Population health issues relevant to neuroscience in Nepal

Stephen Bezruchka, MD, MPH
Department of Health Services
School of Public Health and Community Medicine
University of Washington
Seattle, Washington
USA


Abstract
Neuroscience provides understanding of the mechanisms through which the determinants of population health act. After basic needs are met, a population with a smaller hierarchy will have better health than one with a bigger gap. Neuroendocrine aspects of the hypophyseal-pituitary-adrenal axis in which the hippocampus plays a key inhibitory feedback role are the mechanisms at work. In Nepal, basic needs, such as food and clean water are lacking for a substantial portion of the population. Remedying this is the first priority of the population health doctor. Thereafter, decreasing the hierarchy is necessary for Nepal to achieve good health. Neuroscientists can play a critical role by not promoting extensive clinical interventions, but using their understanding of the mechanisms of action of population determinants to advocate for social justice.

Key Words: hierarchy, hippocampus, Kerala, population health, social justice, Sri Lanka, structural adjustment