Abstract
We argue that public health matters more today than ever because it is uniquely positioned as a meeting point or fulcrum between health care and social welfare policy perspectives on the social determinants of health. It combines a grounding in the sciences of biomedicine and epidemiology with the moral imperatives of social advocacy. Health cannot be delivered through health care policy alone and neither can social welfare policy ensure the well-being of all citizens on its own. Social policy is at a disadvantage because it does not engender universal consent the way health policy can. While the way that illness should be addressed is debated, it should be addressed to be not contested, as is social welfare for vulnerable populations. The convergence of health and social policy to address the social determinants of health means public health advocacy must explicitly leverage biomedicine to provide materialist and substantive arguments and social welfare to provide the normative and moral arguments. We conclude that a new model of public health advocacy or social lobbying is necessary to effectively raise concerns that health care-focused thinking will not, but with potential heft that social welfare, historically, has not been able to command.
Résumé
Nous affirmons que la santé publique importe plus que jamais puisqu’elle agit comme point de rencontre entre deux perspectives concernant les déterminants sociaux de la santé : celle des politiques de santé et celle du cadre de la politique du bien-être social. La santé publique regroupe une base dans les domaines de la biomédecine et de l’épidémiologie avec les impératifs moraux de la défense d’intérêts sociaux. Une politique sur la santé seule n’est pas en mesure de dispenser des soins de santé, et les politiques du bien-être social, à elles seules, ne peuvent assurer le bien-être de tous citoyens. La politique sociale est défavorisée car elle ne donne pas lieu à un consensus universel de la même façon qu’une politique sur la santé. Alors que nous débattons des stratégies pour aborder les soins de santé, personne ne conteste le fait que nous devons adresser ce problème, tout comme le bien-être social des populations vulnérables. La convergence des politiques de santé et politiques sociales pour aborder les déterminants sociaux de la santé exige que la défense de la santé publique exploite la biomédecine afin de fournir des arguments matérialistes et de fond et le bien-être social pour fournir des arguments normatifs et moraux. Nous concluons que la défense de la santé publique et le lobbying nécessitent un nouveau modèle afin de soulever les inquiétudes que la pensée axée sur les systèmes de soins de santé ne réussit pas à atteindre. Ce nouveau modèle aura une pesanteur que le bien-être social, historiquement, n’a pas réussi à inspirer.
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Our thanks to Renée Huntley for translation of the abstract.
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Littlejohns, L.B., Smith, N. & Townend, L. Why public health matters today more than ever: the convergence of health and social policy. Can J Public Health 110, 275–278 (2019). https://doi.org/10.17269/s41997-018-0171-1
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DOI: https://doi.org/10.17269/s41997-018-0171-1