Annals of family medicine
-
People working on behalf of population health, community health, or public health often experience confusion or ambiguity in the meaning of these and other common terms-the similarities and differences and how they bear on the tasks and division of labor for care delivery and public health. Shared language must be clear enough to help, not hinder people working together as they ultimately come to mutual understanding of roles, responsibilities, and actions in their joint work. Based on an iterative lexicon development process, the authors developed and propose a definitional framework as an aid to navigating among related population and community health terms. ⋯ Realities are social determinants as influences, health disparities as effects, and health equity as both a goal and a design principle. Ways to get the job done include health care delivery systems for enrollees and public health in population-based civic activities-with a broad zone of collaboration where streams of effort converge in partnership with served communities. This map of terms can enable people to move forward together in a broad zone of collaboration for health with less confusion, ambiguity, and conflict.
-
Annals of family medicine · Sep 2021
"I Need to Keep Me and My Mother Safe": The Asylum Crisis at the US-Mexico Border.
In Tijuana, Mexico, 16-year-old Joaquin, a refugee from El Salvador where LGBTQ people are persecuted, was hoping for asylum in the United States based on sexual orientation. But as a volunteer physician in Tijuana, I had learned hard lessons about the asylum process-or lack thereof-at the US-Mexico border. ⋯ The lack of transparency about the realities of this system left thousands of families stranded in Mexico without basic rights such as health care. Health care professionals should be aware of the ongoing asylum crisis and be an active faction in the fight for its reform.
-
The story depicts my close relationship with Mr Schwartz, an elderly Holocaust survivor, spanning over 20 years. During those years, he became a significant patient to me; during my many home visits, we often shared significant conversations about life. When Mr Schwartz was diagnosed at age 90 with advanced cancer, we made an alliance whereby I would represent him in his decision not to receive medical interventions. ⋯ Over the years; I was moved by his honesty, frustrated at my inability to offer him relief or a sense of meaning, and pensive, as I would inevitably reflect on existential issues pertaining to myself and my dear ones. Mourning his loss was complex, for I was very close to him, yet not a part of his family. With whom can we physicians share our sadness at the loss of a person with whom we never actually spent a holiday or family dinner?