images: Upstream/Downstream Parable, the Determinants v Spending Graphic, The Heckman Curve
What images anchor your view of the problem of public health? What are your first premises and where did they come from? The most important problem facing anyone who wants to improve the quality of life of those in need is focus — your attention, your time, your charity dollars. How do you decide to allocate these scarce resources?
Today, the three most powerful graphics I have come across over the last half century. If you know of better ones, please share.
Experts — please chime in. Correct, elaborate, elucidate.
THE UPSTREAM/DOWNSTREAM PARABLE — know of a better graphic depiction? If so, please share.
1. “In the classic public health parable credited to medical sociologist, Irving Zola, a witness sees a man caught in a river current. The witness saves the man, only to be drawn to the rescue of more drowning people.”
2. “After many have been rescued, the witness walks upstream to investigate why so many people have fallen into the river.”
3. “The story illustrates the tension between public health’s protection mandates to respond to emergencies (help people caught in the current), and its prevention and promotion mandates (stop people from falling into the river).
NB: For the both tragic and uplifting story of Irving Zola, see the second link below.
THE HECKMAN CURVE — the earlier the intervention, the greater the return
1. Is the best investment in the form of programs to promote the use of Long Acting Reversible Contraceptives (LARCs)?
2. Should the focus be on minimizing the number of parents who are not ready for the burdens of parenthood?
3. Should we be training parents more comprehensively? how?
NB: James Heckman (1944 — ), a professor of economics at the University of Chicago, won the Nobel Prize in Economics in 2000. Personally, I think this graphic is the most valuable single thing to come out of the brain of a winner of that prize. Agree? Disagree? If you disagree, please share the contribution that surpasses it.
WHAT TO FOCUS ON MAKES ALL THE DIFFERENCE — is spending going to the wrong places? or are we doing the best we can? See the third link below which includes a graphic with the mismatch by country. Does France get the ratio most right?
1. Where do healthy behaviors start?
2. Is it ultimately all about ethics and manners?
3. Is it in the end all about being responsible?
NB: We teach and we learn by example. Is it ultimately all about modeling the strength to say “no!” Whether to hitting your sibling, lying, crime, drugs, premature sex, or whatever?
https://nccdh.ca/images/uploads/Moving_Upstream_Final_En.pdf
The Public Health Spending Mismatch — Public Health Post
QUOTE OF THE MONTH
“Make your own Bible. Select and collect all the words and sentences that in all your readings have been to you like the blast of a trumpet.”
- Ralph Waldo Emerson
My spin — then periodically review, re-rank, and exchange your list with those you love. I call this the “Orion Exchange” because seven is about as many as any human can digest at a time. Game?
LAST FOUR YEARS OF POSTS ORGANIZED THEMATICALLY
ATTACHMENTS BELOW:
#1 A graphic guide to justice (9 metaphors on one page).
#2 “39 Songs, Prayers, and Poems: the Keys to the Hearts of Seven Billion People” — Adams House Senior Common Room Presentation, (11/17/20)
NB: Palestine Orion (Decision) — let’s exchange Orions, let’s find Rumi’s field (“Beyond all ideas of right and wrong, there is a field. Meet me there” Rumi, 13 century Persian Sufi mystic)
YOUR TURN
Please share the most interesting thing you learned in the last week related to health, health care or health care policy — the ethics, economics, politics, history….
Or the coolest, most important thing you learned in your life related to health are or health care policy that the rest of us may have missed.
Or just some random health-related fact that blew you away.
This is your chance to make some one’s day. Or to cement in your mind something really important you might otherwise forget. Or to think more deeply than you otherwise would about something that matters.
