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Harsh times lead us to reflect on our values and seek inspiration from revered figures. Italian neurologist and senator-for-life Rita Levi Montalcini celebrated her 100th birthday on April 22, 2009. In 1986, she received the Nobel Prize for Medicine with Stanley Cohen of the United States for discoveries of mechanisms that regulate cell and organ growth. Word of her long life and well-being was refreshing to read at a time when most news reports concern the mortgage crisis and bleak economic outlook. While stories of profound hardship for people around the globe take a toll on all of us, I am personally affected by fears of what the future will hold for my young daughter. The term “new needy” has been coined to denote people who are unemployed for the first time in their lives and unable to pay their mortgages and other debts. They are seeking resources from churches, soup kitchens, and unemployment agencies that are traditionally only utilized by the chronically homeless. These meager safety net systems are quickly becoming overburdened or even bankrupt, and thus unable to provide emergency services for the swelling numbers of the new needy and their families.

There is no quick fix to the current economic crisis. Shared responsibility and collectivism are gaining in popularity as approaches going forward, but when so many of us are in perilous circumstances, making a difference through fulfilling our daily public health mandates seems impossible. Is it enough for programs to keep their doors open when the systems around them are falling apart?

The theme of this month’s issue is “Social Conditions and Health.” These two broad categories are intricately linked, and disentangling them is challenging. An overemphasis on disciplinary exactness forces attention on either social conditions or health, but rarely both. History and context are essential in unraveling the complex relationships of human interactions with their environments and the social conditions that are responsible for most of the health disparities witnessed worldwide. Just how the current financial crisis will affect public health in the long term is uncertain. Nonetheless, the short-term effects are already evident as families lose their homes, belongings, and each other. In some places around the globe, economic upheaval has affected entire neighborhoods, communities, and towns, for financial deprivation affects the health of not only people who lose their homes, but also those who remain behind. Some have opted to forgo payments for health insurance, essential health care, or prescriptions to pay for rent, food, and gas. The toll of these sacrifices will eventually become manifest on population health, as many lack the support and resources to engage in health-promoting behaviors such as eating nutritious foods and receiving preventive health care.

As Nancy Kass put it in her 2001 Journal piece, “The most important asset that public health can have is the public’s trust that work is being done on its own behalf. In such a context, public health professionals can and must advocate what they believe, on balance, are the ethically best approaches for furthering social justice and the public’s health” (Kass NE. An ethics framework for public health. Am J Public Health. 2001;91:1782). As her 100th birthday drew near, Montalcini recounted in a Huffington Post interview how the anti-Jewish laws of the 1930s under Mussolini’s Fascist regime forced her to quit school and do research in her bedroom. “Above all, don’t fear difficult moments,” she advised. “The best comes from them” (von Pfetten V. Rita Levi Montalcini, Nobel Prize-winning scientist turns 100, still works. Huffington Post. Available at: http://www.huffingtonpost.com/2009/04/ 20/rita=levi=montalcini=noble_n_188935. html. Accessed April 18, 2009.).

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This entry was posted on Monday, July 27th, 2009 at 1:28 pm and is filed under Dental Care & Health Care. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.