Some experts say that ‘health is politics’. What the phrase means is that these two are closely related and interdependent.
This is true, because power is exercised over health, and health is amenable to human interventions. These ‘interventions’ are often programs or services provided by the authorities — or those who have control over resources — which in turn determine the health outcome of a community.
Today, the health care system of a country very much depends on government policy. The parliament, politicians, ministers, and policymakers make crucial decisions on how much should be spent on health, what method of health funding or financing is most suitable, how health resources are distributed, and how doctors are recruited.
Those at the top also have the power to decide whether or not specific health care services should be made available, and who gets to access them.
However, it is important to highlight that our health does not depend on medicines or the health care system alone. The health care system is only a small fraction of the larger ecosystem that determines our well-being.
Health is also largely influenced by what is known as the social determinants of health (SDH). These are factors within the social environment of an individual that can affect health directly (eg: by causing injury) or indirectly (eg: by increasing one’s vulnerability to disease).
Examples of SDH include housing condition, access to clean water and sanitation, education, income, employment, social support, and many others.
To put it simply, our daily interactions with our surroundings play an important role in making us sick or healthy. Think of the indoor air quality of our house, the amount and quality of food we are able to purchase, the workplace conditions we are subjected to, the level of awareness we have of our risk of contracting a disease, the degree of physical and social support we receive from our trusted ones, the availability of recreational space in our neighbourhood, and many more.
Most of these factors can be modified by the exercise of power and political interventions. Decisions made at the top can affect, for instance, our access to affordable housing, availability of good schools, adequate budgets for programmes promoting wellbeing, safety policies at workplaces, and stable water supply (talk about recurring water disruptions!).
Similarly, political decisions can lead to (or hinder) a healthy and safe living environment through proper urban planning and provision of good waste management systems — all of which can avoid or reduce the impact of natural disasters like floods.
Health care practitioners are often told “to focus on their job” and “not to meddle in politics”. But here is the problem: the people we are responsible to treat are the product of their physical and social environment, which in turn is a product of either good or poor governance.
If we shy away from engaging in areas beyond our comfort zones, we may continue to treat symptoms, but never the underlying cause of the disease. Worse, we may unknowingly contribute to the disease by perpetuating a system that is harmful to society.
Don’t get me wrong. I am not saying each and every health care practitioner has to make the jump into politics or make political statements.
Nor am I saying that health care practitioners should unnecessarily get themselves into trouble by provoking the authorities. Rather, what we should do is engage, persuade, reach out, and work together.
Many a time, things can get done by mutual cooperation and understanding between the people and those in power. But at the same time, health care practitioners need to be aware of, and educate themselves about the relationship between politics (or power) and health, understand where their position is within these complex dynamics, and how they can make a change for the better.
Of equal importance is to think critically, have the courage to speak out and correct what is wrong, and not simply continue with business as usual.
After all, our main duty is to safeguard people’s health. And the only way to do that is by looking at health from a holistic view.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
