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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 »
“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.”
Josephine Smit and Norman Pagett
Healthy citizens are the greatest asset any country can have.”
Faced with inevitable decline in our access to hydrocarbon resources, we read of numerous ways in which we will have to downsize, use less, work less, grow our own food, use goods and services close to home, consume only what we can manufacture within our own personal environment, or within walking distance. If we are to survive, we must ‘live local’ because the means to exist in any other context is likely to become very difficult. There is rarely, if ever, any mention of the healthcare we currently enjoy, which has given us a reasonably fit and healthy 80 year average lifespan.
There seems to be a strange expectation that we will remain as healthy as we are now, or become even healthier still through a less stressful lifestyle of bucolic bliss, tending our vegetable gardens and chicken coops, irrespective of any other problems we face. And while ‘downsizing’ – a somewhat bizarre concept in itself – might affect every other aspect of our lives, it will not apply to doctors, medical staff, hospitals and the vast power-hungry pharmaceutical factories and supply chains that give them round the clock backup. Nor does downsizing appear to apply to the other emergency services we can call on if our home is on fire or those of criminal intent wish to relieve us of what is rightfully ours. Alternative lifestylers seem to have blanked out the detail that fire engines, ambulances and police cars need fuel, and the people who man them need to get paid, fed and moved around quickly. In other words ‘we’ can reduce our imprint on the environment, as long as those who support our way of life do not. Humanity, at least our ‘western’ developed segment of it, is enjoying a phase of good health and longevity that is an anomaly in historical terms. There is a refusal to recognize that our health and wellbeing will only last as long as we have cheap hydrocarbon energy available to support it.
A conversation with the famous M. King Hubbert by the American Hospital Association, 1976.
There are several important take home messages from this interview.
- The basic impacts of peak oil on our health care systems were understood 1/3 of a century ago.
- Everyone alive today has grown up in a period of growth. That era is coming to a close, but are we ready to face that reality?
- All baby boomers lived through the burning of more than half of the world’s cheap oil.
- It is no surprise that the environmental effects of burning all those hydrocarbons, in a closed system, in such a short period of time, are also showing up now. As the late Barry Commoner has said:
- Everything Is Connected to Everything Else.
- Everything Must Go Somewhere.
- Nature Knows Best.
- There Is No Such Thing as a Free Lunch.
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 »