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Whack-a-Mole: Social Justice Style

By Dena Javadi
on October 13, 2014

It’s been a week since the 3rd Global Symposium on Health Systems Research, and I’m still puzzled by how it closed. It felt a bit anti-climactic that after a week of discussing why a systems approach– grounded in social justice, with enough attention paid to system complexities– is necessary to improve health outcomes in an effective and sustainable way, we closed the symposium with a question about the appropriateness of one goal being devoted to health in the post-2015 sustainable development goals (SDGs).

Of the 17 SDGs (we’re going to make it through the alphabet at this rate), one is explicitly devoted to ensuring “healthy lives and [promoting] well-being for all at all ages.” Now before we get into a do-gooder turf war of why just one goal for health, we should note there are really 17 health goals. 17 poverty goals. 17 food security goals. 17 equity goals. 17 education goals. 17 urban planning goals. 17 environmental goals. 17 peace goals. You get the point. These goals are so interwoven, that to look at any individually would be like pulling at the loose thread on the sweater your grandmother made last year, leaving a distorted image and loose ends. Throughout the symposium these connections were reiterated. The impact of trade laws on the environment and in turn on human health, the importance of empowering women, the need for better education—all of these were brought up across sessions as part and parcel to improving quality of life.

We know that an interdisciplinary, cross-sectoral approach is important, but there’s still a tendency in practice to revert to a siloed approach. How do we move beyond our comfort with boxes to allow for real consideration and integration of social and political determinants of health when planning and implementing reform?  If we don’t, we’re consistently going to be blind-sided by “outside” policies and decisions that irrevocably affect health. We are health advocates. What’s the point of advocating within our own field to other advocates?  We should contribute to an environment where advocacy comes during planning and implementation and not only when problems arise. An environment where a health advocate has a voice in planning and implementation of education initiatives, of urban planning projects, of trade negotiations, and so on.

Sure it sounds like a pipe dream to have that kind of trans-disciplinary transparency, but without it, we’re going to continue this spiral of whack-a-mole: social justice style. As the media frenzy around one injustice dies, we divert our eyes to another, seemingly disconnected one, shifting resources, dialogue and advocacy efforts. This kind of short-term planning is hurting our social sectors—it’s time to systematically reconnect the dots. Let that be an SDG.

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