Showing papers by "Jocalyn Clark published in 2014"

Medicalization of global health 1: has the global health agenda become too medicalized?

Abstract: This is the first in a series of four papers critically examining the medicalization of global health. Please find the other papers here . Medicalization analyses have roots in sociology and have critical usefulness for understanding contemporary health issues including the ‘post-2015 global health agenda’. Medicalization is more complex than just ‘disease mongering’ – it is a process and not only an outcome; has both positive and negative elements; can be partial rather than complete; and is often sought or challenged by patients or others in the health field. It is understood to be expanding rather than contracting, plays out at the level of interaction or of definitions and agenda-setting, and is said to be largely harmful and costly to individuals and societies. Medicalization of global health issues would overemphasise the role of health care to health; define and frame issues in relation to disease, treatment strategies, and individual behaviour; promote the role of medical professionals and models of care; find support in industry or other advocates of technologies and pharmaceuticals; and discount social contexts, causes, and solutions. In subsequent articles, three case studies are explored, which critically examine predominant issues on the global health agenda: global mental health, non-communicable disease, and universal health coverage. A medicalization lens helps uncover areas where the global health agenda and its framing of problems are shifted toward medical and technical solutions, neglecting necessary social, community, or political action. Keywords : Global health; medicalization; sociology; development (Published: 16 May 2014) Citation : Glob Health Action 2014, 7 : 23998 - http://dx.doi.org/10.3402/gha.v7.23998 To access the supplementary material for this article, please see Supplementary files under Article Tools

Medicalization of global health 2: The medicalization of global mental health.

Abstract: This is the second in a series of four papers critically examining the medicalization of global health. Please find the other papers here . Once an orphan field, ‘global mental health’ now has wide acknowledgement and prominence on the global health agenda. Increased recognition draws needed attention to individual suffering and the population impacts, but medicalizing global mental health produces a narrow view of the problems and solutions. Early framing by advocates of the global mental health problem emphasised biological disease, linked psychiatry with neurology, and reinforced categories of mental health disorders. Universality of biomedical concepts across culture is assumed in the globalisation of mental health but is strongly disputed by transcultural psychiatrists and anthropologists. Global mental health movement priorities take an individualised view, emphasising treatment and scale-up and neglecting social and structural determinants of health. To meet international targets and address the problem's broad social and cultural dimensions, the global mental health movement and advocates must develop more comprehensive strategies and include more diverse perspectives. Keywords : global health; mental health; medicalization; sociology (Published: 16 May 2014) Citation : Glob Health Action 2014, 7 : 24000 - http://dx.doi.org/10.3402/gha.v7.24000 To access the supplementary material for this article, please see Supplementary files under Article Tools

Medicalization of global health 3: the medicalization of the non-communicable diseases agenda

Abstract: This is the third in a series of four papers critically examining the medicalization of global health. Please find the other papers here . There is growing recognition of the massive global burden of non-communicable diseases (NCDs) due to their prevalence, projected social and economic costs, and traditional neglect compared to infectious disease. The 2011 UN Summit, WHO 25×25 targets, and support of major medical and advocacy organisations have propelled prominence of NCDs on the global health agenda. NCDs are by definition ‘diseases’ so already medicalized. But their social drivers and impacts are acknowledged, which demand a broad, whole-of-society approach. However, while both individual- and population-level targets are identified in the current NCD action plans, most recommended strategies tend towards the individualistic approach and do not address root causes of the NCD problem. These so-called population strategies risk being reduced to expectations of individual and behavioural change, which may have limited success and impact and deflect attention away from government policies or regulation of industry. Industry involvement in NCD agenda-setting props up a medicalized approach to NCDs: food and drink companies favour focus on individual choice and responsibility, and pharmaceutical and device companies favour calls for expanded access to medicines and treatment coverage. Current NCD framing creates expanded roles for physicians, healthcare workers, medicines and medical monitoring. The professional rather than the patient view dominates the NCD agenda and there is a lack of a broad, engaged, and independent NGO community. The challenge and opportunity lie in defining priorities and developing strategies that go beyond a narrow medicalized framing of the NCD problem and its solutions. Keywords : global health; non-communicable disease; chronic disease; medicalization; sociology (Published: 16 May 2014) Citation : Glob Health Action 2014, 7 : 24002 - http://dx.doi.org/10.3402/gha.v7.24002 To access the supplementary material for this article, please see Supplementary files under Article Tools.

Medicalization of global health 4: the universal health coverage campaign and the medicalization of global health

Abstract: This is the fourth in a series of four papers critically examining the medicalization of global health. Please find the other papers here . Universal health coverage (UHC) has emerged as the leading and recommended overarching health goal on the post-2015 development agenda, and is promoted with fervour. UHC has the backing of major medical and health institutions, and is designed to provide patients with universal access to needed health services without financial hardship, but is also projected to have ‘a transformative effect on poverty, hunger, and disease’. Multiple reports and resolutions support UHC and few offer critical analyses; but among these are concerns with imprecise definitions and the ability to implement UHC at the country level. A medicalization lens enriches these early critiques and identifies concerns that the UHC campaign contributes to the medicalization of global health. UHC conflates health with health care, thus assigning undue importance to (biomedical) health services and downgrading the social and structural determinants of health. There is poor evidence that UHC or health care alone improves population health outcomes, and in fact health care may worsen inequities. UHC is reductionistic because it focuses on preventative and curative actions delivered at the individual level, and ignores the social and political determinants of health and right to health that have been supported by decades of international work and commitments. UHC risks commodifying health care, which threatens the underlying principles of UHC of equity in access and of health care as a collective good. Keywords : global health; universal health coverage; health care; medicalization; sociology (Published: 16 May 2014) Citation : Glob Health Action 2014, 7 : 24004 - http://dx.doi.org/10.3402/gha.v7.24004 To access the supplementary material for this article, please see Supplementary files under Article Tools.

Do the solutions for global health lie in healthcare

Abstract: Jocalyn Clark argues that the medicalisation of global health, like other aspects of human life and health, produces a narrow view of global health problems and will limit the success of solutions proposed to replace the millennium development goals.