Posts Tagged ‘WHO’

By Dr Alex Gatherer

Consider some of the facts relating to prison health.  The majority of prisoners, some 80% or so, have some form of mental ill health, and between 5-10% have serious mental illness, which requires specialist care in suitable facilities.

Furthermore, in any community, the local prison at any one time will hold a disproportionately high number of non-nationals and minority ethnic groups, of people positive to HIV and Hep C, of people with educational and social skills deficiencies, of those addicted to some form of substance addiction, of those with serious communicable diseases and of those previously hard-to-reach in our cities and towns.

In most countries, including our own, this high needs group will be detained in old premises with inadequate facilities for meaningful activity and recreation and often in overcrowded conditions.

And the majority of prisoners will be out of prison and back in their home environments on the streets in our communities often after only a short time.

‘Statistical compassion’ is one of the unmentioned skills required of top quality public health practitioners.  We must be able to look behind the statistics and see the suffering, the unmet needs and the social injustices amongst the individuals who make up the overall figures that are so central to the reports we write.  Without ‘statistical compassion’, how can we make sure that we take into account, in everything we do, those who are in greatest need?

Public health has a choice. We could ignore the above, as we did for many years and waste any opportunities to help a vulnerable high risk group. Or we could realise that it is in the interests of public health as a whole to prevent our prisons from being focal points of disease.

We could also realise that the right to health applies to all.

  • Dr Alex Gatherer is Fellow of the Faculty of Public Health. In November 2009 he was awarded the American Public Health Association’s Presidential Citation for his work in improving health in European prisons.

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Climate change is so often associated with doom and gloom, so it was a welcome surprise to hear some good news yesterday at the London School of Hygiene and Tropical Medicine. I was attending the launch of the latest publication in the Lancet’s series on health and climate change, which looks at the public health benefits of action taken to reduce the damage we’re doing to our planet.

Ahead of the vital discussions in Copenhagen in two weeks time, it was unsurprising that the event attracted top brass. WHO Director General Dr Margaret Chan, UN Secretary General Ban Ki-Moon and Kathleen Sebelius, Secretary of the US Department of Health and Human Services all recorded video messages of support. Secretary of State for Health Andy Burnham declared it to be the “most important meeting I’ll attend all year”, which hopefully wasn’t far wrong.

The messages presented were no less important. Alongside comprehensive evidence about the severity of the crisis that we are all facing as our planet heats up, the report’s authors outlined the largely positive impacts upon our health that will result from taking decisive action to avert global warming. Professor Sir Andrew Haines and his team looked at four key areas in which strategies are being developed to reduce greenhouse-gas emissions: household energy, urban land transport, low-carbon electricity generation, and food and agriculture.

They found that many of these measures will impact positively on the public’s health. For example, a transport policy that enables people to walk or cycle more will not only reduce carbon emissions, but also result in lower cardiovascular disease as a result of more active lifestyles. Better insulated houses will result in warmer homes, reducing the number of deaths in winter. A reduction in the amount of meat in our diets would not only reduce methane emissions from livestock, but reduce ischaemic heart disease.

The models that the researchers explored included those in developing nations. For instance, the simple carbon stoves used by the poorest half of the world’s households are inefficient and produce airborne particles, including black carbon, and cause respiratory problems in adults and children alike. Replacing the old stoves with new, cleaner and more fuel efficient stoves over a ten year period in India would reduce the burden of these problems by a sixth, the equivalent to eliminating nearly half the country’s entire cancer burden. The message is clear: what is good for the planet is good for health.

It was an unusual feeling to walk out of a climate change meeting feeling positive about the future. It’s very easy to feel hopeless when confronted with the terrifying reality of where our world could be heading, but this event, and the accompanying publication, provides cause for optimism.

Fear paralyses, but hope energises. Let’s make sure that politicians remember these strong messages about health and climate change when they sit down in Copenhagen on 7 December.

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