Moral Determinants of Health

Donald Berwick, MD, MPP, Institute for Healthcare Improvement, pens a “Viewpoint” essay for JAMA in which he examines the “moral determinants of health.” In it, he suggests that social determinants of poor health and shorter life expectancy could be addressed if either taxes were raised to fund social programs or health expenditures were shifted to prioritize social determinants of poor health. “Neither will happen unless and until an attack on racism and other social determinants of health is motivated by an embrace of the moral determinants of health, including, most crucially, a strong sense of social solidarity in the US,” he says. He challenges healthcare institutions, physicians, and nurses to call for “US ratification of the basic human rights treaties and conventions of the international community.” He calls for health care to be a basic human right. “The number of uninsured individuals in the US is 30 million and increasing,” says Berwick. No other wealthy nation on earth tolerates that.” He also calls on healthcare leaders to “reverse climate change,” and to work to reform the criminal justice system. “The US has by far the highest incarceration rate in the world,” says Berwick, “and it imprisons people of color at 5 to 7 times the rate of white persons.” Essentially he calls on healthcare leaders to address every issue in our society. (JAMA, 6/12, https://jamanetwork.com/journals/jama/fullarticle/2767353; summary from 6/23/20 Hospice News Network.)