Hi Chose.

Thank you for your your response. we know major differences exist, but we don't know what those differences are. (We don't know all of them). I have a manuscript on country differences in the effects of socio-economics (age, gender, education, income), and health behaviors (smoking, drinking and exercise), and chronic diseases (diabetes, heart disease, etc.) are differently associated with perceived health. Don't you think there might be some use of such information? I think such information should have implications.... In some countries, gender stays in the model. In some countries, income but not education has an effect . In some other countries, education and income have additive effects. What does this tell us?

I agree with you that the effect of same social determinants are different across countries. I argue policy makers should be aware of the effect of social determinants in their setting. This means we will need to compare countries and populations for the effects of social determinants...

Hello Shervin (and Ghose!)

I don't have too much to add, but wanted to let you know that your conversation is thought provoking. As researchers, we are quite attuned to the idiosyncrasies of our populations and environments, and the impacts those differences will have on data, results, even implementation of programs and uptake by users. We know this. Individuals seem to understand this. But these are often overlooked by policy makers or large funders. I often find that strong or reliable sounding results will make programs or policy decisions seem "fundable" and take precedence over considerations for what will work best for the accessing population/end users. I also find myself scratching my head over how to make decision makers aware of the fact that a program/treatment/policy/etc. that was studied and found successful for one population/country/illness does not automatically translate to being successful in another.

Sorry if that went on too long, but thank you for bringing this up, and I am going to continue to follow this conversation closely!

Hi Laura!

Thank you for your post. I 100% agree with your point "that was studied and found successful for one population/country/illness does not automatically translate to being successful in another".

My first paper on cross-country determinants of health is out:

http://www.ncbi.nlm.nih.gov/pubmed/24393171

Early proof:

http://www.jdmdonline.com/content/pdf/2251-6581-13-3.pdf

My second paper is at the proof stage, and will be out soon.

I would love to hear what you think.

Thank you for that Shervin! I enjoyed the article, and it left my head buzzing with more questions and curiosity about the contexts, lifestyles, and availability of support, care, and accessible communities for each country (even each individual! but maybe that is a little too far!) I have sent out the link to a number of Occupational Therapist colleagues of mine and think that they will benefit from at least considering the information presented in the article (especially because Canadian health care users are so diverse in country of origin)

I was particularly struck by the education piece - I would be curious about the levels of formal education in each country versus the levels of disease-specific education or support for health/wellness education related to disease management and daily functioning.

I look forward to the next paper!

Hi Laura!

Thank you for reading the paper and also thank you for sending it to possible users. Nothing is more important for an author than having readers and users. I will update you with the next work soon.

Best

Shervin

Thanks Iffath for your response! They definitely help me better discuss the implications for my future papers.I have observed a lot of gender differences across countries and I should learn more about "feminist political economy perspectives ". I had never heard of that.  Please kindly see these papers if interested to read some of my cross-country papers:

http://www.ncbi.nlm.nih.gov/pubmed/24559091

http://www.ncbi.nlm.nih.gov/pubmed/26157460

http://www.ncbi.nlm.nih.gov/pubmed/24393171

http://www.ncbi.nlm.nih.gov/pubmed/26445632

journals.bmsu.ac.ir/ijtmgh/index.php/ijtmgh/article/view/58

very helpful. thanks. will read and cite them in my papers.