While I understand that drug use for some people is unwise (and best avoided) either because of their age, pre-existing health conditions or other vulnerabilities, the decision to use drugs is one that must always be treated with respect.
Over time, I drifted to spending more and more time trying to figure out how to improve the health of low-income New Yorkers and the most vulnerable among our neighbors. What I have learned over the years is that poverty and health challenges are intrinsically intertwined.
It is essential to generate and communicate evidence in a way that enables decision-makers to understand the value of investing in prevention while taking into account their priorities, interests and constituencies.
The desire to fit in is a powerful shaper of behavior. In some cases, social pressures serve us well. Just think that 20 or 30 years ago, smoking in public places, drinking and driving and littering were not only commonplace, but widely accepted. Thankfully, things have changed. In other cases, social pressures are lagging behind their times, specifically at work.
I have clung to the conviction that truth is often immediately furtive, but relentless and ultimately indomitable. Seekers of truth are patient of necessity, obliged to be disciples of time. So far, I have kept the faith that eventually enough data would rally us to common understanding and common cause.
Lifestyle is the greatest of all medicine, but it may feel in this morbidigenic, obesigenic world of ours that we can't get it to go down, because we just don't have the right spoon. It may feel that we can't get there from here. That is, in a word, wrong.
High BMI and smoking remain among the top three risk factors that contribute to the highest burden of disease in Western Europe and the U.S., and the research mentioned above highlights this issue and discusses potential solutions, with implications far beyond South Africa.
Health isn't built in hospitals; disease is treated there. Health is built every day, over the course of a lifetime, in the places we work, and learn, and play, and pray, and love, and live. Or it isn't. And if it isn't, the "health care" system can't fix it.
Addressing HIV/AIDS in 2013 and Beyond: Why the Future Demands Its Integration Into the Chronic Diseases Spectrum
Integrating HIV disease management into our conversations about and strategies for addressing chronic diseases would be a public health game changer -- not only medically, but socially.