When I talk about 'health' in the general sense, I'm referring to the ways that social and economic policies impact our health. So when we consider, for example, how drugs, alcohol, urban planning, industry, poverty, education, employment opportunities and other social and economic factors impact our health, we may see how addressing or regulating those factors—or not doing so—becomes a reflection of the way that we, as society, see and value our health.
For example, a discussion on power generation will most likely include a conversation on the burning of coal for electricity. Burning coal releases microscopic particles in the air that can be breathed in by people nearby and likely further downwind, increasing the risk of respiratory issues like asthma (or, worse, depending on the length and intensity of one's exposure to these particles). From a health policy perspective, it would be better not to burn coal because of these effects—after all, there are 'cleaner' alternatives to burning coal. But economic policy might suggest that burning coal is cheaper and more convenient than alternative forms of energy and provides an entire industry with employment opportunities—for example, jobs for those digging for coal, transporting it, making equipment for it, building related facilities, etc. So from a health policy perspective, what does one say when faced with that economic argument?
Well, ardent followers of health policy might suggest that the burning of coal should be minimized considering the known impact that it has on health. But they, alone, do not make the final decision on that question. Questions like this are typically tried in the 'public space'—through conversations with our peers, politicians, academia, clinicians, interest groups, businesses, and others. Those conversations will result in decisions, typically in the form of laws or regulations, that formally decides how society will proceed with economic or social policies and their consequences on health. In the case of burning coal, society may decide to invest in renewable, clean energy technologies at a greater (at least in the short term) economic expense, implying that society will make a decision to also support health by minimizing the burning of coal. Or society may decide to maintain or deregulate the burning of coal, which would imply that we have accepted the negative impact of burning coal on health, but will be doing so at a lower immediate economic expense for society while providing for another social or economic gain, like employment in the coal industry. If we're lucky, there may even be a third option—for example, if there are ways of burning coal more cleanly, avoiding some of the negative effects on health, while providing employment opportunities in that sector, wouldn't society just choose that approach instead? Are there other consequences to consider?
These decisions are not easy to come to. And my example perhaps oversimplifies the intensity of that specific discussion. But we can anticipate that while these conversations may be challenging to mediate, compromise will likely be needed in getting us to a solution. Importantly, while we all have the right to express our opinions on the social and economic policies that affect us, it is equally important that we learn or are informed of all the facts, risks and opportunities related to such decisions and balance the resulting outcomes and consequences. There are many sources for that information—whether it comes from experts, the media, government, our peers, or advocates, like myself. Getting informed makes sure that you can make an informed decision. When an issue has a clear impact on health, it's no different—balance all the implications that a policy issue has, including any effects on health, then make an informed decision with the knowledge that you have gathered. And how do you actually decide? Perhaps formally with your votes in a general election or referendum on a topic or issue, or informally through a comment on social media, or by supporting a cause that you really care about.
Sites like mine should help provide some consideration on the issues that we all have to decide on. For me, I value social and economic decisions that minimize costs to our health while ensuring that we support our fellow citizens in meeting their social and economic goals. For example, a policy decision may negatively impact the mental health of workers in an specific industry that is being curbed through regulation because of that industry's negative impact on physical health. In this circumstance, there should be associated regulation that makes sure that those working in that industry are supported—that their mental and emotional health needs are looked after—so that they do not feel deprived of their ability to meet their individual and communal social and economic goals, like being able to support their families or being productive citizens. In these situations, society can support those affected by offering compensation and re-training opportunities.
In my next blog post, and in continuing to build the 'narrative' on this site, I'll frame my thoughts around 'Health Care' next—that is, the mechanisms for how health conditions are actually treated—and how future topics will touch on both speaking points.