Daniel Dawes is a lawyer, author, scholar, educator and leader in health equity and health reform. His research focuses on the drivers of health inequities among under-resourced, vulnerable and marginalized communities, he has pioneered a new approach to examining inequities - the political determinants of health. Daniel was instrumental in shaping the Affordable Care Act in the US (also known as Obama Care) and chaired the National Working Group on Health Disparities and Health Reform.
Episode summary:
01.15 How he became involved in work on the political determinants of health
07.45 What are the political determinants of health?
18.30 How do the political determinant of health impact rural communities in the US?
26.10 How important is it for people to understand the political determinant of health?
32.15 Is the political will there to address the political determinants of health?
36.15 How can advocacy groups work together with policy makers to address the political determinants of health?
42.05 What kind of people become community leaders?
44.05 Will the political determinants be addressed in the future?
Key messages:
We have only scratched the surface when it comes to the determinants and drivers of inequalities.
Socially derived inequities, not private choices.
For each social condition or social determinant of health there was a preceding political action or inaction, or policy action or inaction, that led to the social condition.
Political determinants of health involve the systematic process of structuring relationships, distributing resources and administering power. They operate simultaneously and influence one another to shape opportunities that either advance or hinder health equity.
Having sidewalks in one community and not in another is a political decision, the evidence shows that having sidewalks makes communities more walkable and encourages physical activity.
How does the law structure relationships among communities?
How are resources distributed?
The administration of power is the most contentious. Are people allowed to be involved in the political process?
Lack of voting in many rural communities and communities of color means that the decision makers are not representative of those communities.
Continual strategic process that never ends, people think that when a policy is passed and implemented then it is done, that is not the case, it requires constant monitoring and participation from the electorate.
Lower voting participation in minoritized groups.
It is important for people to be aware of the political determinants of health, they are the invisible hand that has been operating behind the scenes affecting all aspects of life.
Advocacy is at the heart of the movement to advance health equity.
Important to understand the history, the politics, the policies and the tools that have been used and can be used in their advocacy movements. It is built on relationships and is a continuous process.
You have to build relationships - within communities, with policy makers and with non traditional partners.
Building coalitions to address particular issues. Work with policy makers, find the evidence and do the research, then find the champions that can get your agenda through.
Introspection to determine personal and organizational strengths and weaknesses. Harness the power of collaboration.
In order to be an effective leader you first have to care enough, know enough, have the courage to do enough and then persevere until the job is done.
Resources:
Videos to help you understand the political determinants of health:
Jessica’s story
https://www.youtube.com/watch?v=G54x6Y-aJvE
Allegory of the orchard -
https://www.youtube.com/watch?v=mux1c73fJ78
https://www.youtube.com/watch?v=8gTbPog_J9s
Meharry Global Health Equity Institute: https://home.mmc.edu/meharry-to-launch-new-global-health-equity-institute-led-by-health-policy-expert-daniel-e-dawes/
Thank you for listening to the Rural Road to Health, contact me via ruralroadtohealth@gmail.com
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