Global Health Starts at Home
December 8th, 2009
The following post by Meryl Bloomrosen, Vice President at the American Medical Informatics Association (AMIA), is part of Disruptive Women’s “The Value of Health: Creating Economic Security in the Developing World” series.
Ms. Bloomrosen supports a number of AMIA committees and task forces, provides executive oversight to AMIA’s contracts and grants, and provides support for AMIA’s ongoing efforts on Clinical Decision Support (CDS) and informatics workforce development. Prior to her position with AMIA, Ms. Bloomrosen was a Vice President at the eHealth Initiative and the Program Manager of the Connecting Communities for Better Health Program, a HRSA-funded, multi-million dollar cooperative agreement.
My 30+ year health care career is catching up with me – my eyes are wide open, my heart is heavy, and my mind is racing. What is happening? In the summer 2008, I had the privilege to help convene and participate in a week long, by invite only conference on ehealth capacity and workforce, sponsored by the Rockefeller Foundation and part of their series of topically focused conferences. In June 2009, I traveled with my daughter to Ecuador as part of a humanitarian trip to provide health, education and infrastructure support to several indigenous rural villages. And at AMIA, I have the good fortune to participate in several globally focused health informatics and workforce projects.
I have learned a lot about how health workers are inequitably distributed throughout the world, with severe imbalances between developed and developing countries. It is clear to me that tens of thousands of people lack the information, knowledge, or resources to take care of themselves or their families. The growing worldwide shortage of health care workers, along with the imbalance of the availability of health workers, stands in the way of achieving such key global public health priorities as reducing child and maternal mortality, increasing vaccine coverage, treating people with chronic diseases, and combating epidemics such as TB, malaria, HIV/AIDS and H1N1 .
Over the decades, there has been much discourse and many, many meetings on the topics of access to health care, the shortage of health care workers, and the lack of adequate information about health and health care. Philanthropies have created and launched multiple programs to help eradicate poverty and disease; to help educate generations of world citizens; to help train doctors and nurses; to increase world literacy. Papers and reports written. Speeches and testimony given. There are just too few hands-on healthcare workers to provide essential health interventions, and reports conclude that this shortage requires adopting a global approach to health worker human resources.[1-12]
The United Nations’ (UN) Millennium Development Goals (MDG) to promote poverty reduction, education, maternal health, gender equality, and aim at combating child mortality, AIDS and other diseases represent one global partnership. The World Health Organization (WHO) devotes resources to the topic of the ongoing and growing shortage of health care workers as it relates to global health noting that prevention and treatment of disease and advances in health care cannot reach those in need. In the U.S., several reports discuss the current and future demand for health workers (including primary care physicians, nurses, providers, and public health workers) and conclude that we too face a critical national shortage driven by such factors as U.S. population growth, increased need for health care, the aging population, an aging and retiring workforce. The general consensus is that demands will outstrip the supply.
Historically there is consistent under-attention given to women’s health and inadequate information available to and for women about women’s health issues worldwide. Women are a vulnerable population, and programs that improve women’s health have a direct impact on maternal and fetal morbidity and mortality. Women’s health is particularly at risk due to pregnancy, childbirth, their role in conflict and in displaced populations, and lastly because of their role in society. Organizations like Global Alliance for Women’s Health and Our Bodies Ourselves as well as initiatives like Wye River Call to Action for Global Women’s Health and The Global Women’s Health Fellowship at the Connors Center for Women’s Health are among many that seek to combat the worldwide deficit in information and attention.
These days, the US government is tackling the complex topic of health care reform “to ensure Americans get the high-quality, affordable care they need and deserve.”
Attainment of health and access to health care and health information, is a multi-faceted, long-standing political, economic, educational, social, cultural and GLOBAL issue.
The status quo is killing us.
References
[1] Paula O’Brien and Lawrence O. Gostin Health Worker Shortages and Inequalities: The Reform of United States Policy http://www.ghgj.org/ Accessed 11/26/09
[2] World Health Organization. 2006 World Health Reports Accessed 11/26/09
[3] http://www.who.int/whr/2006/en/ and fact sheet on migration of health workers http://www.who.int/mediacentre/factsheets/fs301/en/index.html
[4] International Organization for Migration. Background on and strategic plan for the organization’s Migration for Development in Africa program http://www.iom.int/MIDA/. Accessed 11/26/09
[5] American Public Health Association. Policy on ethical recruitment of international health workers Accessed 11/26/09
[6] (http://www.apha.org/programs/globalhealth/section/advocacy/globalihtest2.htm).
[7] Joan Stephenson Health Worker Shortage JAMA, April 16, 2008; 299: 1764.
[8] Bridget M. Kuehn Global Shortage of Health Workers, Brain Drain Stress Developing Countries JAMA. 2007;298:1853-1855. Accessed 11/26/09
[9] http://www.asph.org/UserFiles/PHWFShortage0208.pdf Accessed 11/26/09
[10] AAMC Center for Workforce Studies The Complexities of Physician Supply and Demand: Projections Through 2025 October 2008 https://services.aamc.org/publications/showfile.cfm?file=version122.pdf&prd_id=244&prv_id=299&pdf_id=122 Accessed 11/26/09
[11] http://www.aacn.nche.edu/media/shortageresource.htm Accessed 11/26/09
[12] Out of Order, Out of Time: The State of the Nation’s Health Workforce AAHC http://www.aahcdc.org/policy Accessed 11/26/09
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