INTRODUCTION, Global Health Narratives: A Reader for Youth
By Emily Mendenhall
Dr. John Snow thought something was fishy. Others proclaimed that the cholera epidemic was caused by something in the air, but John knew it was more than that. He went from house to house, questioning his neighbors about where they worked and what they ate, seeking what they had in common. After much investigation, he was led to the Broad Street pump. In 1854, John was one of the first doctors to associate disease with the environment, an association he was able to make because hehad discovered that the polluted well caused the cholera epidemic in London. The field of public health grew from John’s discovery. Today, public health aims to solve health problems by examining the many contributors to disease.
Public health is important because prevention is key to preserving a person’s health. Common aspects of public health are providing vaccinations, supplying education, and encouraging healthy behaviors. Making healthy choices, such as getting vaccinated for childhood diseases, prevents ailments for the individual and improves health at the population level. As biomedicine continues to turn to “band-aids” and “treatments” for ailments after they occur, public health works to educate people about prevention before the onset of disease or disability.
The essential reason for this text is to provide youth with a context for understanding the importance of healthy communities. Public health takes many forms and includes such projects as 1) vaccinating children to prevent polio and measles; 2) reducing maternal mortality; 3) encouraging people to eat diverse and healthy foods; 4) providing essential medicines for individuals suffering from malaria, tuberculosis, and HIV/AIDS; 5) unveiling the silence of depression; 6) improving water sources for communities who subsist on unsafe water; 7) reducing stigma for people living with diseases such as obesity or AIDS; 8) preventing chronic diseases such as diabetes and hypertension; 9) smoking cessation; and 10) increasing people’s access to health care. This list is in no way exhaustive of the many forms public health programs take within communities or even of how public health is presented in this book.
The definition of health used in this book includes physiological, psychological, and social aspects. “Health,” as the preamble to the 1946 constitution of World Health Organization puts it, “is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” It is important to remember that an individual’s sickness is not always visible and that depression is one of the most pervasive epidemics worldwide. The cause of health problems can also be difficult to trace if they are linked to environmental problems. Dangerous pathogens and viruses are often easier to diagnose than high levels of mercury in one’s water, for example. Although physical, emotional, and behavioral disorders are all defined at the individual level, environmental factors affect health at the community level, which means many people can be affected by one polluted source. Because such a wide variety of factors affect health, the best way to improve public health is to address these broader factors in combination with biological- and individual-centered approaches to health.
The narratives developed for this book demonstrate that global health is not only about reducing disease burden but also about monitoring the environment (such as homes, workplaces, schools, urban parks, and farmlands) to improve overall community health. Global health disparities often result from structural violence, which means that social structures outside of individuals’ control (such as poverty and unemployment) prevent them from meeting basic needs (such as eating healthy foods and finding sustainable housing). This means that disease may not result from the choices one makes; rather, disease may result from physical and emotional distress caused by political-economic problems such as poverty and poor working conditions. For example, if a family lives near a river, and wastes from a factory contaminate the water upstream, then the family’s water supply may be unsafe. The family’s sickness results from the inability to find a cleaner water source and the factory’s noncompliance with governmental regulations of waste disposal. Another example is HIV and AIDS. Many people affected by HIV and AIDS are children; some children are born with the disease and must live with the virus their whole lives. Many children who are not themselves HIV positive are nonetheless affected by the disease because they lose a parent or sibling. In this case, their suffering is a result of association with the virus, which they do not have the power to prevent.
The importance of global health stems from its systematic approach to solving health problems by identifying the source. In order to develop long-term solutions to public health issues, a global perspective is not only useful but also critical. Furthermore, as the population, even within the United States, continues to become more diverse, it becomes ever more necessary for youth to learn about global health issues. These narratives, rich in detail of different communities and customs, focus on the most critical basic element of any thriving community: health. By providing these narratives, we aim to raise critical public health consciousness in the community—in your classrooms with your teachers, at your lunch tables with your friends, and at your kitchen tables with your family—so that the next generation will be more knowledgeable than the last.
This book is a guide to educate youth about disease, inequality, and the environment.