Health Is Political

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Why Healthcare Policy Is the Strongest Determinant of Our Well-Being

Dr. Sharon GoldfarbFrom workforce shortages to climate change, Dr. Sharon Goldfarb highlights the structural and political forces driving health inequities.

During the smoky months of California’s fire season, a young woman rushes to a free clinic struggling to breathe from an asthma attack. The clinic staff stabilize her, but she’s told to go to the ER if symptoms flare up again since the clinic only operates two days a week.The woman, an undocumented domestic worker in her thirties, breaks down in tears. The last time she visited the ER, she received the same treatments she had received at the clinic, a prescription for an asthma medication that cost $500 and then received a bill from the hospital for $6000. She could not afford the hospital bill or the prescription medication. Her story is just one of many examples shared by Dr. Sharon Goldfarb, DNP, in her recent presentations on the political determinants of health at DEI meetings.

What Are Political Determinants of Health?

Put simply, political determinants of health are the policies and structural conditions that drive inequities. For this young woman, those forces included:

  • Socioeconomic status → her wages made healthcare costs unmanageable.
  • Workforce shortages → the clinic’s limited hours restricted access to care.
  • Climate change → worsening air quality exacerbated her asthma.
Beyond Biology and Behavior

Dr. Goldfarb, a public health and community health professor at the University of San Francisco and a League Board member, emphasized that health outcomes are shaped less by individual choices and more by the structures around us.

“Socioeconomic status is just one piece of the puzzle,” she explained. “Policies around labor, climate change, infrastructure, and even quality of education, health care literacy, digital literacy, and information can all determine whether a community gets the care it needs.”

Research from the American Public Health Association echoes her point: race, gender, immigration status, socioeconomic status, and rural residence can magnify the inequities created by policy. For millions of Americans, access to care is fragile—or altogether absent.

The Workforce Crisis and Climate Threat

Dr. Goldfarb also drew attention to the fragility of the healthcare workforce. “Health care depends on workforce strength,” she said. “That’s why the League should make sure we come out as pro-labor and pro-union as part of our platform.”

Her remarks align with U.S. Health Resources and Services Administration projections showing shortages in nearly every category of health professional by 2036.

Climate change adds another layer of risk. Rising temperatures are already expanding the range of ticks carrying Lyme disease, according to the CDC. From asthma to infectious diseases, climate change is reshaping the health landscape.

Finding Hope in Action

Despite the daunting challenges, the DEI Team’s discussion ended on a hopeful note. Members underscored practical steps to blunt the impact of political determinants:

  • Support fact-based, nonpartisan public education.
  • Expand digital and medical literacy programs.
  • Promote access to reliable health information.
Get Engaged

Health is political — and informed communities can be powerful agents of change.

The LWVBAE DEI Team meetings are one way to learn more and take action. The Zoom meetings where health care is discussed are open to the public at 7:30 p.m. every other Thursday – see the League’s calendar at lwvbae.org:

See the link: https://us06web.zoom.us/j/88131772900

Learn More

Public education is essential to counter misinformation and empower communities. Dr. Goldfarb recommends:

Public Health & Policy News Toolkit

This toolkit provides trusted sources, newsletters, and strategies to stay current on public health and policy news. Use it as a guide to develop a weekly reading and learning routine as a student, practitioner, or advocate.

Top U.S. Public Health & Policy Resources

  • Kaiser Family Foundation (KFF) / KFF Health News: Independent, nonpartisan reporting on health policy and coverage. Website: https://www.kff.org
  • Health Affairs / Health Affairs Forefront: Leading journal for health policy analysis. Website: https://www.healthaffairs.org
  • American Public Health Association (APHA) Newswire: Policy updates, advocacy, and public health campaigns. Website: https://www.apha.org
  • National Academy for State Health Policy (NASHP): Deep dives into state-level health reform. Website: https://www.nashp.org
  • Health Policy Watch: Global health policy news with comparisons to U.S. trends. Website: https://healthpolicy-watch.news
  • Fierce Healthcare: Policy, payer, and provider news. Website: https://www.fiercehealthcare.com
  • JAMA Health Policy: Peer-reviewed health policy articles. Website: https://jamanetwork.com/collections/44020/health-policy

Governmental & Institutional Sources

  • CDC Newsroom – https://www.cdc.gov/media/index.html
  • World Health Organization (WHO) – https://www.who.int/news
  • Johns Hopkins Bloomberg School of Public Health Headlines – https://publichealth.jhu.edu/headlines
  • Agency for Healthcare Research and Quality (AHRQ) – https://www.ahrq.gov
  • AcademyHealth – https://www.academyhealth.org
  • AHIP SmartBriefs (Insurance and payer policy) – https://www.ahip.org/ahip-newsletters

—Margaret Montag

 

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