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A long engagement

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If you’re well-educated and relatively wealthy, you’re much more likely to live a long life, with many more disease-free years. If you’re less fortunate, both in terms of your education and means, you won’t fare as well.

Unfortunately, the disparity in health outcomes between the rich and poor is continuing to widen. Of course, education and economic stability are not the only social determinants of disease.

Evidence suggests that one of the most crucial factors is an individual’s ‘engagement’ with healthcare. But we need to distinguish between ‘engagement’ and ‘use.’

We know that ‘healthcare’ – better described as ‘disease care’ – can be incredibly dangerous. In fact, preventable deaths in hospitals are one of the greatest sources of risk in our society. So, avoiding responsibility for your health – and handing it to someone in a white coat when something goes awry – is a dangerous way to live.

Someone who’s ‘engaged’ in their healthcare throughout their life – proactive instead of reactive – fares much better. This kind of person takes an interest in their treatment options and works with their doctor to really understand the benefits and risks for their specific circumstances.

That’s part of engagement, but not all. It’s also about taking an interest in choosing healthier foods. Taking time out to exercise or relax. Seeking help when life’s demands start to interfere with daily life.

An educated person may be more able to discern relevant information from the conflicting noise that comes at them via media, celebrities and their circle of friends. And some of these things are only accessible to people with disposable income, as they won’t be covered by health insurance.

If you’ve got the money, and you care about your health, you’ll prioritize this kind of spending. That’s why the healthiest people in our societies, and also the biggest users of non-standard, ‘alternative’ therapies – despite their being marginalized by mainstream medicine – are the most financially well off.

We’re told that narrowing health inequality requires that the social determinants, especially education and financial independence, be addressed. But this encourages disengagement and then implies – when bodies start breaking down from abuse by junk food and unhealthy lifestyles – that the healthcare system people know and trust is the only place to get help.

Maintaining the status quo involves building trust in the mainstream model and breeding distrust in the alternative system. Access to drugs, vaccines and surgery are made to look like the only viable options for the less privileged. But this is an illusion that lacks scientific basis and relies on negative publicity about the more natural, less drug-dependent system used to great effect by more educated and wealthier people

What would happen if the poorest, most disengaged people were to able interact with the more progressive and holistic model of healthcare that so many of us are calling for? Primary care and family physicians, as the first line of care, need to be trained quite differently to look more broadly at the body’s functions.

The medical curriculum has been co-opted by pharmaceutical interests, with doctors turned into glorified drug salesmen. If doctors spoke a language that wasn’t filled with technical jargon, they could enter into a much more constructive, collaborative decision-making process with their patients.

Clinicians also need to be trained to search out the underlying causes of disease, rather than focusing on treating symptoms. And what if we all got used to having routine check-ups to find out how we were functioning across multiple domains of health, so we could modify behaviors before a disease actually manifested? These are all fully accounted for in the health sustainability blueprint of the Alliance for Natural Health (see my column in theWDDTY March issue).

Even if we assume no change in the level of engagement by a hypothetical patient with a low level of education and very little cash, if that patient walks into a doctor’s office with severe knee pain, a mainstream doctor might prescribe NSAIDs at best, while a holistically trained doctor would look for other signs of poor health, ask questions about the patient’s lifestyle, and take the opportunity to draw a blood sample and order a cluster of highly informative tests.

By encouraging the patient to join a group of others with similar issues, under the guidance of a health coach, they could be inspired to lose weight, exercise more, consume an anti-inflammatory diet and find better ways of transforming stress. Not only would the knee problem go away, the risk of future heart disease, cancer and type 2 diabetes would be massively reduced too.

This is the kind of upstream, sustainable health system we all need to be part of, regardless of our education or means. Don’t think you can wait for mainstream medicine to do it. It won’t – too many are benefiting from the status quo. Join our movement for change that’s working to make this a reality. Visit for more information.

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Article Topics: Health care, medicine
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