CDC Global/PHI Conference, Aug. 21–4, Atlanta.
Hyatt Regency Atlanta Hotel, August 24, 2011.
Comments & Suggestions for a Global Public Health Informatics Research Agenda
(This draft of quick notes about scientific research needs has more to do with our western world medicine, epidemiology/hygiene & public health that with the informatics & IT sphere, but are in my view key premises to support the Global & Public Health Informatics in the next years, and some CDC and/or HHS structure must take them in their hands.)
1) Information & communication are of the main factors of world modernization, together with universal freedoms & rights, industrialization of free market economies, and modern science & technology.
2) Our world has advanced very much in globalization of libertarianism & market economy refinements, after been retarded from 1917 to 1989, thanks to the globalization of information and of its communication technologies.
3) In the last 20 years global health funds for research & development have been concentrated in bio-medicine, bio-epidemiology, medical & agrarian biotechnology, supporting shyly the research to promote & maintain healthier living policies & systems (including the banned socioeconomic & civil-political factors in most current academics discussions), and the research needed to give a whole picture of health with all the dimensions of its concept, and health care preventive as well as therapeutic strategy, and to the emerging top information & communication technologies.
4) There cannot be global health (within the WHO western civilization concept) when still about 40% of the world population lives captive with high equity at the bottom by autocratic regimes elites (the only rich), suppressing the freedoms & rights, and with about 20% without been able to emigrate to escape from extreme poverty, due to the still existence of primitive economies without developed & stable institutions, or deformed, backwards & inefficient due to rigid decentralization of a one-two ma(e)n and/or one-party dictatorships.
5) Global public health informatics is suffering from an unnoticed barrier that makes it work as an informatics for global diseases, birth & deaths, and resources, static concept developed since the appearance of the first French modern hospitals in the 18th century, and maintained by the ten revisions of the WHO ICD, and all the last concomitant developments to make it broader, complemented with the great 70-year advances in population risk factors & high risk segments.
6) There is needed a transition of the Global Public Disease, Birth/Death, & Resources of today to a broadest Global Public Health WHO concept, health preventive care strategy, and classification & measuring of much more the mental dimension, in relation with the social dimension that have not been well classified & measured yet, in every country of the world (passing over all the left-wing academic socioeconomic & civil-political taboos).
7) I feel very sorry, because of the scarce world financing to global public health informatics contrasting with the great efforts by the computer & IT scientists, are being wasted. It is required a new whole concept of health & preventive health care strategy, making emphasis in primary care of basic socioeconomic & civil-political hygienic & healthy living conditions. It is also required a new primary health care classification of health promotion, maintenance & recovery, including all dynamic transitions between abilities & disabilities, wellness & suffering, with the wide & diverse gradients of healthy states & variables, in all the intermediate process of the health process, with all the interactions of risk factors with general & specific health safety factors, of the individual, family & community.
8) There are in use today for primary health care classifications, different truncated WHO ICD since the 1960s, without positive health clinical medical, hygienic/epidemiological & public health categories, with the least ones for the mental & social dimensions of health, due to the predominant & comfortable for physicians, nurses & all health professionals of the predominant basic biomedical, bio-clinical medicine, bio-epidemiological & bio-hygienic approaches to public health.
9) The classifications is use today reflect very well the health physical dimension of syndromes & disease, and the therapeutic disease care of today for morbidity & mortality uses, but both are not enough to classify health in absence of disease as well as all the transitional dynamic states of health progression, regression and stabilization by all lifetime groups of ages and gender, in whole health care & surveillance systems, as well as in the necessary & basic component of individual & family electronic-health records. Of course that this will need research, and after, pilot tests, adjustments, and finally, practical implementation.
10) The principal barriers are the still classical & narrow basic biomedical, clinical medicine, hygiene & epidemiology negative & indirect view of health anchored only to biomedical disease treatment and to risk factors protection at most. The great challenge is to do research intensively designing a new & broadest health concept & health care strategy, and classification complemented with the development of a more positive health approach to clinical medicine, hygiene & epidemiology, over a more psycho-social basis & measures, to reach to the full use in health care of the visionary & promissory health definition of the WHO accepted since 1946-8.
Thank you for reading this,
Rodolfo
Rodolfo J. Stusser, M.D., M.Sc., M.PH.
Global Primary Health Care Medicine Research Consultant
(Former Advisor to Cuban Ministry of Public Health Informatics/Tele-Health Division)
14055 SW 51 LN, Miami, Fl. 33175-5937, USA; http://rational.fortunecity.com ;
Cell: +1-786-216-8310; [email protected].