A significant amount of medical academia is definitely concerned with upstream causes, especially since a great deal of overall mortality these days is from can

A significant amount of medical academia is definitely concerned with upstream causes, especially since a great deal of overall mortality these days is from cancers and heart disease, where impeding the upstream causes can have a large affect on overall mortality rates. This in some ways contrasts with a perspective where people fall ill primarily to infections and it is primarily the role of medicine to identify and cure those. Even when an upstream cause for an issue is infective, (for example the young adult deaths from Rhuematic Fever in my country, New Zealand), there are many further upstream causes such as the level of insulation in housing, socioeconomic deprivation, the level of access to primary care physicians, access to transport, etc. A crucial issue is whether the healthcare and economic system are geared to encourage or discourage addressing the most strongly associated upstream causes that are identified. In countries with established government-funded healthcare systems, options like public health campaigns and legislation are considered as tools that can potentially be brought to bear on these issues. In other countries where government-funded healthcare is not a norm, these options are less emphasised. In a system oriented towards private healthcare, often the approach leans more reactive than proactive, eg likely to be initiated as the response to a costly court ruling.