There are many paradoxes in life and many of these are concentrated in the realm of health and medicine (a major sub-division of life and death).
For decades the link between poverty and standards and quality of health has been recognized and politicized in the media and policy. In June there was news of a Bill to make the eradication of child poverty a legal obligation not something that can be the political objective at the start of a Government and then cast aside.
Many things are relative and poverty is often described in this way applying to individuals, social classes, communities, regions and whole nations. Using the domains of Hodges' model what reflections does this prompt? Let us see:
SOCIOLOGY: A key resource we all ordinarily rely upon is that of family, friends and community. While a source of stress at times as in you can choose your friends, but you can't choose your family..., and then there's the history of psychosocial intervention; the family is nonetheless usually seen as the asset.
Social poverty - having no (immediate, accessible) next of kin, friends or social network has been identified as a key deficit that may result in negative outcomes and problems in rehabilitation, recovery and staying well. There is an expanding literature on the role of social networks. Despite the current emphasis on e-social networks the interpersonal form of social network remains pivotal as a key strength for people to deal with major challenges to their health, social care and well-being.
The socio-economic contribution of informal carers is well recognized and vital in the management of long term medical conditions ('self-care by proxy'?). 'Caring' and carers predates what we today call 'nursing'. Carers shoulder a care burden saving the State an enormous sum of money. Within Hodges' model this domain - the SOCIOLOGICAL - may be a remote cousin, far from the sciences, but the fuzzy logic here is predicated on families and relationships.
In the social domain the whole community can act as a pool of kinetic and potential energy, a resource - locking up wealth in knowledge and skills that can counter social poverty and periods of self-neglect should this occur. The future health and social care agenda depends upon the workforce being able not only to create this social wealth, but ensuring people are able to release this knowledge. Physics, energy, time - there is no escape. Perhaps assumptions as per this quote* also have a role to play -
‘‘Of all the self-fulﬁlling prophecies in our culture, the assumption that ageing means decline and poor health is probably the deadliest.’’ Marilyn Ferguson, The Aquarian Conspiracy, 1980
*Sirven, N., Debrand, T. (2008) Social participation and healthy ageing: An international comparison using SHARE data, Social Science & Medicine, 67, 12, 2017-2026.
Mitchinson, A.R., Kim, H.M., Geisser, M., Rosenberg, J.M., Hinshaw, D.B. (2008) Social Connectedness and Patient Recovery after Major Operations , Journal of the American College of Surgeons, 206, 2, 292-300.