It wasn’t much more than a year ago that most solutions proposed to fix broken healthcare systems, whether in the US, the UK or elsewhere, were down to people taking greater responsibility for their own health.
This is because the biggest burdens on our healthcare systems were from aging populations with chronic, preventable diseases like heart disease, cancer, obesity, diabetes, arthritis and Alzheimer’s. They’re viewed as preventable because they’re linked to diet, lifestyle choices and other factors associated with the poor adaptation of our hunter-gatherer genes to our modern, technology-dominated lives.
In the US, this idea was spearheaded through the National Academy of Medicine’s Vital Directions program. The UK’s premier medical journal, The Lancet, developed a Global Health spinoff that in 2018 called for a revolution in health care. It was all about radical reform of public health, getting people more engaged with their own health through democratization and of course digitization, given the massive expansion in wearables and other tech to keep tabs on our bodies.
This kind of approach was first
proposed decades ago. But again and again, research showed that only some people were prepared to get more involved in their own health, typically those who were already highly motivated—perhaps like many WDDTY readers. The trouble is, the primary burden for chronic diseases is not among the more educated and affluent but among the most deprived in our societies.
Those in industrialized nations who have the very least materially face the worst health outcomes. They buy the cheapest, most highly processed foods. They are more likely to abuse their bodies with alcohol and tobacco, and less likely to prioritize physical activity. They also report lower quality of life and less purpose or meaning in their lives, and they suffer a greater burden of depression, anxiety and other mental health problems.
Simply telling people that they should eat better, move more and engage in mindfulness practices fails spectacularly. It’s not only been tried repeatedly, it continues to be one of the dominant public health thrusts—one that just keeps failing. It reminds me of that famous quote, often misattributed to Einstein: “Insanity is doing the same thing over and over again and expecting different results.”
Health disparities have complex origins and are likely to have equally complex solutions. But many have argued that socioeconomic determinants of health may often be at least as, if not more, important than physiological ones, rooted in a lack of sense of control over our lives, a lack of purpose, deep-seated attitudes and expectations that drive unhealthy behaviors, and disconnection from communities and from nature.
On top of health systems collapsing under the strain of chronic, noncommunicable diseases came a communicable one: Covid-19. At the time of writing, around 2.5 million people worldwide are said to have lost their lives with Covid-19 being associated.
There are around 22 million active “cases,” but these are not cases of disease, they are cases of infection demonstrated by PCR. PCR tests have been shown many times over to be inappropriate for mass screening because they have a high rate of false positives. More to the point, only 0.4 percent of these “cases” are serious or critical, the remaining 99.6 percent being mild or asymptomatic.
These numbers might seem very large, but they need to be seen in perspective. What are the generational effects going to be for the 1.5 billion children who’ve missed out on getting a proper education over the last year? What will be the effects on health for all those who’ve missed out on getting early treatment for heart disease or cancer?
Covid-19 has turned the clock backwards on all the work that has been done to help narrow the health inequality gap.
The current winners are undoubtedly the much-discussed billionaires who’ve profited from the pandemic. But rather than feel despondent and helpless—which I sense is what those who’re pulling the strings around this pandemic would like us to feel—we must find ways of becoming empowered.
We cannot wait for public health to reform and deliver what it should have done three decades ago to reduce the burden of preventable chronic diseases. And it won’t do it for this particular infectious disease or any others that might emerge. In essence, public health is bought and paid for, so don’t hold any hope for it to come to our rescue.
We must take back control over our bodies and shun
efforts by authorities to reduce our autonomy over our own health. We must also redevelop our sense of community. That might be by supporting a food bank or helping young people find connection with others, or with nature.
The one thing we can’t afford to do is feel helpless while governments decide how best we should be managed or treated. Nor can we tolerate efforts that have diminished our fundamental freedoms—the very things that have been hallmarks for advanced, responsible, peaceful and tolerant societies.
Let’s get a grip on the things that are most important to our future, or they will be stolen from us at huge cost not only to us but to future generations.