Measure and evaluate, key to decision making

It is social evidence, but also scientific, that to make decisions it is always necessary to measure and evaluate. In turn, in order to be able to measure and draw conclusions, it is necessary to validate surveys whose conclusions faithfully represent what they measure. All this is, in short, Sociology in general and the Sociology of Health in particular.

Recently, we had the opportunity to present the book Sociology of Health. A practical guide for decision-making, which we took a long time to make known to society due to the Covid-19 pandemic in the Sala dos Passos Perdidos of the Upper Chamber. For us, a luxury of facilities that belong to all Spaniards and that I always recommend visiting.

Its presenters in this case were Narciso Michavila, general director of GAD-3 (sociologist) and professor Eduardo Díaz Rubio, president of the Royal National Academy of Medicine. For us a luxury that we deeply appreciate. We recently held a presentation ceremony on the island of La Palma in the social part of the Real Club Náutico (Calle Real) and a World Heritage Site and we must also say that with a wealth of presenters such as teachers and former Presidents of the Government and palmeros Jerónimo Saavedra and Fernando Fernández, as well as Gabriel Mato, deputy and friend. In these presentations we were able to clarify the foundations of the book and its objectives (part of the doctoral thesis in Sociology), as well as exchange opinions with the large audience that honored us with their presence at both events.

It is true that Spanish Health is a permanent and sustained success story that belongs to all Spaniards and that until the Covid-19 pandemic it was in good health, but this same Health is also exhausted and devastated. This requires a detailed analysis and, once assessed, taking urgent corrective measures. To reach the same levels as before the pandemic, a mandatory paradigm shift is necessary, which is genomics, individualized and precision medicine, and One Health, where health, animal health and the environment combine and enhance each other. In the coming years, the key will be in data management for decision making, analysis and evaluation, in short, Sociology of Health.

All of this is relevant because the urgency of carrying out validated surveys that measure the fundamental parameters of Health and public health is an objective need for the health system and not a fad. This was the objective we already discussed in the recent publication titled in the same way.

In the preface to the aforementioned publication by Narciso Michavila, a sociologist of great prestige, he makes clear the principles established there. Among other things, he says that “once again rigorous research is the best antidote against false myths, as it shows that there is no dissonance between the principles of Health and patients”. And he continued: “We are not sufficiently aware in Spain of the role of the backbone of the public health service, which far exceeds its reason for being, to guarantee the best possible health care”. I would add that the most important cohesion factor this country has by far is the world of transplants and ONT.

Interestingly, there are few studies with a high impact on the Sociology of Health, which is why we believe that this work can provide methodological light with clear practical application.

It is demonstrated with the validated surveys carried out for the aforementioned work (290 items) in which Health, the health status of users, the Health of users, the evaluation of health professionals, transplant patients, health tourism and sources of information in health.

It is worth briefly highlighting some data that may be interesting: 58% of the population is very satisfied with public health and 17% is dissatisfied or very dissatisfied. That 51% never smoked, a substantial change, that 62% consume alcohol regularly and that 54.4% are overweight, which confirms that obesity and diabetes are the pandemic of the 21st century, what is called metabolic syndrome (diabesity) . Another fact that deserves to be highlighted at this time is that 15% of the population has private insurance and 84% feels very satisfied with it. Likewise, alternative medicines and pseudosciences occupy a prominent (worrying) place and seriously interfere with scientific medicine. Likewise, 84% state that the State must bear health expenses. As for the trust of different professionals, the most valued are scientists, teachers and doctors. And the last by far are politicians and religious people. And as for the vision and trust in health institutions to inform, the first is the WHO and the last is the media.

In short, health is a right for only 20% of the world's population and a life is priceless (moral concept) but Health has a cost and is necessarily limited. The search for equity and sustainability seems essential to us.