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Lifelines: Part 2 Discussion
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Replying to question 1, I enjoyed part 2 of Lifelines very much. It was amazing to hear about how much Dr. Wen and her team achieved. I was very impressed by how thoughtful Dr. Wen was about selecting her team and how she navigated many tricky political situations while maintaining her integrity. I especially enjoy the chapter "Going Upstream" and I think it is important to think of the underlying causes of public health issues.In answer to question 2, I live near San Francisco and I believe the homelessness is one of the most important health problems affecting my community. There is a lot of stigma around homelessness and a disproportionate number of people who are homeless suffer from addiction and have other health issues. NIMBYism also makes homelessness hard to address. I am not sure of a bold solution that would solve the issue but I recently read about some work being done by the University of California San Francisco which will hopefully help.
Hi Michael, Thanks for your comment! I too really enjoyed this part of the book, and the parable of saving people struggling in the river by "going upstream" really hit home for me. I agree that the stigma and NIMBY attitude impede progress addressing homelessness. I currently live in St. Louis, which has a homelessness problem that disproportionately affects Black residents in the city (by a ratio of 3.72: 1). This issue is one example of a reason for health disparities. If you haven't already, I highly recommend listening to the podcast 99% Invisible's miniseries on homelessness called "According to Need". It was released in late 2020 and is an excellent look at homelessness in California and the successes and struggles that certain initiatives have seen when trying to address it.
Thank you for the podcast recommendation Hannah. I listened to the first episode last night and I am looking forward to listening to the rest of the series!
Hi Michael,Thank you for your comment. I agree with you and Hannah when thinking about public health problems - the most impactful solutions will be the ones addressing upstream issues. However, downstream solutions will be needed to address the issue in the mean time. I appreciate that Dr. Wen took both approaches to address the overdose crisis in her community. By providing naloxone and trainings, they were able to provide an immediate solution, while they worked on setting up more treatment centers.
Michael, I was reading about a new tiny village for homeless people in San Francisco. I thought this was a very progressive solution that will also help people get the additional help they need after being provided a home. Here is the link to the article I found. https://www.ktvu.com/news/san-francis...
Reflecting on the importance of ‘going upstream’—at PoshanTracker nutrition data for community health, we enable real-time tracking of maternal & child metrics to proactively support public health interventions.https://poshantrackers.com/
2. On pg. 130, Dr. Wen mentions that waiting for others to figure out solutions is the safest route and encourages bold actions and solutions to address health problems in our communities. If money, time, and resources were not an issue, what bold solution would you take to solve a health problem in your community?
3. A big theme of this part of the book is compromise: finding a stopgap solution to a problem until an ideal solution can be found (as Dr. Wen did with a blanket prescription for naloxone that could be accessed as long as that individual had received the necessary training). On pg. 140, Dr. Wen says “ideological purity is a luxury that those of us on the front lines can’t afford.” Have there been times when you’ve had to compromise to achieve progress? Do you think there is a downside to compromising public health initiatives?
4. On pg. 198, Dr. Wen tells the story of providing free cribs to families and describes how providing assistance to assemble the cribs drastically improved safe sleeping habits in a way that wasn’t seen before providing assembly help. Do you think there are other ways public health interventions can meet people where they are at and tackle barriers to implementation?