The Public's Health: As Midterm Elections Approach, Three Steps to Creating a Healthier World | Public Health Post

We have argued often in this column that health is the product of the social, economic, and political forces around us, frequently invisible unless we pay close attention to how they influence health. The challenge of addressing these forces is one of abstraction. We realize that it is more tangible to say “we need to build more hospitals to make our health better” than to say “we need to ensure that the political environment creates more health.” And yet, the latter is critical and as we head to the midterms we offer a simple three-part prescription for how we can improve health that is so inextricably linked to the world around us.
1. Governance for health

If the conditions of the world around us create health, then we must make sure that health is borne in mind in all decisions made by the political actors who dictate these conditions. This means, for example, that governments need to recognize transgender equity is a sine qua non of health among the transgender community, that punitive incarceration policies undermine the health of minority communities, and that investments in cleaner environments reduce disease in all of us. We should vote for the candidates who will prioritize health in all its forms.
2. Cross-sectoral action that promotes health

Health is created only in part by the public sector. The food we eat comes from the private sector, as do the cars we drive, and the consumer products we use on a daily basis. The private sector influences what we eat, breathe, and drink, and how we behave. We should endorse corporate action that promotes health, directly through choosing to invest in companies that are pro-health, and indirectly through public sector policies that incentivize pro-health corporate action.
3. Demand for health

Ultimately none of the above will be possible without a population-level demand for both public and private sector actions that promote health. The history of this country is full of examples where shifting public demand created health, from the introduction of Medicare, to Obamacare, to demand for mental health parity in insurance payments, gender wage equity, and marriage equality. Ultimately, making health a priority will require a full-throated demand. And this is where, of course, elections come in.
Perhaps these midterms are an opportunity to take a step in this direction.

Michael Stein & Sandro Galea