It's not just poverty that worsens health and vice versa: in Italy the psycho-social aspect is too neglected and excessive weight is given to the statistics that hide suffering. The doctor cannot stand by and bow to the perverse system that treats more and better those who need it least. Angelo Sefanini, professor of Community Medicine, is one of the most committed in the international arena on the subject of health and socio-economic disadvantage. For many years he has been trying to understand to what extent low social positioning, little or no schooling and similar things generate that chronic stress which, in turn, induces pathology. It is all too well known that the resulting stress induces hormonal changes that cause anatomical changes. What is new is having understood who is subjected to this stress: not the managers, but the unemployed who have to fight every day for survival. Stefanini hypothesizes that the doctor should have a very active and almost political role of the doctor. The word "doctor" comes from "docere" which means to tell, disseminate, inform both patients and political decision-makers about their activity. It is up to the family doctor to practice the profession of "advocate for the weakest", who tries to satisfy the patient's requests. In some very poor countries such as Cuba, Armenia, Costa Rica and Sri Lanka one would expect a very low life expectancy, which is instead comparable to that of rich countries. In fact, in these places there is a capillary health system, based more on dispensaries, clinics, small clinics in the villages than in large hospitals of excellence in all cities. The result is that health issues are addressed and resolved immediately, often even without or with very little medication. Prevention Primary Medicine can give immediate answers to the first problems that appear in the population. A group of doctors also organized with other professional figures gains both in quality of life and in effectiveness of intervention. From quantitative studies it is necessary to move on to qualitative ones, not because one must replace the other, but because the two cannot be separated. Doctors must go back to listening, to direct observation of the symptoms, to conversation. And possibly integrate it all with numbers.
Inf global health
Inf global health
