Cultural Determinants of Health: The Epidemic of Ignorance

John Steen , the author says, " I would love to have our readers' reactions to the article." This article is a follow-up to "It Takes a Village" published in the Spring Issue.

My previous articles have identified politics as the principal factor blocking improvement of the social determinants of health. Here I argue that it is the unique culture of America that gives rise to a form of politics that is opposed to good governance in general, and to public health in particular. Our mission involves promoting the public health ethic, and that begins by distinguishing between public interests and those corporate interests subverting the role of government. The success of our mission depends on an informed public able to see the conflicts of interest. And it depends on our acknowledgement that the epidemic of poor health reflects more than unhealthful lifestyles. It is a manifestation of an imbalance of political and economic resources.

Doing public health with a moral compass and with professional ethics requires us to address what is, in fact, a class war. As public health professionals, we are contending for the minds of our public – to “inform, educate, and empower people about health issues,” an essential public health service. And in order to do that, we must realize that it is a political process in which the stakes are high – good health, community empowerment, and social justice. To do any less is to fail in our mission. 

.....Read more