Medicine
The city of Astana, the capital of the former Soviet republic of Kazakhstan, is well known to U.S. professional cycling fans as the team sponsor for Lance Armstrong and his rival Alberto Contador, who won this year's Tour de France. Earlier today I met two earnest physicians from Astana who are in the United States to learn about public health and prevention in order to inform their country's effort to reduce death rates from preventable diseases. Despite obvious differences in size, history, and demographics, the similarities between Kazakhstan and the U.S. in health policy are striking. Like us, they have concluded that promoting healthy behaviors such as smoking cessation, alcohol moderation, diet, and regular physical activity are the keys to improving the long-term health of their population. Like us, they are moving to enact health reforms to ensure that all of their citizens have access to screening tests and other preventive services. And they told us a story that could teach U.S. health care reformers a thing or two.
Several years ago, the government of Kazakhstan decided to made a major investment in modern health care facilities - primarily by expanding specialty clinics and hospitals. They focused on acquiring the most advanced diagnostic and treatment technologies and training specialist physicians in the use of those technologies. The result? Mortality and disease rates remained the same, or rose. Astana's health officials belatedly realized that their neglect of their country's primary care infrastructure made it difficult for people to access care, or have their care coordinated by primary care physicians. To their credit, they have diagnosed the problem and are moving aggressively toward a solution - including reforming their system of medical education to produce greater numbers of primary care physicians. In my opinion, Washington, DC would do well to learn from Astana's example.
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When U.S. health reformers were looking abroad last year, the health systems of Canada and the United Kingdom were the most commonly mentioned. In this blog, I've also compared our primary care to better-functioning systems in more out-of-the-way...
- Primary Care In Developing Countries
While this blog focuses on health and the dysfunctional health care system in the U.S., it's worth noting that many other countries have problems providing their citizens with good primary care. Last year, the World Health Organization released a...
Medicine
Health care lessons from Astana
The city of Astana, the capital of the former Soviet republic of Kazakhstan, is well known to U.S. professional cycling fans as the team sponsor for Lance Armstrong and his rival Alberto Contador, who won this year's Tour de France. Earlier today I met two earnest physicians from Astana who are in the United States to learn about public health and prevention in order to inform their country's effort to reduce death rates from preventable diseases. Despite obvious differences in size, history, and demographics, the similarities between Kazakhstan and the U.S. in health policy are striking. Like us, they have concluded that promoting healthy behaviors such as smoking cessation, alcohol moderation, diet, and regular physical activity are the keys to improving the long-term health of their population. Like us, they are moving to enact health reforms to ensure that all of their citizens have access to screening tests and other preventive services. And they told us a story that could teach U.S. health care reformers a thing or two.
Several years ago, the government of Kazakhstan decided to made a major investment in modern health care facilities - primarily by expanding specialty clinics and hospitals. They focused on acquiring the most advanced diagnostic and treatment technologies and training specialist physicians in the use of those technologies. The result? Mortality and disease rates remained the same, or rose. Astana's health officials belatedly realized that their neglect of their country's primary care infrastructure made it difficult for people to access care, or have their care coordinated by primary care physicians. To their credit, they have diagnosed the problem and are moving aggressively toward a solution - including reforming their system of medical education to produce greater numbers of primary care physicians. In my opinion, Washington, DC would do well to learn from Astana's example.
- Health Outcomes: The Interaction Of Class And Health Behaviors
. I have recently discussed (Poverty, Primary Care and the Cost of Medical Care, February 10, 2010) the “Whitehall Studies” conducted by Sir Michael Marmot and colleagues that “demonstrate that there is a more or less linear correlation between...
- Perspectives On Preventable Causes Of Death
A few years ago, I blogged about varying definitions of "actual" causes of death, which include disease-specific causes (the top five in the U.S. being heart disease, cancer, chronic lower respiratory diseases, stroke, and unintentional injuries);...
- End The War Metaphors For Cancer Screening And Treatment
Like millions of cycling fans all over the world, I was very disappointed about revelations that 7-time Tour de France champion and cancer survivor Lance Armstrong had been using banned performance-enhancing substances for most of his career, despite...
- Spain: An Unlikely Primary Care Model For The U.s.
When U.S. health reformers were looking abroad last year, the health systems of Canada and the United Kingdom were the most commonly mentioned. In this blog, I've also compared our primary care to better-functioning systems in more out-of-the-way...
- Primary Care In Developing Countries
While this blog focuses on health and the dysfunctional health care system in the U.S., it's worth noting that many other countries have problems providing their citizens with good primary care. Last year, the World Health Organization released a...