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Upstream versus downstream in public health

Those who know public health know Prof. Irving Zola‘s “upstream vs downstream” parable. Irving Zola is a medical sociologist. His friend, John McKinlay, describes Zola’s parable in his 2019 article, “A case for re-focusing upstream: The political economy of illness”1. The “Upstream boat” sails through this upstream path. Following is the reproduction of the parable; ” I am standing by the shore of a swiftly flowing river, and I hear the cry of a drowning man. So, I jump into the river, put my arms around him, pull him to shore, and apply artificial respiration. When he begins to breathe,…

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