Proposing new politics of medicine

The United States, said Helena Hansen, M.D. ’05, Ph.D. ’04, spends more on medicine than any developed country yet has poorer outcomes. Meanwhile, low-income countries like Cuba and India are improving health care.

“What’s missing?” asked Hansen, an assistant professor of psychiatry and assistant professor of anthropology at New York University, speaking to members of the Yale Global Mental Health Program in March. “We have technology that practitioners in other countries can only dream about. But we focus on eradicating the patient’s acute symptoms, not on the social or institutional factors that led to them.”

Calling for a “new politics of medicine,” Hansen said that American clinicians need to look beyond the patient and focus on where patients live as well as their level of education, diet, and income level. Clinicians also need to engage in interdisciplinary collaborations with such community partners as urban planners, educators, and criminal justice leaders.

“Doctors need to prescribe structural interventions, so that ailing systems become the patient, not only the individual,” Hansen said. “We need to push clinical professionals to think of themselves as agents for institutional change, social change, and policy change.”