Promoting patients’ proactive attitude in the care of their illness, can this generate more inequalities?

23 Jul

Joan EscarrabillJoan Escarrabill, Director Chronic Care Program at Hospital Clínic Barcelona

As participants in a mature society, we’re responsible for our actions and it’s clear that these actions have consequences. Take healthy habits as part of this responsible attitude. From the health point of view, this attitude of individual responsibility leads us to value this role of “active patient” to the maximum. In addition, we know that active patients have better health outcomes.

Now this storyline has a weakness that wouldn’t exist if we all had the same cards to play with. Unfortunately there are social inequalities. In 2014, in an article in the NEJM, Sayer and Lee explain very well this relationship between social conditions and health. Not all citizens (patients) start the race from the same point and in the same conditions. Social inequalities cause that not even “starting up early, very early…” can offset these imbalances. Naturally, from the point of view of the health care organization we can not attempt to resolve social inequalities. However, we can hope to mitigate them. From my point of view, to mitigate social inequalities we’d have to act in three directions simultaneously: Continue reading