Far Out....literally and figuratively -- July 12

Today was our last day of formal class for the week because tomorrow we are taking a field trip to Versailles (Ver-sigh for my KY friends -- gotta remind myself not to pronounce it like the next town over in Woodford County) and Friday is Bastille Day (a major French holiday akin to the 4th of July -- https://en.wikipedia.org/wiki/Bastille_Day).  

We talked about social supports built into the French system that positively impact health outcomes and modern public health problems in France compared to the same problems in the US.  From a social support perspective, the French emphasis on solidarity shows up here again -- the good of the whole over the good of the individual.  For example, lose your job in the US?  There goes your health insurance -- unless you are able to pay for it under COBRA for 5 or 10 times (or even more) what you were paying for it when you employed...AND...you now have no income.  What sense does that make?  In France, the government steps in automatically to cover your health insurance. 

What about childcare?  A mid-range daycare in Lexington runs about $9,000 per year/per kid.  It's better not to do the math -- it's too stressful.  In France, all daycare is subsidized by the government, it operates on an income-based sliding scale for all, AND...at age 3, children are guaranteed a spot in a public preschool.  The bottom line is that France does a better job of supporting the whole person -- and as a result, there is decreased stress for many, resulting in better health outcomes. Far out? Right?!

From a modern public health problem perspective, we talked about HIV/AIDS, obesity, and the opioid crisis (with a bonus discussion about organ transplantation).  I'm going to highlight some of what we learned in HIV/AIDS and organ transplantation, but if you're curious about the others, feel free to ask! 

The HIV/AIDS rates are about the same (.3% in the US vs. .5% in France) in 2023, but the rate of people receiving the life-saving ART meds is 49% in the US vs. 81% in France.  HIV/AIDS is a disease you LIVE WITH as opposed to DIE FROM in most cases now....if you have access to medication and regular healthcare.  It's not cheap -- and I bet you can guess by now that France covers it, while US does not across the board.  It all depends on your insurance.

The organ transplant part of our conversation was fascinating to me.  The biggest difference between the 2 systems is that France is an OPT-OUT system at time of death, while the US is an OPT-IN system.  As a result, most French transplants rely on deceased donors, while most US transplants rely on live donors (especially if we're talking about something like kidneys).  Only 2.7% of people on the waitlist died waiting for a kidney in France in 2015, while 6.5% did in the US.  Again...far out.  Something as simple as changing from an opt-in to an opt-out system could make a big change in the organ transplant process. 

When I was planning for this trip, I knew I'd have some afternoons and a weekend "free" with nothing planned for me.  I spent hours looking through sites like "Get Your Guide" trying to figure out what I wanted to do and at least narrowing it down enough to pick a few things. Today was my first adventure -- I went on a guided tour of the UNESCO Headquarters here in Paris (https://www.unesco.org/en).  If you're like me, you might vaguely remember that it's an offshoot of the UN, but not be quite sure what UNESCO does exactly.  It's the UN arm focused on education, science, and culture.  Ironically, the United States just rejoined UNESCO...ON MONDAY.  We withdrew during the Trump Administration and have just rejoined the other 193 nations who are part of the organization this week. 

The tour guide made a big deal out of telling us that UNESCO is often on the forefront of addressing social issues....and here's an example from the 1950s! UNESCO is also responsible for the creation of the UN Declaration of Human Rights (https://www.un.org/en/about-us/universal-declaration-of-human-rights).

In addition to seeing lots of symbolic art that was offered to UNESCO as a way of promoting peace (think remnants from Japan during the World Wars, for example), we also got to see the room where it happens....all the negotiations that is.  AND, they were rolling out a literal red carpet because the President of Portugal was due to arrive 2 hours after we left.  You'll also see the Portuguese flag flying beside the UN one in advance of his visit.

 

One of the coolest things we saw was this wall in all the languages of UNESCO talking about peace...and facing toward an olive tree in the courtyard.  

  

Overall, I really enjoyed the tour.  In this very global city, it was nice to spend time thinking about the global impact of working together towards common goals as well.  I also enjoyed talking with a couple from North Carolina who have retired and now spend part of every year in France.  They were retired Marine Corp Musicians -- what a cool vocation! 

It was early afternoon when the tour finished up and a BEAUTIFUL day here, so I decided to go check out "Bercy Village" at the suggestion of some of my students. As I was heading to the Metro, I got turned around...and happened to wander by the European Space Agency.  Happy accident for sure! (And of course, got another view of the Eiffel Tower!)

 

The metro ride was by far the longest I've done so far, but it was cool because the train went above ground and I got to see some awesome street art along the way.  I wandered around Bercy Village for a while, grabbed a snack, and then stopped by the park next door.  When I got tired of walking, I headed back to my neighborhood and grabbed a pizza for dinner.  

 

  

 

Until tomorrow...