I found the section about the relationship between depression and heart disease very interesting. The authors explained that, though there is an association, depression (and other psychological predictors) are not the cause of illness and disease. Instead, the authors bring up the concept of “pathways of health” that is often discussed in the book. An individual’s “pathway” through life is impacted by the social influences as well as other factors. In the case of war veterans, their role in the army and potential exposure to combat could cause significant stress. This stress can lead to depression, as well as other unhealthy life choices which further affect one’s path of life. With this lens, we can see that heart disease is not directly caused by depression, but the unhealthy choices that are often associated with depression, such as overeating and substance abuse.
I was also compelled by the idea of a polypill that will cure and protect against all diseases and causes of ill health. It does seem, especially in today’s media, that there is no health risk that can’t be combatted with some kind of pill or diet. I rarely scroll through Facebook without seeing an ad for a pill or diet that seems to solve all of life’s problems. However, the authors argue for a more inclusive approach to healthcare, in which doctors stray from the idea that illness is caused by one single factor. In this case, doctors would not treat heart disease by simply prescribing a medication, but would work to understand the complete “pathway” of their patient by gathering information on their social networks, personalities, and habits.
Both of these instances highlight the importance of a fuller approach to healthcare. Even with the improvement of medicine over recent decades, it is still important to see a patient as a person with a life instead of just a list of symptoms in order to promote better health rather than just freedom from illness.
The beginning of the epilogue introduces and interesting point: “Health care costs are exploding while overall quality of health is static” (217). Though the quote is not discussed much further, it struck me in an uncomfortable way. One would like to think that, as a society, we are aiming to improve the population’s health and longevity. However, it seems that “health” is getting more expensive as the years go on, which is never good for the bulk of society, and detrimental for some. That being said, if we do want to look to a healthier population that leads longer lives, we must find a way to make health care affordable and accessible to as many people as possible. Advice to “eat healthier” and “exercise more” only works as long as adequate healthcare is available.