Public Health’s Response to Decline: Loyalty to the 1%

Dan Bednarz

American institutions are in decline and rife with corruption brought on by a combination of hitting the limits to growth while under the control of neoliberal capitalism[i]. To the extent one deviates from the appearance and demeanor of staid white middle or upper class norms, an encounter with the police in many localities[ii]^,[iii],[iv] can be dangerous to ones person and pocket[v]. The government’s reaction to the “the most destructive epidemics of elite financial frauds in history”[vi] has been to further enrich[vii] –rather than jail- financiers,[viii] and protection of the banks continues to harm and ruin the lives of millions of citizens. Higher education is embroiled in several scandals, from encouraging students to take out usurious loans few will able to retire, to the exploitation of adjunct professors, to covering up campus rape cabals. Many Americans are trapped in debt with virtually no possibility of paying it off; trust in government and corporations[ix] is at all time lows; and in fashions too lugubrious to list the federal government –and the two major political parties- do not promote the public interest,[x] preferring instead to serve political/economic elites.[xi]^,[xii]

Health systems, neoliberalism, and the end of growth: The World Health Organization in denial

Dan Bednarz

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] 

Postcard from the Frontline

 Peter Gray, MD.

I’m a small town family physician in Ontario, Canada with an unremarkable practice consisting mainly of obesity, diabetes, arthritis, hypertension, anxiety / depression and the “worried well” who want to know why they feel tired all the time.  Nothing unusual, nothing particularly glamorous.  One thing which is different about my practice is that I became aware of peak oil five years ago, and since then I have been struggling to integrate this knowledge into my medical practice and family life.

Power, Identity and Social Change as We Enter Degrowth

Dan Bednarz

 Understanding the interplay of power[i]^,[ii] identity, and social change is critical to those who recognize that modern societies are at the limits to growth, in ecological overshoot[iii] and undergoing a first phase reaction of economic contraction;[iv] disintegration of modern finance, as evidenced by massive corruption and wealth destruction;[v] and political upheaval[vi]. While responses to these dilemmas can take the form of involvement in community localization, disengagement from modernism, studying yoga and Zen Buddhism, shrugged shoulders, political activism, or focusing on one institution –like health care, education, transportation, public banking, or the food supply, they all contain layers of nuance involving the relationships among power, identity (personal and collective) and social change.   

Health groups put climate first in election poll – Media release 5 August 2013

The health community in Australia is calling for strong action on climate change as the prescription for political parties looking for a winning formula in the upcoming federal election. The electorate is becoming more aware of the growing risks to the wellbeing, safety and health of communities around Australia.

The Climate and Health Alliance (CAHA), a national coalition of health groups, representing over 300,000 doctors, nurses, midwives, social workers, psychologists, physiotherapists, allied health professionals and health care consumers, has launched its policy platform this week, outlining the priorities of health groups for effective climate action to protect health.

Leading experts such as Professor Tony McMichael from Australian National University have joined the call, saying climate change should be the key health issue in this election….

…CAHA President Dr Liz Hanna said: “The health sector is already under pressure, and increasing heatwaves, fires, floods and storms will place even greater demand on frontline and community health services as people struggle with associated injuries, illnesses and trauma. The long recovery period from these events is often under estimated, as the toll upon human health and local economies linger for years.”……

…..The Climate and Health Alliance is calling for Australia to commit to the major emissions reductions now urgently required by developed nations in order to avoid the globally agreed ‘safe’ maximum of a two degrees Celsius increase.

A national strategy is a key issue, health groups say, as is the establishment of a sustainable healthcare unit within the Department of Health and Ageing to help drive the health sector’s transition to low carbon operations.

Australian Healthcare and Hospitals Association (AHHA) Chief Executive Alison Verhoeven said: “The health sector has an important role to play in terms of responding to changing demand patterns arising from climate change but also by improving the sector’s sustainability relating to emissions, energy production and waste management.  This can not only deliver significant financial savings, but also support improvements in health status of staff and the community.”

See full press release at: http://caha.org.au/wp-content/uploads/2013/04/130805_Health-groups-put-climate-first-in-election-poll_final.pdf
For more information about the Climate and Health Alliance federal election 2013 policy platform, visit: http://caha.org.au/campaigns/federal-election-2013/ <http://caha.org.au/campaigns/federal-election-2013/> 

Deciphering Detropia: The Power of Degrowth, the Destructiveness of Neoliberalism

Dan Bednarz

Detropia[i]^,[ii] stirs anxiety and disorientation among its viewers[iii] through poignant visuals[iv] of the desolate and denuded cityscape blended with the accounts of Detroiters. But what are we to learn from this surfacing of collective dread?

Caution! Paradigm Shift Ahead: “Adolescent mobility health”

This is a multimedia presentation by Professor Hank Weiss, delivered Tuesday, October 02, 2012 at the Safety 2012 World Conference (47 min).

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.

Sustainable Healthcare by Kim Adams

 What is sustainable healthcare?

The Alliance for Natural Health has defined sustainable healthcare in the following way.

A complex system of interacting approaches to the restoration, management and optimization of human health that have an ecological base, that are environmentally, economically and socially viable indefinitely, that work harmoniously both with the human body and the non‐human environment, and which do not result in unfair or disproportionate impacts on any significant contributory element of the healthcare system.

Alliance for Natural Health  (http://www.anh-europe.org)

Based on this definition, there is very little about our existing healthcare system that is sustainable.  To achieve sustainability, it is necessary to look beyond what we have now to what we really want.

2011 in review

The WordPress.com stats helper monkeys prepared a 2011 annual report for this blog.

Here’s an excerpt:

The concert hall at the Syndey Opera House holds 2,700 people. This blog was viewed about 10,000 times in 2011. If it were a concert at Sydney Opera House, it would take about 4 sold-out performances for that many people to see it.

Click here to see the complete report.

“But You’ve Offered no Solutions,” An Illustration of Kuhn’s Incommensurability Thesis

Dan Bednarz

 Recently I spoke to a gathering of medical and public health students at Columbia University about the contribution the health sciences can make to Mayor Bloomberg’s PLANYC, a vision for a sustainable New Your City in 2030.

Although I had prepared opening remarks on how I was speaking from a paradigm premised upon the end of the physical expansion of the economy, this discussion quickly became an example of Thomas Kuhn’s incommensurability thesis. This means that proponents of competing paradigms are prone to misunderstanding and misinterpretation and, overall, “talking past” one another as they find one another’s conceptual positions and policy recommendations incomprehensible or absurd. The confusion and conflict stem from the incompatibility of the core metaphors around which the intellectual contents of paradigms are organized. In this instance it is the taken-for-granted physical growth of the economy –the core metaphor the students were operating from- versus one where economic activity is constrained by a finite planet with finite resources.