Mental Health

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akhwaja

Gesundheit & Medizin

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In the early 20th century, the treatment and conditions of the mentally ill in asylums were harsh, brutal and inhumane. They were isolated in institutions and discourage to enter society. They also had no opportunity to lead normal lives. The institutions were state facilities.

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838 journal of law, medicine & ethics The Journal of Law, Medicine & Ethics, 46 (2018): 838-840. © 2018 The Author(s) DOI: 10.1177/1073110518821976 The Future of Health Equity in America: Addressing the Legal and Political Determinants of Health Daniel E. Dawes F or more than 225 years, the United States has struggled with aligning the constitutional notions of equal protection and general welfare to our health laws and policies, which resulted in a chasm between researchers and the patients who need their discoveries, and a chasm between clini- cians and the communities that have been locked out of the health care system. Despite this struggle, there have been lawmakers and advocates who have worked assiduously throughout the years to uphold the integ- rity of scientific research and build longer and stronger bridges to ensure that the discoveries made in a lab, a clinical setting or in the field translated positively to all communities, including those that have historically been marginalized and underserved such as racial and ethnic minorities, women, children, veterans, rural individuals, and most recently LGBTQ individuals. Today’s struggle to increase access to health care for our most vulnerable populations parallels the struggle 150 years ago when abolitionists worked tirelessly to increase access to care for poor whites and newly freed slaves and mental health champions labored assiduously to increase access to and improve behavioral health services in the United States for people with mental illness or substance use disorders.1 In 1865, the federal government attempted to address the social determinants of health by enacting the first compre- hensive health law, An Act to establish a Bureau for the Relief of Freedmen and Refugees,2 giving these vulnerable population groups who were displaced by the Civil War, access to food, education, employment, housing, and health care. However, after seven years, that effort to address the social determinants of health, reduce health disparities, and advance health equity3 was terminated by lawmakers.4 It would take more than one hundred years before there was another coordinated federal effort to enact a law to address the disparities in health status among racial and ethnic minorities and lower socioeconomic status individuals.5 Thanks in part to a landmark report by the Institute of Medicine, Health Care in a Context of Civil Rights,6 which highlighted the latest evidence concerning minority health and health disparities, the Reagan administration through Secretary of Health and Human Services Margaret Heckler, recognized that while the overall health of the nation had been improving the health of African Daniel E. Dawes, J.D., is the author of 150 Years of Obam- acare, co-founder of the Health Equity Leadership and Ex- change Network (HELEN), associate professor at Nova South- eastern University, and Senior Adviser & General Couns ...

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