Degrowth and health: local action should be linked to global policies and governance for health

Abstract

Volume and increase of spending in the health sector contribute to economic growth, but do not consistently relate with better health. Instead, unsatisfactory health trends, health systems' inefficiencies, and high costs are linked to the globalization of a growth society dominated by neoliberal economic ideas and policies of privatization, deregulation, and liberalization. A degrowth approach, understood as frame that connects diverse ideas, concepts, and proposals alternative to growth as a societal objective, can contribute to better health and a more efficient use of health systems. However, action for change of individual and collective behaviors alone is not enough to influence social determinants and counteract powerful and harmful market forces. The quality and characteristics of health policies need to be rethought, and public policies in all sectors should be formulated taking into consideration their impact on health. A paradigmatic shift toward a more caring, equitable, and sustainable degrowth society will require supportive policies at national level and citizens' engagement at community level. Nevertheless, due to global interdependence and the unavoidable interactions between global forces and national systems, a deep rethinking of global health governance and its reformulation into global governance for health are essential. To support degrowth and health, a strong alliance between committed national and global leaderships, above all the World Health Organization, and a well-informed, transnationally interconnected, worldwide active civil society is essential to include and defend health objectives and priorities in all policies and at all levels, including through the regulation of global market forces.

Degrowth – Taking Stock and Reviewing an Emerging Academic Paradigm

“…To be successful, degrowth has to identify a concrete and inclusive development perspective (see Schwartzman, 2012 ) for the affluent and powerful elites and the marginalized poor. Direct benefits of degrowth might be experienced by consumers in areas where further growth has obviously become undesirable, such as in the health care industry as illustrated by Missoni (2015) , in the food, nutrition and the agricultural sector, or in urban transportation. Degrowth could address psychological stress related to over consumption, long working hours, and the commodification of social relations and highlight the benefits of a simplified life style away from positional competition and towards more collaborative community development.…”

Human health and social-ecological systems change: Rethinking health in the Anthropocene

“…Modern health care is highly complex, technologically advanced, and resource and energy intensive (Bednarz and Beavis, 2012; Odum, 2007). It is integrated into and dependent upon the capitalist economy, with market forces determining medical research priorities, trends in professional specialization, and the ongoing medicalization of social problems (Alley and Sommerfeld, 2014; Bauman, 2012; Janes et al, 2006; Missoni, 2015; Twenge and Campbell, 2010). Biomedical health care is upheld by modern ontologies that individualize illness and position curing individual bodies and extending the lifespan as the primary goals of medicine (Beck and Beck-Gernsheim, 2002; Gawande, 2014; Janes et al, 2006).…”

Regional organisations supporting health sector responses to climate change in Southeast Asia

“…While this may appear positive, and similar to commentary about WHO more broadly (e.g. [ 6 ]), its potential is not being realised. While the lack of CCTWG meetings is indicative of low prioritisation of climate change and health, the re- endorsement of the CCTWG at the Ministerial Meeting of the APRF in October 2016 (researcher’s observation) suggests it is other factors that have inhibited activity.…”

“…For health, this includes more than climate-proofing treatment centres and preparing for more cases of climate-sensitive diseases, because health determinants include factors both inside and outside the direct control of health ministries, including “access to safe water and clean air, food security, strong and accessible health systems, and reductions in social and economic inequity” ([ 5 ], p. 2). Missoni [ 6 ] argued that inequality, including health inequality, is exacerbated by a focus on economic growth and, further, that addressing health determinants ahead of time is less expensive and leads to longer-term sustainability. Similarly, improving health determinant access will increase adaptive capacities, emphasising the growing importance of interactions between health and CCA [ 7 , 8 ].…”