Sleep walking to South Africa

In the same week that WCPT sent out a call asking for us all to contribute to its future strategy (link), a paper showing that 'Even walking is more dangerous if you're black' (link) reminded me that the next WCPT congress will be held in South Africa in 2017, and this should represent a golden opportunity to show that physiotherapy has something critical to say about things that are an everyday reality for many people around the world. The study from the journal Transportation Research titled 'Racial bias in driver yielding behavior at crosswalks' showed that there was clear racial bias in driver yielding behaviour directed at pedestrians, and that 'black people are more likely to be ignored or neglected by drivers, which could lead to a greater risk of getting hit by a car' (Vox).  This follows on from a similar study which showed that white people sleep much better than blacks, and this has some significant downstream health effects (link);

[su_quote]The study was just one data point in a mount­ing pile of evid­ence that black Amer­ic­ans aren’t sleep­ing as well as whites. This past June, the journ­al Sleep pub­lished a study on the sleep qual­ity of black, white, Chinese, and His­pan­ic adults in six cit­ies across the United States. The par­ti­cipants were pooled from the Multi-Eth­nic Study of Ath­er­o­scler­o­sis (MESA), a co­hort of more than 6,000 people who, for the last 15 years, have been in­ter­mit­tently pricked, prod­ded, and as­sessed to dis­cov­er how geo­graphy and race in­flu­ence health over time. (More than 950 pa­pers have been pub­lished on this co­hort. It’s from them that re­search­ers have found evid­ence that the farther people live from a wealth­i­er area, the more likely they are to de­vel­op in­sulin res­ist­ance—or that blacks ap­pear to have high­er levels of the sub­stances that cause blood to clot.)[/su_quote]

The call for ideas that came from WCPT included a survey asking for feedback on different strategic directions which centre around nine 'exciting opportunities for physical therapy.'  These opportunities are instructive because they give a clear indication of the things that WCPT thinks are important:

*In fairness, a box allowing you to add 'others' is included below this list. Notwithstanding the chance to add your own ideas, there is clearly a lot of interest in the economic changes that physical therapists are having to face up to, and some recognition of emerging populations of need (elderly, for instance), but there is precious little suggesting that WCPT is thinking about taking a more critical stance on things that might bring about significant structural changes to people's health and wellbeing. Perhaps we have never thought of ourselves as 'political,' even though we've been happy to work for The State in most developed countries for the best part of a century.  Perhaps we think that it's enough to understand the biomechanics of elbow flexion, and not to think too much about what it means to drink water from a polluted pool?  Perhaps we think that sleeping, walking, and all the other human functions that we rehabilitate on a daily basis fall below the threshold of interest for people, and don't really make for interesting (or well funded) research and practice?  Perhaps we are happy to leave these things to others so that we can concentrate on treating the body-as-machine, in the hope that people will still think that's enough in the years to come. Two recent papers suggest that others are looking at things issues like walking and movement - things that physiotherapists believe are rightfully their territory - and seeing much broader, deeper meaning in these actions (see this and this).  Surely this kind of work is not beyond the scope of physical therapists?  What is needed is a steer.  And so, perhaps, WCPT could be the ones driving this radical change. WCPT could look at the symbolic importance of its congress in South Africa as an opportunity to shake the profession out of its self-induced slumber and provide a new, bold direction that doesn't simply give us old wine in new bottles.  South Africa in 2017 gives us a golden opportunity to do something radically new, and WCPT needs to give us a vision for a new professional future that will sustain the profession for the next hundred years.