[This figure is a depiction of changes in popular culture, medicine and health care practices over time in the Pacific Northwest; a variation of the same from my 2000 thesis]
WHAT IS REGIONAL HEALTH?
Can a standardized healthcare system and attached insurance program developed by the insurance industry meet the needs of a population as unique as that of the Pacific Northwest?
Regional health is a term I apply, as a spatial epidemiologist, to parts of this country where specific sociocultural patterns exist that make this region stand out from the rest of the country.
Regionalism has a long history in the field of geography. In the 1950s and 1960s it became disliked due to its “deterministic” like nature.
For the past thirty years, my experiences living in the Pacific Northwest region as an academician and another decade of reviewing its public health history ever since, I can say with certainty that the answer to this question is ‘No!’
The needs of people and families in a region as unique as the Pacific Northwest are not met by the current programs that exist.
This is a link to my work and series on regional health, finished ca 2009 – – Regional Health Planning and the Pacific Northwest Medical GIS and Regions series .
The Pacific Northwest is unique in that its population fends for its beliefs, sometimes as a people, sometimes as unique individuals each with their own demands. The public health and healthcare needs for this region require a careful evaluation of its traditional allopathic medical needs, followed by a review of the non-allopathic medical traditions, a focus on local cultural diversity requirements, and individual (per patient/member) healthcare needs.
A combined qualitative-quantitative research method is the best way to do this.
Portland is where the field of naturopathy matured into the accredited field that it is today (my page on its history – http://wp.me/Puh6r-4if ). [see also the map https://brianaltonenmph.files.wordpress.com/2011/02/naturopathicmap25.jpg?w=510&h=641 ] Unfortunately, there are other naturopathy education programs out there that are not accredited. As an applying student you’ll know this because they lack federally insured student loan programs.
Like osteopathy and chiropractics, there are just a few official schools in this country. But before you merge naturopathy with those other two non-allopathic professions, realize that unlike chiropractic and osteopathy professions, many of the teachings of naturopathy ultimately make their way into the common mindset in allopathy (the traditional MD).
Before there was physical therapy today, there was "physiotherapy" taught as a part of naturopathy. before we had nutritional specialists looking at diseases in ways other than by dietary recommendations, a core specialty in naturopathy schools focused on nutrition, food content and nutritional supplements use. Today’s geriatricians who recommended common herbal blends for women with menopause problems or men with prostate concerns, every one of these OTC recommendations existed for a century or two before in the naturopathy world, and its botanical or eclectic medicine predecessors. The use of a fat-rich diet to control intractable epilepsy in children was discovered in the 1920s by osteopaths, as a result of the nutritional treatments they recommended for kids.
The different forms of physiognomy, cultural physiotyping (eugenics), and electrotherapy we so heavily promoted due to Harvard and Yale professors, a stable way to treat psychological health patients in the 1800s and 1890s, by allopaths, individuals who we believed were born to become doctors due to their own family genetics history (Galtonism, see http://www.pinterest.com/altonenb/human-faculty/ ). Are today’s gene therapy and gene modification therapies coming into play as controversial and troublesome as the eugenics teachings of pre-WW2 years?
The cultural respect many patients have from their other care givers comes from their acceptance of traditional practices. We see that especially with herbalism, nutrition therapy, mindbody healing practices, and exercise therapy, but we also see regular medicine taking it in limited ways, such as through color and music therapy (new teachings in allopathic subspecialties), imagery (or cancer and psychology patients), past life counseling, meditation (taken seriously by allopathy only after 1980), prayer, yoga, exercise, and numerous other forms of mindbody therapy.
In the 1960s and 1970s, allopathy was in stiff competition with the "alternatives," whom later became the "complementary", and then the "integrative" and now the mixed integrative-allopathic forms versus the complementary non-integrative medical philosophies and faiths. Prayer and touch therapy remain around because the patient has to defines his/her treatments, not the MD.
Homeopathy remains extant due to its inexplicable success in some people–an allopathy specialist might call this some form of mindbody impact; a traditional allopath, unwilling to expect change in the original teachings and even recognize how much they were in error in the ’60s and ’70s, might have called it what is was called 30, or 50 or 70 and 90 years ago, different words for the same disbelief their teachings bore (http://wp.me/Puh6r-9cs ).
Allopathy has had more than a half dozen theories as to how acupuncture might be working, ranging from the first ones published in the mid 17th century, to the early neuroscience speculation of the 18th and 19th centuries, to the very complex and contemporary neurochemical, psychoneuroimmunological proposals published today. (Whenever there is something allopaths cannot explain, they need to extend their old model to find a new model with legitimate explanations.) [See my page http://wp.me/Puh6r-46q ]
Traditional Chinese medicine (TCM), present for sure since the Gold Rush years, is a major form of complementary medicine that is still evolving and developing to meet the allopaths’ needs. TCM in the Northwest also has an accredited multiyear school with L.Ac. and TCM as the main professions.
Hispanic/Latino/a healers (botanica, voodoo, and others) are an important the majority of our Hispanic families and communities in the U.S.
Unanisim (a Middle Eastern/muslim offshoot of Hippocrates’ teachings) is practiced, in very predictable places (on unaniism – – http://www.pinterest.com/altonenb/international-health/ ).
The field of geography has this specialty known as medical cultural geography. The post-modern period of medicine, in sequent occupancy terms, is that period when the culture of medicine goes beyond its emphasis on just allopathy and modern science forms of therapy. In the Pacific Northwest, monoclonal antibody or gene therapy can be just as important to the health of an individual as the different forms of herbal therapeutics options out there, or the availability of a spiritual counselor.
Does an allopath in the Pacific Northwest know the history, makings and consequences of these non-allopathic health traditions?
In a database I developed for this philosophy in 1982 (the toxicity of herbal medicines; at http://www.ouribis.com/ , updated every several years ever since), we can see how much an allopath needs to learn to be an expert in just this one facet of integrative medicine–the impact of herbal medicines on hepatic, renal, intestinal, neural, ocular, immunal, endocrine, dermal and other systems, and their impact upon metabolic pathways for drug breakdown.
To best understand how to develop a broad-based healthcare program at the population health level (institutions, teaching hospitals, insurance companies), there are these studies I developed to help these programs better understand their complex, interdisciplinary patient load. These are the "hot topic" in public health and healthcare administration for the next decade or two. Perfecting the mixed model (qualitative-quantitative methods) for evaluating a health care system is the next way we need to go in the "managed care" and health insurance professions. Combining EMR, GIS and NLP make such a change possible.
Regional Health Planning and the Pacific Northwest Medical GIS and Regions series (sections available for review).
Part I – Introduction — http://wp.me/Puh6r-7TZ
Part IV – 3D Mapping of Health — http://wp.me/Puh6r-8l5
Part V – Pacific NW 3D Mapping. — http://wp.me/Puh6r-8l2