Just attended an incredibly exciting and inspiring talk by Rishi Manchanda, the founder of RxDemocracy, a group whose two-fold mission is to advance civic participation through health care and to improve health through civic participation – creating a “virtuous cycle” of civic health and health equity.
RxDemocracy is partnering with civic organizations to bridge this gap, bringing meetings with local politicians and voter registration into clinical settings and persuading health providers that they will be serving their patients better by opening up the conversation to include civic engagement. After all, public policy is an important determinant of health and research suggests that there is a link the other way around – those who are engaged feel a higher sense of control, and thus fare better health-wise.
Dr. Manchanda pointed out the barriers to creating the civic health/health equity virtuous cycle, including the biomedical paradigm of the medical profession (something I’ve been thinking about a lot as I’ve moved from biomed undergrad to public health) and the divide between community organization/civic engagement and healthcare (with healthcare often seen as just the curative, expensive, high-tech side of things).
He also highlighted the fact that healthcare is second only to education as an access point for many to society, making it a huge untapped civic organization. One symptom of this, Dr. Manchanda pointed out, is that physicians themselves (despite being very well educated) vote 9% less often than the public and 22% less often than lawyers.
Another theme that arose from this talk is the idea of advocating with those you are trying to help versus advocating for them, which ties in perfectly with the idea of community engagement and empowerment (linked with Amartya Sen’s capability approach) that I have been thinking about a lot lately (and which is an area of public health with huge potential for use of new/social media and digital technology – along the lines of new urban mechanics). More on that soon!