Lifelines: Part 1 Discussion

[Hannah]

In Part 1 of Lifelines, we learn more about Dr. Wen's path to becoming a doctor and what motivated her to advocate for public health. Please feel free to pick any of the discussion questions listed below to answer. We look forward to an engaging discussion!

Discussion Questions:
1. What stood out to you when reading Part 1?

2. The prologue of the book begins with Dr. Wen describing the traumatic experience of witnessing her neighbor Tony die of an asthma attack. She credits this as an inspiration for her decision to pursue a career in medicine and public health. Do you have a similar story of an inciting incident that inspired you to pursue a certain career?

3. One of the most powerful quotes thus far came on pg. 8: “How can we bend the arc of the universe back toward justice, so that health is no longer defined as the opposite of poverty?” What do you think are the ramifications of living in a society where health and poverty have this relationship? Do you agree that health is the opposite of poverty?

4. On page 65-66, Dr. Wen references numerous studies that state that 90% of a person's health is attributed to the social determinants of health and only 10% on medical care. How can we, in our current roles, put a bigger emphasis on addressing the social determinants of health?

[Sallee]

I am choosing to respond to Question 3. I found the relationship between poverty and health eye-opening and so thoughtful. We use life expectancy as a metric to describe the health of the population of a country, but I also think it is heavily associated with the wealth of the nation. The consequences of ignoring this relationship include many deaths that could, and should, have been prevented. I think this thought also ties in well with Question 4. Housing is public health. Food is public health. Everything is public health. More focus needs to be on providing basic necessities to avoid these health-related deaths that are directly related to poverty. I am loving the book so far and am looking forward to future discussion. Thank you!

[Michelle]

Hi Sallee, thank you for your thoughtful comment. I agree, we cannot ignore the relationship between health and poverty because we can prevent deaths by addressing this relationship. Your comment reminded me of what Dr. Wen said in her prologue on page 4, that everything is public health and the living conditions and environment have consequences for health. That second paragraph on page 4 hit home with me because it clearly explains what public health is and why it is so important.

Thanks again for participating and we are looking forward to further discussing this book.

[Hannah]

Hi Sallee and Michelle,
I totally agree with your thoughts about the relationship between health and poverty as well. Although we wish it were different, we cannot ignore the reality. The discussion about how everything is public health reminded me of the first full paragraph on pg. 7: the breadth of impact that public health has is shown when Dr. Wen credits her life to public health ("My life is a testament to public health"). In public health we are often focused on the health of populations, but I liked how we are able to see the true impacts of public health on Dr. Wen and her family.

[Michael]

Like Sallee, I am loving the book so far and am looking forward to the future discussion. The chapter "Opening pandora's box" was what most stood out to me. I found Dr Wen's first hand descriptions of the USA's "sick care" system very eye-opening. One story that stayed with me was that of Eileen who could not afford medication for her diabetes until her health deteriorated and she had to start dialysis. It was a sad reminder of the studies mentioned in question 4.

[Hannah]

Hi Michael, I really liked your comment about Eileen's story. It is truly a broken system whose cost is such that it prevents patients from receiving care until they are sick enough to be deemed worthy of care. I found several studies discussing the "sick care" system that Dr. Wen mentioned. Reading them got me thinking about the part that this type of system likely plays on the burden of chronic disease in the US.

[Michelle]

Hi Michael, thank you for your comment. I agree with you and Hannah, Eileen's story is heartbreaking. It was shocking to learn the response from one of the doctors that Dr. Wen was working with, who said her job was not to open the Pandora's box. I would agree with Dr. Wen, that this is why I love public health, because it is essentially our job to open the Pandora's box and get to the root cause of problems.