In May 2009, the World Health Assembly called on national governments to politically commit to tackle health inequities and to embrace the principles outlined in the final report of World Health Organization’s (WHO) Commission on Social Determinants of Health (CSDOH).
In my last post, Healthy Policies looked at a recent Lancet debate over who owns health inequalities in the US. The dispute was contrasted with the Marmot Review, England’s response to the WHO CSOH. I wondered, “Where is the US Commission for Health Equity”.
On the Australian health blog, Croakey, Professor Fran Baum of Flinders University similarly ponders “why successive Australians governments have paid so little attention to health inequities and certainly a lot less than Europe does”.
As a Commissioner on the WHO’s CSDOH, Baum notes mixed feelings in response to England’s Marmot Review:
“On the one hand I was glad to see how our Commission’s report translated to a developed country context and very much enjoyed the depth of evidence and support for an approach to health that tackles the underlying determinants.
Another part of me felt a sharp pang of regret that no Australian equivalent of the Marmot Review has been commissioned by the current Government and that I had failed in my mission to ensure that the CSDH’s report was acted on by Australia.”
Baum imagines what an Australian Health and Equity Commission might look like would she be in the position of advising the federal government. Her visions of policies informed by health and equity impact assessments made me wonder if any of the American Commissioners are involved in policy making, and if so, what they have been up to.
Of the 19 Commissioners, three were from the US:
- William H. Foege,
- David Satcher, and
- Gail Wilensky
Looking into the backgrounds and current projects of these Commissioners, the person seemingly closest to a position of informing national policy is definitely Gail Wilensky. Wilensky’s virtual bio details an extensive history of political affiliations. Her website highlights that she “testifies frequently before Congressional committees, [and] serves as an advisor to members of Congress and other elected officials”.
A quick Google search also identifies Wilensky as an advisor to the Robert Wood Johnson Foundation (RWJF). In some ways, the closest the US has gotten to a US Commission on Health Equity is the work done by this group. (Though in a previous post I show how many of the fundamental principals necessary to building evidence on the social determinants of health were largely ignored in a recent project undertaken by RWJF).
Google also presents an article published by Health Affairs, co-authored by Wilensky and fellow US Commissioner David Satcher. It is titled “Don’t forget about the social determinants of health”.
Published in the context of US health care reform, the article intends to remind everyone that health isn’t just about health care. While the piece mentions many resources important for health, it fails to really drive home that it is political decisions which create and re-enforce unequal distributions of resources important for health.
(Side note: Health Affairs is published and copyrighted by Project HOPE — The international health foundation where Wilensky “develops and analyzes policies relating to health care and the economy” According to her resume, she has been doing this at Project Hope for the last 17 years).
I continue on my Google hunt and find that Wilensky is also a Health-Care Expert at the National Center for Policy Analysis (NCPA). The NCPA’s mission is “to provide private sector, free-market solutions to public policy problems”. Her history with this group might also explain her recent role as an advisor on GE Healthcare’s new business strategy, Healthymagination.
My search also turns up a profile on Wilensky at Forbes.com. The site highlights a handful corporate health care boards Wilensky acts as a director on. It also documents her compensation for these positions. State of the Divison places Wilensky’s 2008 stock holdings in these companies at $20.3 million. A profile at Bloomberg Businessweek details more of Wilensky’s corporate affiliations.
Unlike Baum, Wilensky has the influential ears of members of Congress and other elected officials. However, with such large personal investments in private health care corporations, one need not wonder where her priorities lie when making policy recommendations.
