Monthly Archives: June 2013

What pediatrics can teach us about addressing adult social determinants of health

patient-centered-medical-homeAttending to the social determinants of health is especially important for children, since children’s experiences – of poverty, poor nutrition, trauma, abuse, neglect, the prenatal environment – can affect physical and mental health for an entire lifetime. As the authors of a recent commentary in JAMA write: “Pediatrics … continues to evolve clinical practice aimed at addressing social determinants because of children’s exquisite vulnerability to the deleterious effects of the social and physical environment, especially the aggregation of social factors associated with poverty.”

The occasion for the commentary – titled Addressing the Social Determinants of Health Within the Patient-Centered Medical Home: Lessons From Pediatrics — is the imminent implementation of the Affordable Care Act. The medical home (also known as the patient-centered medical home) is a concept that originated in pediatrics. The basic idea is that when a team of providers — physicians, nurses, nutritionists, pharmacists, social workers – work together, they can best meet the needs of patients. The Affordable Care Act has several provisions designed to establish and promote medical homes, and the authors of this commentary (two pediatricians and a family medicine practitioner) ask: What has pediatrics learned about addressing social determinants that can be translated to medical homes for adults. Read more


A new blog on the self

new-blog-kittenI’ve started another blog called Basic research on the self. My intention is to write there about the social and cultural history of the self, aided by insights from sociology, anthropology, philosophy and psychology (especially critical psychology). This is a subject that relates to a number of topics I’ve written about here.

A while back I grouped together my interest in psychopharmaceuticals, cosmetic surgery, happiness/positive psychology, and self-help and labeled these topics “psychological and physical conformity.” When I’ve written about these subjects, I’ve talked about the way things are today. In my new blog, I’d like to step back and ask: How did the society I live in end up valuing self-actualization, self-improvement, and maximized happiness – as well as an impossibly ideal notion of physical appearance — above all else?

That question also relates to a number of my other interests here — healthism, the social determinants of health, inequality, neoliberalism. It’s much easier to convince people they’re personally responsible for their health and well-being (including their socioeconomic status) if they’ve already developed a self-concept based on the ideology of the self-contained, autonomous individual. Read more