En route to becoming a health professional, the academic preparation of many students will involve enrolling in a course in chemistry. A typical classroom usually features a wall display of the Periodic Table of Elements. Its presence is the result of the work of Dmitri Mendeleev who published it 150 years ago. A show of remarkable prescience on his part, one of its impressive characteristics was the inclusion of gaps waiting to be filled by new elements yet to be discovered that are based on properties he predicted. When initially formulated, the Table contained only 63 elements. Currently, there are 118 of them.

Most elements are found in nature (the number is subject to debate) while others were discovered in laboratories and nuclear accelerators. It is possible that some students enrolled in chemistry offerings at the University of California, Berkeley may have a deeper appreciation of the discovery process because 16 elements were synthesized or discovered on that campus, including Berkelium, Californium, Lawrencium, which honors Professor Ernest Lawrence who invented the cyclotron, and Seaborgium after Berkeley professor Glenn Seaborg.

This brief history of achievements in the physical sciences may serve as a segue into developments that occur in the sphere of health care. Public policy continues to be dominated by discussions regarding how best to achieve accessibility, affordability, and accountability in the provision of health care services. Just as chemical elements are grouped together in the Periodic Table on the basis of shared common properties, it is possible to examine comparable proposals aimed at enhancing accessibility, for example, while recognizing that significant gaps continue to occur between the provision of health care and the attainment of improved health status at both individual and community levels.

One definition of chemistry holds that it is concerned with the transformation of substances and all the energies associated with these transformations. Health care can be transformative either by preventing disease or by halting ill health in its tracks. The term mutability has some relevance in this regard. Race and ethnicity represent an immutable human characteristic. Age is another one, for an 80-year old patient cannot be transformed into a 20-year old individual. Unfortunately, interventions in health care that produce salubrious outcomes for members of one racial/ethnic or age group do not always prove to be as effective with other groups.

Social determinants hugely affect who gains and who loses in the acquisition of high quality health care services. While portions of human existence may be mutable in theory, it remains insurmountably challenging to overcome the effects of poverty, discrimination, joblessness, insufficient formal education, a low level of health literacy, loneliness, and residence in turbulent neighborhoods ravaged by pollution and violence. Such conditions often prove to be highly refractory to generating positive alterations, but change they must if the aims of health care are to be realized. Meanwhile, an understanding both of chemistry and health may be enriched by reading The Periodic Table by Primo Levi, an author who composed a poetic link between the disparate worlds of physical and human nature.

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THE PERIODIC TABLE OF ELEMENTS

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