User:Agnese marino basc/sandbox/Approaches to Knowledge (LG seminar)/Group 8/Power

Role of Power in Human History

The concept of power started when human has entered into the agrarian society where surplus of resources are produced. For example, people from one argarian settlement would fight a weaker settlement to try to get their resources. In return, defence mechanisms are developed to defend one's resources from invaders. This makes power "the inescapable accompaniment of social order" (Gellner, 1995).

There are two types of power:

1. Primary power - one party confronting another party directly in physical threat
2. Secondary power - one party using rules to bend the wills of another party (this type of power is strongly dependent on the power of the social rule)

If two parties are facing each other, there are two situations that can happen. In the first scenario, one party seems more powerful, and therefore it attracts followers who think it is going to win. Due to the fact that it is gaining sufficiently more followers than the other party, its control over people (aka. power) would build up like a snowball, and it would result in a concentration of power. In this case, the leader with the concentrated power would take pre-emptive action whenever possible when there is potential enemy with the resource he needs. If he is slow in action, he may be attacked because of as he has the concentrated power, he must have the majority of resources which his potential enemy desired.

On the other hand, if there is a both parties in conflict has obtained a relatively equal amount of followers, a balance of power may occur because the result of a conflict is uncertain. Leaders from both parties are more willing to keep their power to themselves rather than risk losing them in a conflict. The balance of power is based on the loyalty of the people in both parties to retain the balance.

Taken from Gellner, Ernest. Plough, Sword and Book: the Structure of Human History. Univ. of Chicago Press, 1995

Nikki

How can power structures influence the production of knowledge in academia?

Nina:

The choice of curriculums in schools have an important influence on the students, especially if they are young children. Indeed, their ideas and opinions of the world and structures are still forming. What we learn in school is often considered as a universal truth, we aren’t usually encouraged to second guess what our textbooks say and are expected to study what it says for a considerable amount of time. However, the knowledge we are acquiring is carefully chosen and to some extent curated by power structures. Whether it is the minister of education or a specific teacher, the subjects studied by children are a reflection of what the power structures deem “important” or “valid”. All in all, each curriculum taught is subjective and highly depends on the power structure making decisions. This is reflected in the variety of education systems. The curriculum in history, for example, varies enormously from country to country. In fact, educational systems are rarely neutral. I witnessed this firsthand when a Turkish classmate of mine refused to read a chapter about the Armenian genocide. He had learned many arguments suggesting it had never happened in his previous school, which followed the Turkish education system and was not aware of the “other version of History” that was being taught in the French education system. It can be extremely hard to accept that what you have been taught your whole life can be biased. However, it has been proven that the production of knowledge can easily be used as a tool for propaganda or manipulation. For example, almost all dictators use youth camps and education systems as a tool to manipulate the masses. For example, Harold Innes coined the term “monopoly of knowledge”. Indeed, knowledge has been spread and used by power structures to achieve specific goals throughout history. A good example of this is the middle ages, when most of the population was illiterate the clergy had a complete monopoly on the laws (which were written) and used them to their advantage. This can be noticed-to a lesser extent, in the gender divide we can find in different courses. Indeed, it is a reflection of the pressures and expectations of society and power structures on each respective gender.

However, understanding and questioning power structures can enable us to shape a less biased world and society. Being aware that the information we are fed can potentially be biased or come from a source with ulterior motives can help shift our way of thinking, spreading and using information.

The power of social media

The Me too mouvement spread like wild fire and helped raise awareness about sexual harassement. Many celebrities came forward and encouraged other women to speak up. I think this mouvement was really effective and did shine a light on an important and, unfortunately, very relevant issue in our society. However, some countries censor social media. Therefore, they minimise it’s power. For example, China’s government banned the hashtag me too on all platforms because women were rising up against some very high placed government officials. However, women around the country decided to use code “emoticons” to counter the government. Indeed, in Chinese “Rice bunny” pronounced as “mi tu”, is a nickname given to the #MeToo campaign. Social media isn’t just a place to like pictures of cute animals, it is a powerful place where people can come together and support each other, even with censorship.

Power in Language

Language is the main tool for human communication and expression, it is in fact that which differentiates us from other animals and it helps us understand the way we think and the way we behave. It is considered to be a cultural, social and psychological phenomenon according to linguists. The uniqueness as well as the universality of language is studied permanently, and the way in which is acquired and modified over time is a timeless issue. Language not only translates thoughts into words but also translate words into thoughts. The power of language qualifies the way that words shape people, and how by studying someone's way of talking, scientists can determine that someone's way of thinking. This study has progressed, namely through the analysis of people's typing processes on their computers. For instance, when someones writes something on their computer whether it is to write an essay, a wikipedia page or a very simple research on google, analysts are watching what what they are doing very precisely: their drafts, the way they combine words into sentences etc. and with that information, intrude on that someone's thoughts and actions. Words serve as proxies to action, skills, interactions, emotions, thoughts etc. even though they express a minor part of what actually goes through people's minds every single second. Therefore language is not only a key tool in communication but also in the formation of one's identity. The choice of words, of combinations, sentences and their richness are determining factor's of one's image and personality traits. Furthermore, apart from the choice one has on the use of words and sentences, the languages in which they speak also shape the way they think, through the structure of the language itself. Compound words are a good example of this argument, as all languages do not have the same compound words, to define the same emotions, objects, phenomena. In this case, the same information is not identically perceived by two people speaking different languages because of the different structures characterizing their respective languages. In extreme cases, words in a language might even be unique and not translatable into others languages, therefore giving those who speak the first one a totally different perspective of that information. This is the reason why speaking many languages is so valuable, not only for the capacity to communicate to a wider group but also the power to understand and analyze more information in general, regardless of the language it has been communicated in.

Inés

The concept of power in regards to the theory of Marxism

The approach of power from a Marxist perspective greatly differentiates itself from other interpretations of the same concept. In the theory of Marxism power is dominantly tied to oppression and the dynamics between the hierarchically built social classes in society. It studies the economic and general exploitation of the lower classes in capitalist societies through the common abuse of social power. The power manifests itself mainly in economic factors as well as the despotism in beliefs caused by political doctrines. In Marxist theory, social power can be misused by politics as well as the state’s economy and is rather short-lived and easily shifted between people. Marxism also focuses on finding out why the exploited lower classes seem to endure their misery or cannot acknowledge it.In theory there are three different ways of how the abuse of power can result in the separation and thus oppression of certain social classes:

- economy of the state, which means the measures that the different classes in society have to go to in order to survive or to finance their lives (the process of production)

- ideologies and political oppression which may results in tyranny and the misuse of authority

- psychological and intellectual oppression

All of these factors are different approaches to the concept of power and how it is distributed and used within the Marxist theory. The first one is a key point however, as it relates to an important part of Marx theory, namely the “Labour process”. The theory of the different elements of labour, its end products and how it is affecting the “natural” world surrounding us. In conclusion, power according to Marx’s theory manifests itself in the different aspects of capitalist societies and the oppression between different social classes and can only be overcome if it is overthrown by for example revolution which then results in the end of the oppression of the lower classes.

Taken from: ‘Marxist Approaches to Power’ in E. Amenta, K. Nash, A. Scott, eds, The Wiley- Blackwell Companion to Political Sociology, Oxford: Blackwell, 3-14, 2012.

Camilla

Power imbalance prevents shared decision making

Patients find it hard to speak up

• Adoption of shared decision making into routine clinical settings has been slow
• Patients find it hard to speak up, even when they are well educated and informed, still find it difficult to use this knowledge to participate meaningful in decisions about their healthcare
• Sometimes it is also the case whereby patients don’t know much about the subject matterà when they don’t, less knowledge makes them feel more powerless in comparison to doctors who know seemingly everything about their condition
  • Patients often feel prohibited from speaking up, even when they are concerned with the quality or safety of care they are receiving
  • Pressure to be compliant and passiveà fear of annoying the clinicians and potential repercussions it might have eg being labelled as difficult/ receiving less or lower quality care
  • Feel like they cant participate in shared decision making, do not know the available options

How to overcome passivity

• Though great strides have been made to ensure patients are informed about treatment options, patient passivity has been neglectedà focus has been on supporting the process if and when a patient becomes engaged, rather than working out how to engage patients
  • Earliest attempt was in 1985, aimed to alter traditional patient role through decision coaching before the appointment
  • But its both time and resource intensive
  • Comprising 20-45 min session w a trained research nurse or counsellor before a clinical appointment
  • Unlikely to be sustained in already pressurised healthcare systems
• Other campaigns eg Ask Share Know, try to increase participation by encouraging patients to ask: what are my treatment options, what are their benefits and harms, how likely are they to happen to me
• Use brochures and other media eg websites to exp why this is important
• Though these campaigns show promise, patients often not aware of them till given leaflets in waiting roomsà insufficient time for patients to change attitudes and beliefs
  • Links back to the question the lecturer posed: what do people do now that they know of the prob? Here they are taking action, but its not v effective

Better preparation

• Another interventions do not do enough to overcome 2 important barriers to participation
  • Patients perception that their knowledge is inferior to medical knowledge
  • Desires to act like a good patient out of fear they will receive worse care otherwise
  • Treatment of patients does not lie in their hands, doctors have the power to control this
• Early work suggests interventions should be delivered in 2 stages:
• 1. Preparation
  • Sent a preparation intervention eg booklet w accompanying website link
  • Inform patients about shared decision making – what it is, what to expect, why it is appropriate
  • Redefining perceptions of a good patient, reassure patients that participation will not result in retribution
  •  Social acceptability of this role, confirm clinicians want patient participation
  • Build patients belief int heri ability to take part
• 2. Enablement
  •   Offering appropriate decision support tools
  • Interventions need to be promoted from within the organisation
  • Make it easier for patients to feel included and respected
• Patients need to believe they can and should be involved, clinicians need to ensure they make the effort to understand what matters most to patients

Taken from: Power imbalance prevents shared decision making by Natalie Joseph-Williams, Adrian Edwards and Glyn Elwyn

Pei Yen

Power in Foreign Policy

Today, the idea that women could be excluded from Parliament, or their right to vote questioned, would be seen as an utter contradiction in terms. So as we move forward, I take great strength in Gandhi’s words:

“First they ignore you, then they laugh at you, then they fight you, then you win.”

A feminist foreign policy essentially seeks to address what former Secretary of State Hillary Clinton has so aptly described as “the great unfinished business of the 21st century”.

Many countries are still characterised by the systematic subordination of women. In many parts of the world, the fact that women and girls continue to be denied their human rights constitutes a growing threat to peace and security. Women are also increasingly becoming the target of violence as a means of control to prevent them from exercising their rights.

A newly published report by the World Bank shows that in most of the world, no place is less safe for a woman than her own home. More than 700 million women globally are subject to physical or sexual violence at the hands of their husbands, boyfriends or partners. Not only is impunity widespread, in many countries intimate partner violence remains outside the law, and in some cases even allowed by law.

The extent of this problem is dramatic and in many places violence against women and girls is seen as the norm even by women themselves. In the World Bank’s recent analysis, derived from 52 developing countries, one in three women agree that wife beating is justified for going out without permission.

Striving towards gender equality is not only a goal in itself, but also a precondition for achieving our wider foreign, development and security policy objectives. Working towards greater gender equality and ensuring women’s rights is therefore at the heart of the Swedish Government’s foreign policy.

I will focus here today on the ‘how’ and the ‘what’ of our feminist foreign policy. What are our priority areas and what are the tools at our disposal to advance the feminist foreign policy agenda?

a. Rights, representation and resources

There are three indispensable and interdependent concepts that are crucial to the ‘how’ of moving the feminist foreign policy agenda forward: RIGHTS, REPRESENTATION and RESOURCES – “the feminist toolbox”.

First, respect for human rights and the rule of law constitute essential starting points for every discussion about gender equality. Ensuring women’s rights and access to justice must be seen as central to achieving the overall human rights agenda. This is far from today’s reality. Women’s rights are often seen as a specific and separate issue. We will need to work multilaterally and bilaterally, creating global coalitions in order to ensure that gender perspectives are included in strategic discussions, decisions and, most importantly, concretised at country level.

Second, increasing women’s representation across the board – in governance and peace-building efforts, in economies and core institutions – is a sine qua non in achieving gender equality. Only through women’s active participation at different levels of decision making can we transform agendas so that the needs and interests of women are truly reflected and addressed.

Our goal must be to bring gender aspects and priorities to the heart of peace-building and peacekeeping. We must ensure women’s full inclusion in all phases of formal and informal processes. Women’s representation remains marginal and gender aspects tend to be seen as complementary, rather than central to the successful outcome of the operations. Sustainable peace and security can never be achieved if half the population is excluded.

Another pillar concerns another crucial building block of a feminist foreign policy: the economic empowerment of women for overall development and growth. We must combat discrimination in the labour market, but also promote women’s legal rights with regard to inheritance, land acquisition and possession, as well as equal access to various social services.

Finally, we will also integrate feminist perspectives in our work to promote sustainable development and tackle climate change and other related threats.

The post-2015 agenda will offer important opportunities to mobilise a feminist agenda and promote gender-sensitive approaches in all of these areas.

Irina-Taken from Wallstrom M(2015) "A Feminist Foreign Policy" speech at the United States Institute of Peace

Power and New Technologies

Phones and computers have became an extension of human beings. We barely see nowadays someone without a phone and, moreover, able to put it down often.

• Why is it so ?

Tech engineers and social psychologists are working together to change our behaviour and make us addicted, using for example methods from Robert Cialdini and his book Influence: The Psychology of Persuasion. It relies on six main principles to influence a consumer: reciprocity, commitment and consistency, social proof, authority, liking and scarcity. Another recent and main model of persuasion among tech companies is the Fogg Behavior Model, based on three factors: motivation, ability and triggers.

Commercial and marketing techniques have played with these principles for years and now tech companies have started to use them as well to influence the consumers. The main difference with new technologies is their increasing way to speed up, intensify and personalize the process. They don’t leave us the time to put our phones down to think about what we actually want and need.

• How they act on the brain

Dopamine is a neurotransmitter and can be released in our brains when we experience something good and pleasant. Once we experienced it, we tend to repeat the action which made us feel good. One of the dopamine’s pathway to the brain is tied to the motivational component of reward-based behaviours.

Tech companies, social media industries etc. “sell” dopamine to their customers through persuasive technology and design, using systems of “likes” or notifications. It creates then dopamine’s stimuli to the brain and force us to look as often as possible at these apps. Since they also collect our datas, these companies generate very personal stimuli which affect consumers even more. Thus, it changes the behaviour of the users and in many cases leads them to an addictive behaviour to their phones/apps.

• Why is it a powerful tool ?

Through our addiction to our phones, companies are now able to influence their customers in the way they want, to change our habits, behaviours and thoughts. First in a commercial way, such as all the companies collecting our datas to create specific ads popping up on our screens. Then, politicians may use new technologies to assess and gain power upon us, influencing and controlling mass through softwares like facebook, Instagram, Google etc… New technologies control and monitor people, restraining our abilities to think and basically cutting our freedom back.

As an example, there is the scandal of Cambridge Analytica in 2018 or facebook’s trial for spreading hate and enhancing the rohingyas genocide in Myanmar.

Taken from: Hijacking your brain by Gea Scancarello, 2019, available at: https://www.heidi.news/explorations/hijacking-your-brain

Philippine

The Power of the Harry Potter books

Today, Harry Potter is one of the most famous fictional character in the world. Started by J.K Rowling in 1997, the “Harry Potter” books have been traduced in more than 80 languages and sold more than 500 million times . However, the Harry Potter phenomenon does not stop here. From these seven books, eight movies have been adapted, theme parks and museums have been developed, and more recently new films have been released making Harry Potter the most powerful wizard of our society. In the next paragraphs, we will explore the power of the ‘Harry Potter’ books in our world.

First of all, Harry Potter has transformed our society in many ways:

- It has created a new sport now played in most countries. From the wizarding sport of “Quidditch” (a game played on flying broomsticks where two teams try to mark goals in 10-meter-high rings) has emerged “Muggle Quidditch” (muggle designing non-wizards in Harry Potter). In this "muggle version", players try to mark goals while running around on broomsticks. This new game is more and more recognized by the international society. For example, a French Quidditch federation has been created and European and World championships are often organised.

- It has introduced change in some universities. Many universities now offer courses on the magical world of Harry Potter. For example, Durham University has a module called “Harry Potter and the Age of Illusion”. Even UCL has its own “wizarding” course: “The Chemistry of Harry Potter”!

- It has changed the way youth literature is perceived. Before the success of Harry Potter, fantasy books were less popular and youth books used to be shorter. However, “Harry Potter and the Order of the Phoenix” showed to authors and editors that children were able to read more than 1000-pages-long books. Some studies showed that the year the fifth volume was published, the length of children and young-adults novels significantly increased.

Second of all, ‘Harry Potter’ has a real “psychological power”. It has been shown that reading ‘Harry Potter’ has many benefits regarding mental health, development of empathy and open-mindedness:

- It reduces prejudices people have towards minority groups. Many studies, have shown that children had fewer prejudices against minority groups after reading Harry Potter. This is linked to the fact that Harry Potter and his friends often meet and discuss with goblins or “house elves” who are oppressed by the wizarding society. In correlation, it has also been shown that reading Harry Potter can also increase empathy.

- It can influence your political opinions. Some studies such as one led by the University of Pennsylvania, have shown that Harry Potter’s readers are less likely to have favourable opinions towards Trump.

- It can help you deal with painful experiences. Many testimonies show that Harry Potter helped people dealing with personal issues such as the death of a relative. For example, in a testimony from ‘The Guardian’, Kristie explains that Harry Potter helped her cope with the death of her mother, as she identified to Harry who has also lost his parents.

- It can sharpen your mind and reduce your stress. Even if it’s the case for every book, reading Harry Potter can reduce stress as it allows to escape reality. Reading can also slow down decrease in memory.

Finally, The Harry Potter books are also a great source of knowledge. Indeed, trough the several volumes, J.K Rowling teaches us and shares with us many ideas on the world. For example, many philosophical questions are explored through the books, such as “Does the end justifies the mean?”. This theme is particularly addressed with the story of Dumbledore’s (Director of Harry’s School and one of his mentors) greatest enemy Grindelwald in the last Volume of Harry Potter. J.K Rowling also takes many ideas from famous philosophers such as Sartre, Platon or Aristotle and illustrates them through the books. Moreover, J.K Rowling teaches us about International Relations, Sciences, Feminism and much more. Many books have been written to explicit this hidden knowledge such as “Harry Potter and international relations”, “The Science of Harry Potter" or “Hermione saves the world: Essays on the Feminist Heroine of Hogwarts”.

The few examples listed in the paragraphs above testify of the power of the Harry Potter books and how it has impacted and shaped our world. This shows us how a single fictional story can change the world.

(Louise)

Power and coercion in the treatment of mental illness

Use of the Mental Health Act

· There have been increasing statistics of the implementation of the MHA by 9% between the years 2015 and 2017 in England and Wales which demonstrates a trend that has been ongoing since 2005.

· It has been seen that the coercion of patients in these psychiatric hospitalisations causes anxiety, distress, anger, trauma and the loss of autonomy.

· The coercion described by people studied takes several forms - compulsory admission being the main issue. Other forms include seclusion, involuntary treatment and medication, diagnostic labelling and strict rules and daily routines.

· The coercion seems to stem from the issue of the relationship between staff seeing the people in the hospitals as a 'sick patient'.

· The segregation causes a power divide in relation to what the health professionals and staff think is best for the patient and their ability to implement this.

Political abuse of psychiatry

· Admission of a psychiatric patient to a hospital is often non-consensual and so the psychiatrists has a very different power relationship to his patient than a regular doctor.

· A huge problem of psychiatrists having this power is the subjective nature of the observations on which psychiatric diagnosis currently depends.

· This power must be bestowed by the state, and so the psychiatrist acts as an agent of the state, in a similar way to a policeman or prison guard.

· This therefore means that there is a power held by the state to treat people with mental illness as less able to consent than people with traditional illnesses, even contagious ones, where the patient cannot be admitted without consent.

· The alienation of patients like this adds to stigma and emphasizes their lack of power.

Australian study on the effect of Restraint on patients

· In most constituencies, seclusion and restraint are permitted for use in mental health institutions to control or manage a person in the case of certain behaviour, at the discrepancy of the employee involved

· Restraint includes the use of bodily force or a device in order to mechanically restrain, in order to limit a person's freedom of movement. And seclusion refers to the deliberate confinement of someone to a room or area that they cannot leave, alone.

· A study done in Australia in 2016 aims to look at the effects of this on patients.

· This use of power over patients has led to many accounts of trauma induced by seclusion or restraint.

· A main trigger for the use of restraint and seclusion is the disobedience to a medical routine that was being enforced in the hospital. The strict routine and punishable consequences of not following it, with no conditional elements depending on the mindset of the patient that day raises issues when it comes to human rights as the person is not being listened to or treated with most efficiency.

· This is an example in which power has become counter intuitive to the original cause of rehabilitation and treatment.

Power in Marketing

The power struggle between the consumer vs. the brand has long existed in the world of marketing.

How Social Media Empowers Consumers:

In the past, brands almost had absolute power over consumers as they would actively advertise, influencing consumer perceptions, while consumers would passively watch with little control over what is marketed. However, in this modern era, consumer power has significantly increased due to the prevalence of social media which allows consumers to assume an active role with high control against the branding of marketers. Viral hashtags, tweets, media etc. have the ability to both help and hurt a brand. For example, in 2013, pasta company Barilla’s chairman stated on live TV that the brand would never associate with LGBTQ ideals in its advertising. This created a virtual battlefield between brand power and consumer power, as swarms of criticism within social media circles soon followed in forms such as trending #boycottbarilla, Facebook posts, blogs etc. The negative buzz soon dominated the entire internet environment, bringing great damage to the brand. Under pressure by consumers, Barilla issued an apology and even added U.S. gay activist David Mixner to its advisory board. As we can see, social media seems to have reversed the power asymmetry in marketing, giving more power than ever to consumers at the costs of brands.

How Brands Cope with Empowered Consumers:

It is important to note that consumer power does not always lead to damage of a brand’s reputation. The power struggle is not necessarily a zero-sum game as consumer power can also enhance a brand’s reputation through positive videos, Facebook posts, tweets etc. Therefore, marketers should refrain from seeing the existing marketing environment as a battlefield but as a marketplace instead, where both brand power and consumer power co-exist harmoniously. To their benefit, brands can even work to collaborate with consumers, in other words, by consciously inviting them to co-create the brand. For example, Nutella successfully created a forum for exchanging ideas with their consumers. Such collaboration creates value on both sides as consumers get what they want and marketers acquire immediate consumer insights on the product, potentially increasing brand power.

Conclusion:

Synergy between consumer power and brand power results in the best outcome: a win-win situation. Therefore, neither party should see the other as the enemy nor the marketing environment as a battlefield, because a collaboration mutually empowers.

By Katarina Lau

Power in medical research

Gender bias

Scientific research in general would seem to be a pristine realm of rationality, a neutral area untarnished by issues of gender and racial bias. In fact much established medical research uses a male default, such as in the study of heart attack symptoms. The typical symptom is given as chest pain, yet only one out of eight women experience this, and symptoms like indigestion and fatigue are more common. However due to the focus on male anatomy in research, these symptoms are diagnosed by doctors as ‘atypical’. Many drug tests are also carried out on male cells, humans and animals. For example chemotherapy drugs are only tested on women in a more gender neutral stage, during the early follicular stage of the menstrual cycle when they are most superficially like men. The ideal dose of chemotherapy will in fact vary with the menstrual cycle. Improper gender balance in clinical trials of aspirin and statins also have also resulted in harmful side effects in female bodies such as risk of cancer, cardiovascular disease and gastrointestinal bleeding.

The actions needed to be taken

The ways of addressing these issues involves rewriting the questions being asked within medical research — and calling for a reassessment of what should be developed in the first place. For example there are five times as many studies on erectile dysfunction than premenstrual symptoms due to lack of interest. Viagra was discovered amidst an all male trial for heart medication, and its potential to cure period pain was an afterthought. By the time this could be properly investigated, the world had moved on and there was no longer interest nor profit. There are some steps being taken however. Both the NIH and the FDA have announced intentions to draft new policies and guidelines aimed at incorporating sex differences in research and regulation. The FDA’s decision came on the heels of the discovery that American women were routinely overdosing on Ambien. After running driving simulations and tests on how much of the drug remained in the body the next morning, the FDA last year cut the recommended dosage of Ambien for women in half.

Studies should also be more inclusive across different populations, as it is shocking that 10% or worlds health burden gets 90% of funding. The issue of patchy, biased data sets that leave out significant groups of people has severe implications in this new era of data driven health care based on genetics and artificial intelligence. We ought to keep in mind that there are so many social causes of health failures whilst there a such a massive stretch to look at genetic causes. These novel types of treatment generate much enthusiasm but actually augment a social divide due to the deep power imbalances in society the more impactful measures would be perhaps to address the social determinants of health, such as public health, the urban environment and education.