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Knowing the Body
2004 Second Web Report
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WHO Public Health Reform

by Mo Convery

International public health policies attempt to reform the social and political systems which influence the health and safety of all citizens of the world. In the past, these policies have been created through the strong reliance on and exploitation of socially constructed systems of classification such as gender, sexuality, nationality, and economic class. It has been a system of correlation between the behaviors which seem prevalent within social groupings and chances that those behaviors will lead to disease transmition or infestation. In January 2004, the World Health Organization announced a radical change in their policies surrounding public health study and prevention in the 2004 World Report on violence and health. Instead of focusing on larger global and national trends, the WHO called for an expansion of policies and increase of resources which focused more on the experiences and support of individuals rather than groups. This value of individual experience holds extreme promise in the expansion and effectiveness of public health initiatives as well has changes many societal systems of classifications.

For the past two decades, the main belief pervading social health policy was that group dynamics are the driving force behind disease and violence within culture. The chance that an individual would endure bodily harm for any such reason was not dependant on personal choice or experience, but rather they were a victim of social constructs. Outreach programs and public health initiatives focused on attacking the social dynamics and beliefs. Those groups with the highest prevalence of disease/violence or behavior believed to lead to such harm where the main targets. The international collation took this emphasis on social patterns by placing public health dialogue into the international forum. The WHO stressed establishment of universal "priorities". Research done at both national and international levels was meant to focus on the problems deemed most important on the international level. Moreover, international scientific forums were established and supported to increase collaboration and exchange of information on high priority topics. Nations abiding by UN laws were required to form National Action Plans with the needs of the international community in mind. While this international emphasis did a tremendous amount of good in forming a forum of public discourse and combating larger patterns of social violence/disease, it had serious deficiencies in practical application on an individual basis.

The recent report made by the WHO projected several ways in they and individual nations can expand this international position to include a more personal approach. Instead of focusing on the group dynamics and larger statistical patterns the WHO urged public health organizations worldwide to place value on individual experience and expand the forums which public health initiatives are discussed. Firstly, they urged the enhancement of data collection on the community level. Instead of relying on statistical correlation between group membership and behavior, organizations should be relying more heavily on case studies and individual experience dialogue. While this position may be more time consuming and financially draining, it will give a more diverse picture of the range of experience, cause, and effect.

The WHO urged for a promotion of primary response for both the victims and perpetrators. They believed that all individuals should feel that their personal rights and health are supported by the state and that they are aware of the proper modes of legal action and disease treatment available to them. This would allow for disease transmition to be limited and victims of violence to be treated accordingly. It also holds perpetrators responsible for their actions. If there are clear consequences for violence directed at another person, it is believed that less people would attempt such actions or at the very least be held accountable for their actions. This system of justice would also be upheld on the international level.

The WHO also urged for a more diverse and comprehensive range of social and educational polices and initiatives in the community level. One of the main deficiencies in the past focus on group dynamic was that "at risk" groups were more educated about prevention and response resources while the rest of the community was neglected. These differences in education lead to large discrepancies between people's knowledge of individual rights and health. What became strikingly clear was that violence and disease were not contained by social constructions and that the groups at risk were flexible. It is more important to educate a community as a whole as a preventative measure than it is to focus on the one group of individuals that were suffering from it at one point in time. When a public health institution is able to more completely integrate their knowledge into educational and social policies, the more individuals will receive the needed information and hence prevent disease and violence rather than just combat it.

It is strikingly clear that this shift to emphasis on individual experience is leading to constructive changes in public health systems and policies. First and foremost this change allows a more diverse understanding of cause and effect for violence and disease transmition to develop. This is extremely valuable to groups that for one reason or another are marginalized in social constructed groups and were not getting the education or support of liberties that other groups received.

This diversity of understanding allows for the formulation of more effective programs for outreach and prevention. In placing value in the individual experience, a more complex and comprehensive understanding of disease and violence is able to form. Patterns within these experience and more direct root causes may be able to reveal themselves. Thus the true nature of the disease/violence is able to form. Thus, educational programs can better address the problems at hand and more efficiently get their point across. Furthermore, when public health organizations no longer limit themselves to working within socially constructed groups, they have much more freedom in the defining the proper methods in which to educate and reinforce health rights. They are able to prevent not only within one community, but many.

Most importantly, this value of the individual challenges the reliance on social constructions and classifications in policy formation. By listening to every individual affected by disease and violence, public health institutions are placing equal value on individuals from varying groups. This stance challenges the tendency to classify behavior with social classifications which often placed blame where blame was not due. It also dares individuals to not be restricted in their analysis of disease to denounce their risk due to lack of affiliation. It forces people to see their risk and role in the prevalence of disease and violence and own up to possible responsibility. Once more individuals are able to assess their true risk and see how their behavior fits within this system, they will be more apt to take a more defined active or passive role.

This equalization of experience is so vitally important to those individuals once viewed as marginalized within their communities. No experience should be overlooked or neglected. Rather, each individual is an integral part of the social framework and whose experience can no longer be neglected. In American culture were marginalized groups are often blamed for social ills or believed to be punished through disease and violence, this international stand forces people to think beyond their insular thoughts. Not only does the WHO officially state that all individuals have the same right to health, but it holds governments and communities up to that standard.

Laws and policies have a way of challenging social constructions where social dialogue is not able. It holds individuals to a standard where consequences are clearly present. While an international approach to disease/violence education and research is extremely important for a global community, public health policies are able to be most effective when taken at the level of the individual. Beyond effectiveness, this stance challenges the very social classifications that often limit people from getting the help and support that the need both at the preventative and response level. These recent amendments to the WHO public health policies promote changes extending far beyond the basic level of health a safety to the framework of cultures that are known to promote oppression.

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