social welfare – AQuAS Blog

Crisis and health: the opinion of some experts

16 Feb

In the next few weeks, a new report will be published by the Observatory on the effecs of the crisis in the health of the population, drafted at the Observatory of the Catalan Health System. Based on experience and with the aim of providing some things to reflect on at an individual and community level, we would like to share some words by Xavier Trabado, Angelina González Viana and Andreu Segura about the initiative that was begun three years ago (you can consult the 2014 and 2015 reports).

Xavier Trabado

“Precarious employment, changes in the labor system, unemployment, evictions, debt, household instability and poverty directly affect the mental health of people. The latest Health Survey of Catalonia shows the percentage of people have some kind of risk for of mental health problems. To prevent this number from increasing and working for itstowards decrease reducing it we need programs supporting prevention, to better detect cases that could go unnoticed. It is essential to act in the initial stagesearly to prevent worsening situations from getting worse, by providing support and appropriate tools. There are programs such as the one supporting primary care, which has been evaluated with very positive results, but not yet deployed on in the whole territory. The training of the primary care professionals allows for a quick and preventive approach, and an intervention to provide solutions. Finally, the coordination between specialized and primary care resources is key to make making an initial diagnosis and to continue monitoring the cases detected. We need a change in the way healthcare services are provided, enabling and integrating the efforts of different work areas and professionals, providing tools to the affected person, seizing it , informing the family and accompanying them during the process through psycho-educational groups and support groups”. (Xavier Trabado is spokesperson for the Federation of Mental Health in Catalonia)

“The report by the Observatory on the effects of the crisis on health highlights the communities which have borne the brunt of the crisis and how it has affected their health. It is urgent to initiate community health actions: actions in which the community is the protagonist and which are the transition from the attention given to an illness to a bio-psycho-social approach where these actions promote inter-sectorial work and that done in networks with local agents who share the aim of improving the welfare of the community. Based on the needs detected and then prioritised, with all involved participating, and having identified the local assets, these agents initiate interventions supported by evidence which are later assessed. Ultimately, community health is the application of all these policies at a local level.” (Angelina González Viana coordinates community projects such as COMSalut, at the general Sub-directorate for the Promotion of Health of the catalan Public Health Agency)

“The ongoing crisis has increased income inequality, income poverty and the risk of social exclusion. All this generates anxiety, distress and despair, mood disorders which are not unhealthy, at least initially , and healthcare services not cure . The health of the population has a lot to do with the living conditions of people and their ability to cope with the ups and downs. Hence the importance of the level of education level and purchasing power – work, and pensions and subsidies, if needed – and other social support measures that make us feel part of a healthy community. The Interdepartmental Public Health of Catalonia wants to contribute to that purpose through via intersectoral actions to increase the efficiency of coordinated government and civil society initiatives of the government and civil society in all fields that have a significant influence on the health of individuals and the population as a whole.” (Andreu Segura was Secretary of the Interdepartmental Commission for Public Health and coordinator of the COMSalut project. At present he is retired, is Spokesperson for the Public Health Advisory Board and for the Bioethical Committee of Catalonia)

If the you are interested in this subject, you can read more in this post which was published last year in connection with the previous report: Les polítiques públiques en temps de crisi.

In memory of professor Joan Rodés

12 Jan

With his passing away, Dr Joan Rodés (1938-2017) will be remembered by many people in person, and in many fields, for those who had the good fortune to know him as a doctor, researcher, manager and assessor (of politicians), as his was a life full to the brim. No matter which professional activity he took part in, and with the responsibilities he took on throughout his life, he left his mark and the accolades expressed these days are a clear demonstration of this.

To AQuAS (originally AATM), Joan Rodés has been an exceptional figure and I say this without any rhetoric whatsoever. When the Agency was created in 1994, he presided its scientific board of assessors and at the end of 1999, when the institution became known as Catalan Agency for Health Tecnology Assessment and Research (CAHTA), in Catalan Agència d’Avaluació de Tecnologia i Recerca Mèdiques (AATRM), he presided its Administrative Board, a position that he held till 2010. It was in that period (2000-2006) that, due to my responsabilities within the Agency as Managing Director, I was able to get to know this great personality more closely, very much a big strong fellow (in Catalan, a homenot) was Joan, as Josep Pla would say. At that time, we saw each other often, and I had frequent exchanges with him, aside from the more or less termly meetings of the Administrative Board. I did this in that minute office of the haematology services and later in that of the General Manager at the Hospital Clinic.

No matter what the position he occupied, he was always watchful -very much so- of events at the Agency, being a great facilitator of its duties. It was like this, without a doubt, because with Joan Rodés there was no need to convince him of the importance of informing well about decisions taken in the health services, using the most updated and precise knowledge that was available, not only that regarding the benefits and risks to health of medical interventions, but also in terms of its economic, ethical and social impact. For him and I quote his words literally from the AATRM Newsletter, 10 years of the Agency, of November 2004:

“critical assessment and continued learning are basic tools that need to be maintained and improved, not only by the Agency, in its everyday activity, but also by all the multiple actors and stakeholders in the health system (professionals, managers, politicians and citizens) that wish to continue sustaining this element of such importance for our social well-being”

I said this because of his role of facilitator as highest representative of the Agency giving constant support to the activities it carried out, but also because of his extensive experience and network of relationships that contributed to giving strength to many initiatives that were then being undertaken, especially in the field of research and its assessment. I was able to discuss this with him on many occasions at a later date, and I never once perceived an interventionist or managerial attitude; quite the opposite, always with a laissez-faire approach where each one had to do their assigned task (the technicians and managing director of the Agency, the scientific board and the administrative board) while facilitating that of others.

It has always been a great pleasure for me -a privilege better said- to have maintained contact at dinners and get-togethers, even during the last period in which his respiratory illness worsened, but he would still go to IDIBAPS from time to time despite this. I cannot end without saying that during those times when we would talk about any and everything (medicine, science, politics, society, the past, present and future) we had a really good laugh. Then as now that you have left us, you are and will very much be in my thoughts.

Post written by Joan MV Pons