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The WHO (World Health Organization) has released its latest in a series of reports[i] on public health in 53 European nations, and presents this assessment through a focus on the social determinants of health[ii]. Rather than sounding an alarm or considering the possibility that epochal economic decline is underway which threatens the health of the public, it serves up tepid criticism of government policies that have resulted in surging poverty[iii] and high unemployment[iv], fiscal cuts to health and other social services, increases in suicide and a host of other declining health indicators deforming people’s lives in most –possibly all- of the countries examined. Put directly, the social determinants of health are being laid to waste in several European states and endangered in others, yet the report casts this as a few dark shadows on an otherwise bright picture.
I find the report psychologically dissociative, ethically compromised, and in an intellectual malaise. Sociologically, however, it makes sense: it is self-destructive to analyze or challenge[v] the political/economic system that funds your work, even if it is destroying what your organization was founded to analyze, protect and ensure. As such, this report represents a conflict-ridden and unstable posture of ignorance and subservience to political power.
Revealingly, the report takes virtually no notice of the portents of socioeconomic and political[vi],[vii]upheaval[viii] –like UKip and Golden Dawn- spreading through Europe.[ix],[x] Naïvely[xi], the report calls for slight reforms –like giving health ministers a “seat at the table” of austerity[xii] budgeting to make the case for “proportionate to need” funding cuts[xiii]- as sufficient to ensure, maintain or in some conceded instances restore a portion of the underlying fundamentals of the health of European populations now being sacrificed in the name of balancing budgets and debt repayment. The authors give every indication of having no inkling that their flaccid calls for a realization that too much austerity endangers the public’s health is too little too late and, in any case, will have zero influence on neoliberal policymakers.
Politically, then, this WHO[xiv] report offers no recognition, let alone opposition, to the class-based austerity imposed by neoliberal governments[xv]. Accordingly, this report personifies developing turmoil[xvi] in organizational mission and collective identity for health professions as the divergence between the imposition of neoliberal austerity measures and the mission of public health deepens. This compromised stance, of offering mild warnings about austerity while accepting it as a legitimate policy response, is part of a cultural phenomenon of an inability to democratically address genuine problems while offering rhetoric to reassure and soothe a public that is losing economic ground and its faith in government.[xvii] Read the rest of this entry »
Eric Chivian MD, Center for Health and the Global Environment, Harvard University.
Repost of an article by Steven Johnson, an independent writer, speaker and creative consultant specialising in sustainability, CSR and behaviour change. He blogs and tweets as @Considered. Original article at The Guardian.
Experts in public health have struggled with enabling behaviour change for years. The sustainability sector should learn what it can from their experiences:
Consumer behaviour change is the challenge of our time. As governments and brands are beginning to realise, upstream improvements are relatively easy to make compared with the herculean task of shifting consumer behaviours downstream.
While the sustainability community is just beginning to get to grips with the gravity of this challenge, our colleagues in public health have been wrestling with it for decades. Great progress has been made, but hard lessons have been learned – costly, time-consuming lessons that we can all learn from.
Continued at original site: The Guardian
“One of the penalties of an ecological education is that one lives alone in a world of wounds. Much of the damage inflicted on land is quite invisible to laymen. An ecologist must either harden his shell and make believe that the consequences of science are none of his business, or he must be the doctor who sees the marks of death in a community that believes itself well and does not want to be told otherwise.”
Adolescents warrant special attention. From a road safety perspective, they carry the largest crash and morbidity/mortality risk of any age group. This has led to considerable research and safety programs, but these efforts have plateaued in many countries and remain fixed within a road safety perspective. From a broader perspective, little has been done about the many non-traffic health risks related to teen driving (increased drug and alcohol use, anti-social behaviour, sexually transmitted infections, inactivity and obesity). From a sustainable transport perspective, a contemporary imperative, teens are where the transition from non-driver to driver takes place; an opportune time for interventions to minimize environmental harms.
Professor Weiss introduces a new paradigm termed ‘mobility health’ to bridge the siloed domains of safety, adolescent health and sustainable mobility. In this passionate speech to an international audience, he advocates changing the current narrow paradigm of adolescent road safety to a cross-level/cross-disciplinary, more potent, timely and healthy vision of less driving through mobility modal shift from cars to active and public transport.
There are unprecedented and widely unappreciated dangers posed to public health, nursing, medicine and allied health professions by the ongoing global economic contraction. This is a multilayered and, frankly, emotionally difficult topic to digest. Before discussing how health systems are affected we first lay out the larger social-ecological context of modern society’s predicament. This includes a brief overview of the idea of degrowth,[i],[ii],[iii] which is a response to ecological overshoot and reaching the physical resources and ecological limits to growth, and why it must supplant growth as the cardinal metaphor of modern culture. Then we outline how the inability to perceive that the world has reached the end of growth –by mistakenly seeing the present as a Great Recession- threatens health systems. Read the rest of this entry »
During the 20th century an indispensible yet unrecognized factor allowed the health sciences to attain dizzying levels of organizational complexity and achieve countless life saving and prolonging breakthroughs. The health professions drew upon ever-increasing amounts of human and natural resources, particularly energy. For example, energy’s significance was overlooked because –save for a few peroids of scarcity deemed anomalous or political contrivances- its main supplies –the fossil fuels natural gas, oil, coal- seemed infinite and its cost trivial. Therefore, the complexity of modern health systems and their accomplishments are an epiphenomenon of economic expansion made possible first and foremost by natural resources; only secondarily are they reflections of capital and labor expressed through human intelligence, drive and ingenuity. The era of cheap and plentiful energy is over and this has profound implications for the health sciences and modern world. Read the rest of this entry »
From our friend Kurt Cobb over at Resource Insights
This is the way the world ends
This is the way the world ends
This is the way the world ends
Not with a bang but a whimper.
–T.S. Eliot, “The Hollow Men”
The modern end-of-the-world imagination often seeks out great Hollywood-style cataclysms: an asteroid collision, all-out nuclear war, a solar flare that wipes out the electrical grid, even a worldwide epidemic that leaves few alive. Less compelling is the possibility of relentlessly rising death rates that finally overwhelm birth rates and quietly set worldwide population on a downward path.
While such a development would (gruesomely) address population pressures over time, it would be both highly disruptive–the costs of coping would be very high compared to family planning–and also morally repugnant if allowed to occur through intentional neglect.
The idea that a decline could unfold in this manner, however, is so far from any policymaker’s mind that it doesn’t even seem to register. And, yet the seeds for it are being sown right now. As the world economy continues to sputter, government revenues fall. More and more nations are embracing fiscal austerity and public health budgets are being cut. The situation has become exceedingly dire for Greek citizens whose health care system is being slashed to meet austerity targets demanded by Eurozone lenders as the price for keeping the government financially afloat. Because many pharmacies have not received government payments for drugs they dispense in such a long time, these pharmacies are now demanding cash up front. And, impoverished Greeks are finding it difficult and often impossible to pay.
A year ago I asked, “How to understand health care’s inability to recognize that modern society has reached the limits to growth?”[i] Since then I’ve unsuccessfully attempted to write on the urgent and bedeviling question, “What are the nuts and bolts of organizing a “small is beautiful” health system?” Here I want to lay the ground for exploring this second question while weaving in final comments on the first question. Read the rest of this entry »
In this essay I argue that the rapid decline of Greece’s health system –and socioeconomic conditions throughout the nation- is proximately due to a fiscal/economic crisis that political and financial leaders have chosen to address by imposing draconian austerity measures upon most of the Greek people so as to: a.) protect the wealth, status and power of dominant elites, and b.) shield and resuscitate a moribund financial system. The distal cause of the deterioration of Greece’s health system, however, lies in reaching the earth’s physical limits to perpetual economic growth[i]. Therefore, attempting to restart growth –the taken-for-granted panacea- is not working and the case of Greece demonstrates that “austerity” has pernicious costs. (Stimulus is a nuanced option not developed here.)[ii] Finally, politicians, corporations and national governments are highly unlikely to recognize that the limits to growth are upon us, while local governments and grassroots citizens movements will by necessity be inclined “cyberneticly” to begin fashioning sustainable health systems (and all socioeconomic institutions) as a way surviving –even if they do not label their situation as entering a post-growth era. Read the rest of this entry »