Though environment has known to be an enormous factor in public health since and before John Snow, a man named Bill Davenhall is arguing that where a person spends most of his or her time is still not receiving as much attention in doctors’ offices and in hospitals as it should be. Here is the link to the interview and text transcript of the interview:
http://www.ted.com/talks/lang/eng/bill_davenhall_your_health_depends_on_where_you_live.html
Davenhall, leader of a geographic information software developing company, says that “geomedical” information is still being neglected in relation to health. This “geomedical” information includes knowledge such as overlap of where a person lives with air quality information and other geographic information in order to get clues about each patient’s risk factors. Granted, Davenhall seems to have some economic investment in the matter due to his company, but his argument seems to make some sense through a public health lens. Each region, state and city has its own particular health advantages and disadvantages. For example, states with huge varieties of outdoor activities—such as Colorado—are often home to the fittest and thinnest populations in the country, whereas some states may lead to greater obesity risk factors. Davenhall pointed out the example that living near a polluting factory or a city with extensive emissions can create a particular sector of lung issues in the affected populations.
After reading Davenhall’s interview, my question is whether Davenhall’s proposition of electronically incorporating geomedical information in each patient’s file should be a focus in the future of medicine. I don’t know that medical systems would need Davenhall’s company to be creating software for them, but I do think that health professionals including both doctors and public health workers could have a greater focus on the geographically specific health issues of each area. This could lead to better distribution of resources on a large scale and better patient diagnosis and risk factor analysis on a smaller scale.
I agree, in part with this article. I largely support the idea that environmental factors can be key indicators of one's health status. However, from a medical point of view, how should a doctor treat such factors? A doctor cannot simply tell his patient, "You must move to a more health-friendly environment." While environmental factors can cause serious health probelms for a community, I support the idea that one's health is largely dependant on the individual himself/herself. Just because one doesn't live in Colorado doesn't mean that one can't find fun, strenuous, healthy activities to partake in. Therefore, while I agree with the fact that environmental factors play a large role in determining health status, I believe that these factors can only be treated with personal effort, not at a doctor's office.
ReplyDeleteMy main issue with geomedical documentation is that it could potentially lead to forms of discrimination or misdiagnosing on the part of doctors and other health care sectors. A doctor might single out an individual for a disease based on this information, when that diagnosis is wrong. There might be a stage when health care professionals assume that a person from Colorado won't suffer from any of the cardiac problems that accompany obesity. On the flip side, a doctor may not recommend certain treatments, because they don't feel that the patient will have certain "access" to certain changes in lifestyle as a result of their location.
ReplyDeleteThere is room between predetermining diagnoses based on environmental information and dismissing the validity of geomedical documentation entirely. I agree that there is potential for misuse of geomedical information, but should we not explore how doctors could harness this information to supplement already effective diagnostic measures?
ReplyDeleteSkolnik tells us that the environment accounts for one-third of the global burden of disease (2008). Why should physicians not take place history into account?
What if in 2010 epidemiologists discovered that individuals living in region X from December 1988 through November 1998 were likely exposed to high degrees of vaporized napthalene or toluidine released into circulation by some accident? Would it not be useful for a physician be able to see a flag in his or her patient's electronic record indicating that this patient has lived in region X and is at risk for effects related to the poisoning? This information could be useful in secondary and tertiary prevention.
Is it true that medical professionals can only improve environmental factors of disease by motivating individuals to change their environments?
What about the role of public health policy makers in ensuring every community exists in the healthiest possible environment?
I am inclined to think that geomedical documentation deserves investment and consideration.
I think that was a scam to get more money. See, the poor politicians don't have enough, and they need to borrow more.
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