Health and Wealth “A nation’s health is a nation’s wealth.” Masthead of The Sanitarian, published in Britain in the 19th century
What is Wealth? Experts in ‘alternative economics’ have long suggested that wealth consists of four forms of capital. That view is increasingly accepted by, among others, the World Bank, the World Economic Forum, even (parts of) Wall Street.
Natural capital - the bedrock high environmental quality - air, water, soil healthy ecosystems and sustainable resources habitat and wildlife conservation
Natural Capitalism Increase productivity of natural resources –implement whole system design –adopt innovative technologies Shift to biologically inspired production models –closed loop systems Move to solutions- based business model –services (e.g. illumination) not goods Reinvest in natural capital ( Lovins, Lovins and Hawken, 1999)
Economic capital Natural capital Social capital
Social capital - the glue high social cohesion and civicness safe, livable built environments equitable access to the basic determinants of health
Social capital - the glue Three aspects of social capital social cohesion and ‘civicness’ (Putnam) public investment in the ‘soft’ social infrastructure (health services, education, social services, libraries etc) the judicial, political and constitutional infrastructure of society
Social capital Human capital Natural capital Economic capital
Human capital - the end educated, innovative, creative people participatory governance and civil rights healthy people
Social v human capital Social capital is distinguished from human capital in that it does not exist within any single individual but instead is concerned with the structure of relationships between and among individuals. Coleman, 1998
Social capital Human capital Natural capital Economic capital The four forms of community capital
Global Wealth A 1995 World Bank study suggested that of the world’s total wealth 20% is ‘produced assets’ (economic wealth) 20% is ecological (natural) capital 60% is a combination of social and human capital
What is Development? “A gradual unfolding or growth ” Chambers 20th Century Dictionary, 1972 edition
Health and Development The four forms of wealth require four forms of development if health is to be maximised.
Economic development development of the economy to provide the means of ensuring that the basic determinants of health are adequately met, thus avoiding absolute material deprivation –enables us to ‘purchase’ health
Social development development of the communities and societies of people to ensure that everyone has an equal opportunity of benefiting from development, thus reducing relative material and psychosocial deprivation and ensuring social equity and health.
Sustainable development development in a manner that is indefinitely environmentally sustainable, ensuring that future generations and other species can continue to survive and thrive, while providing for economic, social and human development today and in the future.
Human development ensuring that every human being attains their fullest possible human potential.
Real Capitalism Real capitalists do not build just one form of capital - economic capital - by depleting the other three forms of capital. They build all four forms of capital.
A New Capitalism for the 21st Century The new capitalism must simultaneously increase ecological capital social capital economic capital human capital
How is Health Produced? The main determinants of health are peace food shelter education income stable ecosystem sustainable social justice and resources equity Ottawa Charter for Health WHO, 1986
Who Produces Health? Those who build peaceful relations, locally and globally grow our food build our homes and communities educate our kids create good jobs
Partners for health Public sector –local government –local schools Community/NGO sector Faith organisations Private sector Labour unions etc.
Who should be our private sector partners? Those whose bottom line improves when our bottom line improves. –then we share a common interest
Caveat partner! Don’t partner with those who make money from selling ill health –the tobacco industry and others lose or don’t make money if the health of the population improves –the ‘medical-industrial complex’? profit in ways that harm health
Private Sector Partners for Health Whose bottom line improves when the public’s health improves? health and life insurance companies tourism and recreation industries sport and fitness industries all businesses
Who are the real creators of health in that they provide the basic determinants of health? food producers home builders teachers clean water industries creators of healthful employment Partners/2
Partners/3 Who is already working to increase all four forms of capital simultaneously? community gardeners community-based energy retrofits public transportation
4. Community Development- Building Community Capital Some examples
Community gardens Social capital –Working together –Learning about food from other cultures –Inter-generational links Ecological capital –Creating greenspace –Organic production
Community gardens Economic capital –Reducing cost of food –Creating local employment Human capital –Being active –learning about food and nature –eating better
Energy Retro-fits in housing Social capital –Working together –Creating local planning group Ecological capital –Saving energy –Reducing greenhouse gases and other pollutants
Energy Retro-fits in housing Economic capital –Creating local employment –Increasing disposable income Human capital –Improving health via better housing quality –Acquiring skills and knowledge
Public transit Social capital –The ‘great democratiser’ –Increases access for people without cars Ecological capital –Saving energy –Reducing greenhouse gases and other pollutants
Public transit Economic capital –Reduced cost of living –Increased disposable income Human capital –Reduced disease due to air pollution –Safer mode of transport –More active way of commuting
It takes a whole community to raise healthy people