I still beg to differ with Heather Welford Neil's comment that the health care system cannot overcome inequities in the health care system. I have seen many health care systems that do have an impact on very low Socioeconomic Status individuals AND improve their nutrition. This in it of itself can improve SES as the health of these populations improve. To give you a marvelous example of how social networks can be built through a health care system - just look at the wonderful work done in Tanzania as a collaboration between the Swedes and Tanzanians. They did growthing monitoring right. They put into place community groups that worked through the problems themselves. AND this not only improved nutrition, it improved the social networked in that area. Many many nutrition projects have had success in raising women's income. To give an example of a project to improve vitamin A deficiency, mothers were helped to grow varieties of sweet potatoes that were richer in vitamin A. Again, this project was done properly. The women were consulted and picked the varieties that were less susceptible to disease. They then increased their income because they got into groups and discussed marketing and began selling sweet potato pancakes, a big hit. Another nutrition project was conducted on a large scale in Bangladesh with many many local NGOs. These NGOs worked on gardening for low income women. These women became leaders and worked with other women in their villages. They increased the variety, quantity and quality of the vegetables they grew. They increased their income AND also vitamin A deficiency rates declined. Finally, just take a look at Paula Meier's work. Which where the women that actually had the biggest increase in breast milk doses to their premie infants? The African American women. The same group that supposedly cannot be touched by our health care system. Also, there have been studies that show that race alone (not just SES) has an impact on the type of care provided by health care practitioners. I'm sorry, but the research does not support the fact that health care systems can only have minimal impact, by themselves on health outcomes. It is the very fact that there is no effort in some places to reach the poor that they have worse health. For over 20 years I've worked in developing countries and I can assure you, when it is done right, health care systmes can have a huge impact on the very poorest of the poor and improve their SES. Susan E. Burger, MHS, PhD, IBCLC *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html