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| Dr. Daniel Dawes |
As a new administration prepares to tackle the consequences of the most significant public health crisis in our lifetime, it’s important to understand the dynamics of advancing health care reform. In addition to health and safety, COVID-19 continues to ravage the economy, putting more people out of work. Years after passage of the Affordable Care Act (ACA), astronomical health care costs are preventing people who are uninsured and/or underinsured to seek medical and behavioral health care when they need it.
Dr. Daniel E. Dawes’ latest release The Political Determinants of Health underscores key events in the development of the ACA. Dawes is the director of the Satcher Health Leadership Institute at Morehouse School of Medicine, and has been at the forefront of recent major health policy negotiations in the U.S. In the book, he illustrates how policy and advocacy efforts strengthened the rationale for focusing on health disparities and ensuring that people have access to health care, especially those who are underserved by the health care system. This includes communities that have been historically marginalized in the U.S., including people living in poverty, racial and ethnic communities, people with disabilities, LGBTQ+ communities and others.
Political determinants are the “determinants of the determinants” – the root causes for persistent health inequities. In emphasizing the role of government, voting and policy and advocacy, Dawes underscores how decisions about health care funding involve the interplay of complex dynamics that advance or hinder health equity. Dawes’ framework places voting as a key factor impacting health reform: noting how money, engagement, and demographics determine winners in elections at all levels. He notes structural, institutional, and interpersonal barriers to health care access, as he meticulously documents key actions by lawmakers, professional organizations and advocacy groups to rally support behind addressing health equity.
Policy makers, advocates, anyone involved in advancing health equity and solving disparities must read this book. Health inequities are rooted in unequal power structures that are embedded in the political system, where decisions happen on purpose and are modified largely through law, regulation and incentive. In Political Determinants, Dawes lays bare the important dynamics of policy-making, inspiring us to become more involved in identifying the levers that we can impact to advance health equity for all.
