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Tuesday, May 27, 2014

Guest Blogger Professor Jonathan Todres - Human Rights and the Social Determinants of Health

Todres JonathanPoor people live shorter lives, substantially shorter in certain impoverished communities. A recent New York Times article highlighted the significant gaps in life expectancy among different counties in Virginia: “Residents of Fairfax County are among the longest-lived in the country: Men have an average life expectancy of 82 years and women, 85, about the same as in Sweden. In McDowell, the averages are 64 and 73, about the same as in Iraq.”

The poor are less likely to have access to needed health care and more likely to smoke, be overweight, and to live with constant stress, which we now know is harmful to the human body.  It is at this critical juncture (as well as others) that public health and human rights meet. As public health professionals focus on the social determinants of health, relatively few approach these issues through a human rights framework or in partnership with human rights advocates. Likewise, human rights activists miss opportunities to partner with, and build upon the work of, public health. 

The social determinants of health implicate human rights, and visa versa. And while highly politicized debates swirl around the causes of poverty among adults, everyone ought to be able to recognize that no child chooses his or her place of birth. Yet where and to whom you are born affects access to health care, education, and ultimately life expectancy.  And even within the United States, the ensuing differences can mean an additional decade or more of life. Or the opposite.

The Convention on the Rights of the Child (CRC), the most widely ratified human rights treaty in history, requires countries to “ensure to the maximum extent possible the survival and development of the child” (article 6).  It also mandates that governments ensure every child is protected from harm and is able to realize his or her rights to health care, education, and an adequate standard of living necessary to enable the child to develop to his or her fullest potential.

The elephant in the room, of course, is that the United States is one of only three countries in the world (along with Somalia and newly independent South Sudan) that have yet to ratify the treaty.   But this is not an article about the U.S. government’s approach to human rights treaties or the domestic politics around the CRC.  Rather it is call for public health and human rights professionals to build bridges in their work, much of which has the same aims: harm reduction and the well-being of all individuals.

Whether or not progress is made on U.S. ratification of the CRC in the near term, opportunities exist now to use human rights frameworks to help address the root causes of child exploitation and poor health outcomes for children.  Similarly human rights advocates can bolster their efforts by drawing on the significant work already done by public health professionals in identifying and addressing the social determinants of health.

The gaps in life expectancy across communities in the United States should compel us to utilize every tool we have.  Both human rights and public health strategies can help address these disparities and their root causes.

- Professor  Jonathan Todres

 

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