The health system in a certain place is often a palimpsest which bears traces of both current and historical social and cultural (and health) practices. Health is also a deeply political issue. Legendary German physician Rudolf Virchow in the nineteenth century summarized his belief in the inseparability of medicine and politics. Virchow regarded medicine as not merely the study of human disease but also a general metaphor for understanding society. It’s time we fathom Virchow’s words when he said that “health is a social science, and politics is nothing more than medicine on a large scale”.
The conditions in which a person lives, learns, works, and ages contribute to his/her health more than any other factor. While medical care receives the most attention, studies have consistently shown its small relative impact on health, when compared with social determinants. Medical care is estimated to account for only 10-20 percent of the modifiable contributors to healthy outcomes for a population. The other 80 to 90 percent are broadly called the SDoH: health-related behaviors, socioeconomic factors, and environmental factors. The social circumstances/determinants are in turn shaped by a wider set of forces: economics, social policies, and politics. Ignoring social determinants influencing health and investing solely in medical/clinical care in a healthcare system may lead to an inverted proportion of spending and health outcomes in a country.
Decisions about political, economic and resource distribution made outside the health sector need to consider health as an outcome across the social distribution, as opposed to focusing solely on increasing productivity. A Health in All Policies approach can go some way to ensure this consideration, and we present evidence that some countries are taking this approach. However, given entrenched inequalities, there is still some way to go.
Policymakers are recognizing the importance of the social determinants of health and incorporating them into public policy, indicating a shift from the traditional medicalized approach which countries have taken to solve their healthcare problems. This approach offers a way to reduce medical costs for individuals, insurers and the government, while improving outcomes, and it is worth further consideration and creative implementation. In the USA, a recent authorization for Medicare Advantage plans to cover non-medical benefits indicates a shift toward a more comprehensive approach to healthcare.
The National Health Policy 2017 seemed to have relegated SDoH to ecological factors such as pollution and individual risk factors such as exercise and diet with hardly any attribution to larger political and economic frames and the way power and policy is distributed. It would be right to make health a political issue, thus undoing a wrong turn in the trajectory of understanding health needs. Though the policy recognizes the link between health outcomes and its social determinants, it reflects a perfunctory attitude towards public health, which is apparent in the paragraph regarding the “social determinants of health” (which has been included mercifully in the “Situation Analysis” document). The situation analysis document sees the use of phrases like “context of rapid economic growth and changing life styles”, eclipsing the phenomenon of “poverty” that constitutes the most important context of the lives of those millions of people whose interests are the most affected by this health policy.
What determines someone’s health is a combination of genetic predisposition, behaviors, the medical services received, and social and physical environments. Recent estimates attribute 30 percent of health outcomes to genetics, 40 to 50 percent to behavior, and 20 percent to the social and physical environments. Individual behavior and the environment are often studied together as the non-medical determinants of health. The leading causes of death in the United States – cancer, heart disease, and chronic respiratory disease –are tied to unhealthy behaviors such as smoking and poor diet.
While the healthcare delivery system impacts health during episodes of injury or illness, the social determinants interact with health much earlier, and on a day-to day basis. They encompass the conditions in which people live, learn, work and age, along with the broader social positions in which individuals find themselves that impact health.
Conflict also exacerbates existing health inequalities. Due to the challenges of working in conflict contexts, there is a lack of evidence to support best practices in emergency response, particularly regarding the application of social determinants in these settings.
Mounting international evidence clearly demonstrates that morbidity and mortality follow socio-economic gradients that cannot be explained by health behaviors and diverse biological characteristics. Limited options at work, home or in the neighborhood restrict possibilities for people to live healthy lives. Not surprisingly, public health research shows that efforts to improve health behaviors are the most successful among those who can afford to live well, hold safe jobs and live in unpolluted and secure neighborhoods.
Social determinants can impact health directly, as well as indirectly, by shaping how people behave. Poverty, unemployment, and housing insecurity are all examples of social determinants that result in poor health outcomes. Of course, while the factors and conditions considered here are referred to as “social determinants,” they may be more aptly discussed as “influencers” or “predictors” rather than direct determinants of an individual’s or community’s health status. Most of these conditions are highly correlated with one’s health but not necessarily causal; further, all SDoH (except race) can change throughout one’s life.
The socioeconomic group into which an individual is born is both determined by and a determinant of other social determinants, interacting with many of them to dictate what choices an individual has, and thus how they behave. SES (socio-economic status) determines where a person can afford to live, the amount and quality of schooling one can afford, and in many cases, the type of job an individual can obtain. But despite the many obstacles that might make upward mobility particularly challenging for those with low SES, one’s SES can change over the course of their life.
If the history of public health teaches anything, it is that social justice is the foundation of public health–and this fact will stand the test of time through the decades. We believe that public welfare must be placed before corporate welfare and social equality must be given higher priority than freedom of the economic market.
In Rudolf Virchow’s words, medicine is a social science in its very bone and marrow. In reality, medicine is the science of the healthy as well as of the ill human being. And what other science is better suited to propose laws as the basis of the social structure, in order to make effective those which are inherent in man himself? Once the interests of the privileged no longer determine the course of public events, the physiologist and the practitioner will be counted among the elder statesmen who support the social structure.
The writer is a medical doctor (pathologist) and holds an MA in Creative Writing from the University of London. The views expressed are personal.
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SATELLOGIC AND UP42 TEAM UP TO OFFER RAPID MONITORING CAPABILITIES
Satellogic Inc. (NASDAQ: SATL), a leader in sub-meter resolution Earth Observation (“EO”) data collection, announced today that it has agreed with UP42, a geospatial developer platform and marketplace enabling direct access to Satellogic’s satellite tasking high-resolution multispectral and wide-area hyperspectral imagery via the UP42 API-based platform. The agreement includes the archive of high-frequency, high-resolution Satellogic data.
The companies made the announcement today at the Geospatial World Forum in Amsterdam, Netherlands, where UP42 CEO Sean Wiid and Satellogic Business Development & Sales Director Eldridge de Melo are featured, speakers.
“This exciting new collaboration gives UP42 customers a distinct advantage in rapidly creating geospatial solutions,” said UP42’s CEO Sean Wild. “Users can now derive insights from Satellogic data using algorithms and data fusion via our developer-first platform.”
Direct API access to Satellogic’s multi- and hyperspectral data – with intraday updates – supports rapid, timely, and frequent monitoring of critical assets in diverse sectors, such as energy, utilities, local government, and security. The UP42 platform’s REST API and Python SDKs can be fully customized, allowing UP42 users to build cost-effective solutions and quickly deliver end products to their clients.
“Our mission of democratizing access to critical Earth Observation data means making our data available where it’s convenient for end-users,” said Thomas VanMatre, VP of Global Business Development at Satellogic. “UP42 is a leading geospatial marketplace with value-added capabilities, enabling its customers to access and analyze data without extensive expertise. It is collaborations like this alliance with UP42 that will increase adoption of EO data across new markets, driving better decision making and outcomes.”
The growing Satellogic constellation currently consists of 22 operational small satellites, capable of acquiring 4-band (RGB NIR) multispectral data at 70 cm (1m native) spatial resolution over a 5km swath and up to 29-band (460-830nm) hyperspectral imagery at 25m resolution over a 125km swath.
During pre-processing, Satellogic imagery is optimized for analysis by Machine Learning (“ML”) and Artificial Intelligence (“AI”) applications – a significant benefit for UP42 users who will have access to more than 75 ML/AI algorithms on the UP42 platform.
UP42 users will be able to apply Satellogic data sets and extracted knowledge to support projects in a range of applications spanning the public and private sectors, including Agriculture and Forestry, Energy and Sustainability, Critical Infrastructure Management, Finance, and Insurance, Environment and Climate, and Government.
OTT is giving more opportunities to actors: Aamna Sharif
In an exclusive interview with NewsX, actress Aamna Sharif mentioned that OTT is giving her the scope to perform different things as an actor and she is grateful that she is being able to be a part of all three platforms. For an actress, digital or OTT is an interesting place to be, plus the medium is big and gives opportunity to every actor for different sorts of roles and performances.
Actress Aamna Sharif recently joined NewsX for a fun conversation as part of our special series NewsX India A-List. In the exclusive conversation, the actress opened up about her role in the series Aadha Ishq, what drew her to the role, and much more.
Speaking about what attracted her to ‘Adha Ishq’, Aamna said, “The title itself is beautiful. I believe all of us have experienced adha ishq once in our life. It is a beautiful love story between Sahil and Roma, the journey of Roma (played by Aamna). The story shows the ten years of Roma’s journey of what happens in her life. The interesting part of this love story is that a couple in love gets separated and later their children fell in love. It’s a different concept which is most exciting.”
Talking about doing a romantic genre, she said she loves being a part of such projects as she is a romantic person and loves watching love stories. Adding further, she said, “I have been playing different roles and was waiting for something like this to come, something as intense as Aadha Ishq.”
When asked about her experience of working in an OTT platform and the scope of digital platforms, Aamna said, “I am loving it, I think it’s a blessing for all the actors because of the kind of scope it provides to all the actors for performances. The last show, which I did, was also a very challenging role and Roma has so many layers to its character. It’s a dream for any actor to do such challenging roles and OTT is giving that scope and space.”
Aamna further shared that it is very important to watch other actors’ performances. She explained that she loves watching the work of other actors as it is important to learn as an actor.
When asked about her previous role in Komolika, Aamna said, “I was scared to play Komollika as I have never played such a role ever before, even though in ‘Ek Villian’ my character had shades of grey but not as much as Komollika in KZK2.”
While talking about her last two years’ experience, Aamna said “The last two years have taught us to value small moments in life and be grateful towards life.”
Aamna further stated that OTT is giving her the scope to perform different things as an actress and she is grateful that she is being able to be a part of all three platforms.
Aamna Sharif stated that ‘Kahiin Toh Hoga’ was a game-changing project for her as it changed her life.
ADANI ACQUIRES HOLCIM STAKE IN ACC-AMBUJA
The Adani Family, through an offshore special purpose vehicle, announced that it had entered into definitive agreements for the acquisition of Switzerland-based Holcim Ltd’s entire stake in two of India’s leading cement companies Ambuja Cements Ltd and ACC Ltd.
Holcim, through its subsidiaries, holds 63.19% in Ambuja Cements and 54.53% in ACC (of which 50.05% is held through Ambuja Cements). The value for the Holcim stake and open offer consideration for Ambuja Cements and ACC is USD 10.5 billion, which makes this the largest ever acquisition by Adani, and India’s largest-ever M&A transaction in the infrastructure and materials space.
“Our move into the cement business is yet another validation of our belief in our nation’s growth story,” said Gautam Adani, Chairman of the Adani Group. “Not only is India expected to remain one of the world’s largest demand-driven economies for several decades, but India also continues to be the world’s second-largest cement market and yet has less than half of the global average per capita cement consumption. In statistical comparison, China’s cement consumption is over 7x that of India’s. When these factors are combined with the several adjacencies of our existing businesses including the Adani Group’s ports and logistics business, energy business, and real estate business, we believe that we will be able to build a uniquely integrated and differentiated business model and set ourselves up for significant capacity expansion.”
Adani added, “Holcim’s global leadership in cement production and sustainability best practices brings to us some of the cutting-edge technologies that will allow us to accelerate the path to greener cement production. In addition, Ambuja Cements and ACC are two of the strongest brands recognized across India. When augmented with our renewable power generation footprint, we gain a big headstart in the decarburisation journey that is a must for cement production. This combination of all our capabilities makes me confident that we will be able to establish the cleanest and most sustainable cement manufacturing processes that will meet or exceed global benchmarks.”
“I am delighted that the Adani Group is acquiring our business in India to lead its next era of growth,” said Jan Jenisch, CEO of Holcim Limited. “Gautam Adani is a highly recognized business leader in India who shares our deep commitment to sustainability, people, and communities. I would like to thank our 10,000 Indian colleagues who have played an essential role in the development of our business over the years with their relentless dedication and expertise. I am confident that the Adani Group is the perfect home for them as well as our customers to continue to thrive.”
With India’s cement consumption at just 242 kg per capita, as compared to the global average of 525 kg per capita, there is significant potential for the growth of the cement sector in India. The tailwinds of rapid urbanization, the growing middle class, and affordable housing together with the post-pandemic recovery in construction and other infrastructure sectors are expected to continue driving the growth of the cement sector over the next several decades.
Ambuja Cements and ACC currently have a combined installed production capacity of 70 MTPA. The two companies are among the strongest brands in India with immense depth of manufacturing and supply chain infrastructure, represented by their 23 cement plants, 14 grinding stations, 80 ready-mix concrete plants, and over 50,000 channel partners across India.
Both Ambuja and ACC will benefit from synergies with the integrated Adani infrastructure platform, especially in the areas of raw material, renewable power, and logistics, where Adani Portfolio companies have vast experience and deep expertise. This will enable higher margins and return on capital employed for the two companies. The Companies will also benefit from Adani’s focus on ESG, Circular Economy, and Capital Management Philosophy. The businesses will continue to be deeply aligned to UN Sustainability Development Goals with a clear focus on SDG 6 (Clean Water and Sanitation), SDG 7 (Affordable and Clean Energy), SDG 11 (Sustainable Cities and Communities), and SDG 13 (Climate Action).
The acquisition is subject to regulatory approvals and conditions.
CONCERNS GROW ABOUT THE ELDERLY POPULATION OF INDIA
India has been witnessing an upward trend when it comes to the living arrangement patterns of elderlies. Many today are staying alone or just with their spouses. The features of joint family systems are not just declining but vanishing speedily in correlation with economic development and modernization.
‘For there is assuredly nothing dearer to a man than wisdom and though age takes away all else, it undoubtedly brings us that.” Affirmed Cicero, the Roman philosopher, ages ago. It is time we question ourselves if at all we are valuing this wisdom. One of the indicators of India’s progress should compel us to think through much deeper than this. The increase in life expectancy at birth in India, which is 70 years (United Nations Population Division. World Population Prospects: 2019) is indeed catching up with the global average of 73.4 years. This increase is resulting in a surge in the number of elderly people, with projections of 300 million elderly (more than 20% of the total population) by 2050. Catching up with the global average in statistics is not accompanied by adequate facilities, services, and support systems as a whole that can be considered age-friendly. This only means that India has to work much harder to catch up economically as well as socially.
One of the largest nationwide surveys called ‘Longitudinal Ageing Study in India (LASI)’ published in 2021 has turned out to be an eye-opener on aspects related to the burden of disease, functional health, and the social and economic wellbeing of elderlies. LASI covered a panel sample of 31464 individuals aged and their spouses aged 60 years and above and 6,749 oldest-old persons aged 75 and above from 35 states and union territories of India (excluding Sikkim).
The demographics are mindboggling, 2020 was the year when the world witnessed the number of people older than 60 years of age surpass the number of children under 5 years of age. The resultant life extension, without reducing aging, has increased the extent of aging and age-related diseases. This dramatic increase in life expectancy has increased the risk of disease, disability, dementia, and advanced aging before death. An elderly in India rightly exclaims: “Years are being added to my life, life is not being added to my years: the extra years are being added at the very end of my life and are of poor quality.
Talking about systems and mechanisms that extend care, services, and support to the older people, a lot depends on the settings which vary from those residing in their own homes, and those that access support through old age homes, nursing homes, day-care centres, and many more such units depending on the nature of the problems they face. Essentially, care of the elderly also necessitates ways and means that need to be evolved to address varied issues of varied elderly. The elderly population is not a homogenous group, especially in a diverse society like India. The
Concerns of the young-old and oldest-old vary considerably in terms of financial security, functional competencies, loneliness, and social and work participation. Heterogeneity is visible when it comes to urban and rural geographies. Those residing in rural areas are comparatively less vulnerable when compared to their urban counterparts. As much as the reality reflects that no two elderlies are the same, even the government does not view them in the same frame as far as their needs and challenges are concerned. These obvious disparities naturally fail to register their problems as most elderly get classified based on caste and other socio-cultural dimensions. Likewise, pension and social security are also restricted to those who have worked in the organized sector, as against those who have been labourers for a lifetime in the unorganized sector.
India has also been witnessing an upward trend when it comes to the living arrangement patterns of elderlies. Many today are staying alone or just with their spouses.
The features of joint family systems are not just declining but vanishing speedily in correlation with economic development and modernization. Services that respond to the needs of the elderly are another side of the coin. Despite an aging population, geriatric care is unheard of in our country. Both the system and services focus little on this very age group, with no dedicated facilities for elderly people. Whatever little is available, exists in urban areas alone. One of the greatest challenges that show an increasing trend is elder abuse among those that are functionally impaired, and live all alone.
While the nurturing of an age-friendly ecosystem for the elderlies will take its own time, as the current focus is on adolescents and youth in the light of demographic dividend, a clear strategy to leverage their existence by sensitizing them regarding the challenges of elderlies should not be ignored. Over and above the commitment from governments, a comprehensive support system for the elderly is possible only with the involvement of the elderly themselves, their families, and the communities next door, as the challenges are not limited to economic needs, socio-cultural disparities, or health care requirements alone, the spectrum is much wider than what can be explained in words.
Enhancing the social participation of older adults is a critical factor in achieving the goals of successful aging. Such a participative perspective is indeed present in the current aging discourse the more active the elderlies are, the more they contribute to society. However, the social participation of the elderly has not yet been a focus of the aging discourse in India.
Coming back to the wisdom which Cicero talked about, our socio-cultural fabric should be willing and ready to print the images that emerge from the immense experience of the personal and professional lives of elderlies. It is time we leverage this for a better tomorrow.
The author has attained her PhD in Public Health Policy with a specific reference to policies of government of India vis-à-vis the population, reproductive health and family welfare aspects.
Manik Saha is sworn in as Tripura Chief Minister
After the unexpected resignation of the former Chief Minister Biplab Kumar Deb, the BJP state president Manik Saha was sworn in as the new Chief Minister of Tripura. Governor S.N. Arya administered the oath of office to the new CM Manik Saha at the Raj Bhavan, Agartala.
During the swearing-in ceremony, Saha promised to improvise the law and order situation in the state, taking the development agenda of Prime Minister Narendra Modi ahead. Prime Minister Narendra Modi tweeted, “Congratulation to Shri @DrManikSaha2 on taking oath as Tripura’s CM. Best wishes to him for a fruitful tenure. I am confident he will add vigour to the development journey of Tripura which began in 2018.” The year 2018 put an end to the 25-year communist rule in Tripura.
After quitting Congress, CM Manik Saha joined BJP in 2016 and was elevated to BJP state president in 2020. Earlier, this year, he had won the Rajya Sabha seat from Tripura. Saha is also the president of the Tripura Cricket Association. He is also a dentist by profession, who used to teach at Tripura Medical College in Hapania before entering mainstream politics.
The oath-taking ceremony was attended by Union minister Pratima Bhowmick and the former CM Biplab Kumar Deb, other BJP MLAs, and state ministers. Deputy Chief Minister Jishnu Dev Varma and minister Ram Prasad Paul appeared at the Raj Bhavan minutes after the swearing-in ceremony was over. They protested Saha’s appointment as Chief Minister at the BJP’s legislative party meeting on Saturday. According to the sources, the step was taken after an RSS report submitted to the BJP’s national leadership concluded that the party and government needed a change of guard. Saha’s excellent track record of ensuring the BJP’s victory in all thirteen municipal elections in November 2021 earned the faith of the party.
The opposition CPI(M) MLAs boycotted the oath-taking ceremony, claiming that the BJP’s administration has resulted in “fascist-style violence” in the state. Similarly, the Trinamool Congress, which is attempting to gain a foothold in the state, claimed that the Chief Minister was replaced because the BJP realised that the people had lost faith in the state administration.
AQVERIUM: First digital water bank receives US$500,000 grant
AquaKraft Digital Ventures Pvt. Ltd., a AquaKraft Group Ventures (www.aquakraft.net) today announced that it has received a USD 500,000 grant from Newrl (www.newrl.net) for its digital innovation, AQVERIUM (www.aqverium.com) – 1st Digital Water Bank. A brainchild of Dr. Subramanya Kusnur, Chairman & CEO of AquaKraft Group Ventures, AQVERIUM leverages the rich expertise of AquaKraft’s decade-long journey of advocating sustainability and impactful Water & Sanitation interventions across India. It enables to the creation of a Water Balance Sheet that accounts for every drop of Water making stewardship more accountable and rewarding, powered by a unique blockchain platform Newrl.
Speaking on occasion Vinay Rao, Co-Founder AquaKraft Digital Ventures Pvt. Ltd., said, “AQVERIUM is a next-generation cutting edge digital innovation that looks to leverage AquaKraft’s expertise in water & sanitation along with an optimum blend of Web 3 and various other technologies. One of the main factors for us to collaborate with Newrl is that it is the only public blockchain in the world to have an identity at the chain protocol layer. This mitigates the risk emanating out of anonymous participants on the blockchain. This grant will be used to create a mainstream defi ecosystem which involves tokenization of real-world assets such as Water which enables a high degree of governance and also helps with easier monetization.”
Newrl is a ‘trust network’ – a highly scalable, memory-aware, and multi-token blockchain with a rich protocol layer of template-driven transaction types, smart contracts, and DAOs. It is focused on effective tokenization of real-world assets/contracts and their frictionless financing on-chain ready to be used in institutional as well as DAO-based setups.
“We built Newrl with a specific focus on real-world applications of blockchain. We believe that many of the web3 innovations can add a lot of value to the mainstream. However, such use cases need to be compliant with regulations as well as KYC-AML norms. Newrl is the only public blockchain that enforces identity at the chain layer. We found AQVERIUM to be a fit use case for us to demonstrate our technological innovation and prowess with a real-world solution. It is a matter of great privilege for us to partner with the 1st Digital Water Bank.,” said Swapnil Pawar – Founder Newrl.
A lot has been talked about Water and the imminent crisis the world is facing. Everyone across all stakeholders acknowledges the fact that Water is precious and must be saved and conserved. Governments are trying their best to ensure per capita water adequacy with concrete and definitive steps in policy and action. It is time that every stakeholder realizes and acts in this direction. Water Stewardship needs to be an all-inclusive process across all stakeholders with forcing functions around the use and reuse of water.
Sharing his vision, Dr. Subramanya Kusnur, Founder Chairman & CEO, AquaKraft Group Ventures said, “We are delighted to partner with Newrl as it addresses all the challenges faced by networks today and enables KYC at the chain protocol level enabling a marketplace of qualified and bonafide participants. Water being core to sustainability will play a major role in the way Climate Control & ESG will evolve, and it was very important to create a trusted network that will enable the entire water ecosystem from generation to monetization.”
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