Why Promoting Health is Incompatible with Modern Living.

In 1978 the WHO produced the Alma Ata Declaration and by promoting health, as opposed to treating illness, radically changed the face of healthcare. Today its lofty aspiration: “the attainment of the highest possible level of health” is just another 21century commodity with goods and services traded by governments, insurers and providers.

But the more sinister truth in the evolving health equation is the loss of ownership of our health, which is almost as sacrosanct as motherhood, ie if we eat right, exercise enough, think without anxiety and take the right drugs we are assured of our place in heaven on earth.

In short our health has been repackaged as the currency of our futures. If we work hard we will earn it; if we store up frequent health points we will be suitably superannuated; if we make wise acquisitions from the health insurance supermarket we should be able to trade off some illness points.

Indeed, we are all living longer. The average life expectancy increased over the last century from 50 to 78 years (in the countries that record these data). However extended life does not mean we are healthier, it merely reflects the shift from infectious and parasitic diseases (the leading causes of illness and death) to non communicable diseases and chronic conditions.

How healthy is that?

Though data on multimorbidity varies from country to country, you can be sure that by the time you reach retirement you will have at least two chronic conditions (and probably some misgivings about your health supermarket purchases) and, if you have five or more illnesses, pain killers will be a feature of your healthy daily diet.

How healthy is that?

Surely what we require to live well is robustness. Unlike health, which has become aspirational and unequivocal, robustness describes 21st century living; it encompasses the capacity to change and adapt and, most importantly, it embraces resilience.

How good is that?

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