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R. Stott and D. Holdstock's letter (1) in the April 29th issue of the
BMJ states that the link between war and poverty is critical in the
campaign towards improving health. The letter illustrates how medical
journals are an excellent forum for raising awareness and inciting
interested physicians to action. Many general medical journals are making
an effort to publish literature that addresses the social determinants of
health. JAMA claims to work towards the "betterment of the public health"
(2), the BMJ towards influencing "the international debate on health", and
the CMAJ towards fostering "curiosity and debate about all aspects of
medicine". As Stephen Lock, former BMJ editor, stated, " a general
journal without a social conscience is incomplete" (3). Social issues and
medicine cannot be divorced - the two are interlaced.
Our database of articles from six leading general medical journals (i.e.
Annals of Internal Medicine, BMJ, CMAJ, JAMA, The Lancet and the New
England Journal of Medicine) illustrates how medical journals cover health
catastrophes such as war. To achieve this purpose, we chose to examine
the coverage of the Kosovo crisis. The database consists of articles
reviewed since the day that NATO began bombing in Kosovo up until the end
of July, 1999. Any mention of Kosovo was recorded in the database. Only
23 of the 85 (27 %) issues published from March 24, 1999 to the beginning
of August, 1999 mentioned the Kosovo crisis and only 19 of the 85 issues
(22 %) dedicated entire articles to the matter. Interestingly, 17 of the
19 articles (89 %) that solely discussed Kosovo were news articles.
Annals of Internal Medicine and The New England Journal of Medicine made
no mention of Kosovo in any of their issues. In contrast, the BMJ
addressed the crisis in 10 of its 18 issues (56 %). In the 10 issues that
did mention the crisis, 9 issues dedicated an entire article to the Kosovo
crisis. The CMAJ, a biweekly journal, published articles dedicated to the
crisis in 2 out of its 9 issues (22 %) in the four-month period. The
Lancet made reference to the Kosovo crisis in 10 out of 19 issues (53 %)
and dedicated an article to it in 7 of the 10 issues. JAMA published only
one article on the crisis.
At what point does the Kosovo crisis deserve the attentions of the pages
of internationally distributed medical journals? Is war not one of the
world's most ominous threats to health (4)? The Kosovo crisis serves
solely as an example of an issue that is marginalised by general medical
journals. One need only refer to WHO's list of the social determinants of
health (5) to recognise that more than half of them are not adequately
addressed in the leading general medical journals. General medical
journals need to broaden their focus to include more substantial
publications on the social determinants of health.
References
1. Stott R, Holdstock D. Eradicating war is essential to eliminate
poverty and improve health. BMJ 2000;320(7243):1208.
2. JAMA. The key and critical objectives of JAMA. JAMA
1999;281(19):1776.
3. Lock S. One hand clapping. BMJ 1990;301(6754):677-678.
4. Yusuf S, Anand S, MacQueen G. Can medicine prevent war? BMJ
1998;317:1669-1670.
5. World Health Organization. The Jakarta declaration on leading
health promotion into the 21st century. In: World Health Organization,
editor. Fourth International Conference on Health Promotion; 1997;
Jakarta, Indonesia; 1997.
Angela M. Neglia MA
Faculty of Health Sciences
The University of Western Ontario
London, Ontario N6G 1H1
Paula A. Rochon MD MPH
Kunin-Lunenfeld Applied Research Unit
Baycrest Centre for Geriatric Care and
Departments of Medicine and Public Health Sciences
University of Toronto
Address for correspondence:
Angela M. Neglia, 817 Maitland St. #2, London, Ontario N5Y 2W6 Canada
Social Ills and Medicine: The Kosovo Crisis
R. Stott and D. Holdstock's letter (1) in the April 29th issue of the
BMJ states that the link between war and poverty is critical in the
campaign towards improving health. The letter illustrates how medical
journals are an excellent forum for raising awareness and inciting
interested physicians to action. Many general medical journals are making
an effort to publish literature that addresses the social determinants of
health. JAMA claims to work towards the "betterment of the public health"
(2), the BMJ towards influencing "the international debate on health", and
the CMAJ towards fostering "curiosity and debate about all aspects of
medicine". As Stephen Lock, former BMJ editor, stated, " a general
journal without a social conscience is incomplete" (3). Social issues and
medicine cannot be divorced - the two are interlaced.
Our database of articles from six leading general medical journals (i.e.
Annals of Internal Medicine, BMJ, CMAJ, JAMA, The Lancet and the New
England Journal of Medicine) illustrates how medical journals cover health
catastrophes such as war. To achieve this purpose, we chose to examine
the coverage of the Kosovo crisis. The database consists of articles
reviewed since the day that NATO began bombing in Kosovo up until the end
of July, 1999. Any mention of Kosovo was recorded in the database. Only
23 of the 85 (27 %) issues published from March 24, 1999 to the beginning
of August, 1999 mentioned the Kosovo crisis and only 19 of the 85 issues
(22 %) dedicated entire articles to the matter. Interestingly, 17 of the
19 articles (89 %) that solely discussed Kosovo were news articles.
Annals of Internal Medicine and The New England Journal of Medicine made
no mention of Kosovo in any of their issues. In contrast, the BMJ
addressed the crisis in 10 of its 18 issues (56 %). In the 10 issues that
did mention the crisis, 9 issues dedicated an entire article to the Kosovo
crisis. The CMAJ, a biweekly journal, published articles dedicated to the
crisis in 2 out of its 9 issues (22 %) in the four-month period. The
Lancet made reference to the Kosovo crisis in 10 out of 19 issues (53 %)
and dedicated an article to it in 7 of the 10 issues. JAMA published only
one article on the crisis.
At what point does the Kosovo crisis deserve the attentions of the pages
of internationally distributed medical journals? Is war not one of the
world's most ominous threats to health (4)? The Kosovo crisis serves
solely as an example of an issue that is marginalised by general medical
journals. One need only refer to WHO's list of the social determinants of
health (5) to recognise that more than half of them are not adequately
addressed in the leading general medical journals. General medical
journals need to broaden their focus to include more substantial
publications on the social determinants of health.
References
1. Stott R, Holdstock D. Eradicating war is essential to eliminate
poverty and improve health. BMJ 2000;320(7243):1208.
2. JAMA. The key and critical objectives of JAMA. JAMA
1999;281(19):1776.
3. Lock S. One hand clapping. BMJ 1990;301(6754):677-678.
4. Yusuf S, Anand S, MacQueen G. Can medicine prevent war? BMJ
1998;317:1669-1670.
5. World Health Organization. The Jakarta declaration on leading
health promotion into the 21st century. In: World Health Organization,
editor. Fourth International Conference on Health Promotion; 1997;
Jakarta, Indonesia; 1997.
Angela M. Neglia MA
Faculty of Health Sciences
The University of Western Ontario
London, Ontario N6G 1H1
Paula A. Rochon MD MPH
Kunin-Lunenfeld Applied Research Unit
Baycrest Centre for Geriatric Care and
Departments of Medicine and Public Health Sciences
University of Toronto
Address for correspondence:
Angela M. Neglia, 817 Maitland St. #2, London, Ontario N5Y 2W6 Canada
Competing interests: No competing interests