We have demonstrated time and again that society has a massive impact on your health For example, an analysis of East London found that diabetes rates mapped almost perfectly to rates of social deprivationpic.twitter.com/9LbDP7B6aX
You can add location information to your Tweets, such as your city or precise location, from the web and via third-party applications. You always have the option to delete your Tweet location history. Learn more
We have demonstrated time and again that society has a massive impact on your health For example, an analysis of East London found that diabetes rates mapped almost perfectly to rates of social deprivationpic.twitter.com/9LbDP7B6aX
This has been echoed in my own work - diabetes hotspots in Sydney align amazingly well with areas of social disadvantagepic.twitter.com/TZfasfAvTq
The obesity crisis is another perfect example of this disparity. Obesity rates have skyrocketed, impacting socially deprived communities first and foremostpic.twitter.com/ceb7BulM1G
If "personal responsibility" was a factor, it would mean that the last generation or two were fundamentally different from every human to have lived for the last hundred thousand years or so
The reality is that humans haven't suddenly lost all control, our environment has changed Foods that used to be expensive rare options are now freely available at virtually no cost Exercise is harder to come by as we move to a more dense urban way of life And on, and on
As our environment changes, so do our behaviours, and ultimately our health risks You see this across the board for a huge number of diseases https://theconversation.com/social-determinants-how-class-and-wealth-affect-our-health-64442 …pic.twitter.com/fhTXXm61oo
It's also a disingenuous to argue that personal responsibility drives healthcare outcomes, because we KNOW that society at large has a far bigger impact
When you say things like "We need to do far more to personally take responsibility for our own health" you are implicitly stating that unhealthy people have NOT taken responsibility for their health The evidence strongly contradicts this assertion
Take this chart, from the tweet above We know that social deprivation - due to things like air pollution - increases your risk of asthma It is NOT related to how "responsible" you arepic.twitter.com/QmFlClyX9o
There are, of course, things that individuals can do to improve their own health. I'm not arguing that humans have no agency whatsoever BUT At a population level, "personal responsibility" is simply meaningless
You can point people towards unprocessed food all you want: if it's still far cheaper/easier to eat KFC, your health advocacy is probably going to have little to no effect
We also know that this sort of health advocacy is most effective for people who are already well-off. A major part of my PhD is addressing the inequities caused by providing health services in an inequitable way
For example, one study found that people were less likely to use a free weight control app if they were poor, non-white, or had multiple comorbidities
This is true across the board - if you run a health intervention, the people who are at the top already will usually benefit the most It's formally describe in public health in the equity effectiveness looppic.twitter.com/VjJ69sGQVD
The basic idea is that a health intervention - say, a mobile self-management app - has to go through stages to be effective. Someone has to have access to it, download it, use it, continue to use it, and benefit from it
At each stage in this cycle, social factors get in the way If you don't have a phone, you can't access an app If you don't understand the language used for the app, you can't download or use it And on, and on
Ultimately, personal responsibility is a great thing to tell an individual, but not useful at all at the population level
If you truly want to improve outcomes, you have to address larger social outcomes rather than talking about what actions individuals do and do not take
I've written about all of this before - it's more expensive and politically difficult to change the environment, but if we don't we'll probably never address many of our disease problemshttps://medium.com/@gidmk/personal-responsibility-is-a-meaningless-term-8c1f7732993b …
Also important to note, this is not just limited to health. As this thread aptly demonstrates, welfare and social programs are interlinked with healthcare effortshttps://twitter.com/drcbond/status/1059568949359038465 …
Twitter may be over capacity or experiencing a momentary hiccup. Try again or visit Twitter Status for more information.