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OpEdNews Op Eds    H4'ed 11/2/18

Preventive healthcare strategies are a matter of social justice

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Targeted, early, and preventive interventions are paramount in tackling the marked disparities in healthcare outcomes and should be prioritised by society and government. Socioeconomic determinants of health should be considered in everyday acute care encounters as they have major effects on healthcare use, cost, and clinical outcomes. Social gradients exist in all countries, and we need to recognise that the burden of disease falls hardest on those at the lowest points on this scale. These are people with the greatest adversity, remoteness, and economic hardship, as well as being marginalised members of society.

The need to act early in life is clearly supported by research. The Dunedin Multidisciplinary Health and Development Study followed a large cohort of New Zealanders from early childhood to age 38. A subgroup analysis of the cohort identified a group at higher risk as early as age 3 years, and these people were assessed to contribute to the highest economic and social burdens. This group went on to occupy the most hospital inpatient beds and accounted for the highest healthcare costs and other non-healthcare related governmental spending in adulthood. They were also far more likely to have modifiable healthcare risk factors including obesity and tobacco smoking.

The call for, and evidence behind, tackling the socioeconomic determinants of health is overwhelming, yet it remains far from being included in routine clinical practice.

We must make greater progress towards optimising and prioritising preventive healthcare strategies as a matter of social justice for all members of society and for the sustainability of quality healthcare.

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Peter is a medical registrar in Melbourne, Australia, with experience and interests in Infectious Diseases and Addiction Medicine. He is currently completing a Masters of Science (Infectious Diseases) at the London School of Hygiene and Tropical (more...)

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