Dear Alice,

The demographic transformation in our society resulted from better living conditions and improved health status. Why should we promote health when long life spans only create health, economic, and social problems for us?

Dear Reader,

Your question is an interesting one — and one that begs the question of how to define health and the role it plays in a person’s daily life. To answer your question simply, the best reason to promote health is because every person has a right to health and well-being. According to the United Nations' Universal Declaration of Human Rights, these rights are bestowed to every person as a fundamental human right, just by virtue of having been born, regardless of their nationality, race, sex, gender, language, religion, or political status. The concept of health is multifaceted, and the World Health Organization (WHO) defines health as a “state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” However, there is a difference between health care and promoting health, which seems critical to discuss further in an attempt to clarify and respond to your question (more on that in a bit). Reader, another perspective to consider is that many of the problems that you mention — health, social, and economic — exist due to a lack of health promotion and a lack of health equity, not due to the fact that current society has more favorable health outcomes. Read on for more information about the benefits health promotion has for society.

First and foremost, recognizing health as a human right sets a standard to which everyone can expect to live. Article 25 of the Universal Declaration of Human Rights accords every person a right to “a standard of living adequate for the health and well-being of himself and his family.” While you feel as though putting more effort into improving people’s health would create additional problems, the reality is that not doing so would be a violation of their human rights. Although it’s unclear what you mean by social and economic problems, Article 25 also addresses the social elements of health, acknowledging that people have a right to necessary social services and security in the event of old age. As new concerns emerge, they can continue to be addressed while still maintaining people’s human rights. Additionally, as part of the United Nations, the WHO classifies health as a human right, and as such, the goal is that it’s available, accessible, adaptable, efficient, and of a sufficient quality for all populations, not just for those who are able to afford good health care. While not every country or state adheres or fulfills these rights as successfully as others, doing so is a goal for which many are striving. Focusing on health promotion helps fulfill these rights and helps people to achieve this level of health and well-being.

Before getting into the nitty gritty about the role that health promotion plays, it may be key to parse out the difference between health care and health promotion. Health care, which is talked about most often, refers to the need to treat symptoms or conditions and providing services and insurance to help people access that care. Health promotion, a part of public health, focuses on interventions that helps keep people healthy and improve their overall well-being. It's focused not just on individuals, but on the overall communities and environments in which people live. The results of successful health promotion initiatives are often invisible. After all, it can be much more challenging for public health experts to track how many people don’t get a disease than how many people do. Additionally, it may comprise of activities often not associated with health. For example, improvements in road infrastructure and safety can be the results of health promotion efforts.

While you note that increasing lifespans may increase economic problems, many of the costs associated with health may be reduced with increased health promotion efforts. In the United States, billions of dollars are spent every year on health, yet annually, less than three percent is spent on public health. However, with more health promotion efforts, some of the death and disability attributed to the leading causes of death could be reduced, as some of the death and disability is preventable. You may have heard the phrase “an ounce of prevention is worth a pound of cure,” and it certainly applies here. Health care is often prioritized but there’s a lot of value in health promotion — it’s considered a public good in that its use by one person doesn’t limit its use by another person. This is in contrast to health care, where providers only have so much time and hospitals and clinics only have so many beds. If too many individuals don’t receive preventive care or heed the prevention messages, they may need to be treated for a disease or illness that could cost society more than if prevention had occurred in the first place. Additionally, living in environments and communities that promote health can make it easier for people to make choices that support optimum health.

However, health promotion messages, efforts, and preventive measures don’t just fall on the individual — health and well-being are only economically efficient when robust evidence-based health promotion programs are implemented and when there’s a concerted effort to understand the needs of a given population. After all, a rural community consisting mostly of farm workers is going to have different health needs than an urban community consisting mostly of people who sit at desks all day. Both the United States and the WHO have begun promoting the idea that the communities in which people live and work have a large impact on how healthy their lives are, and that an unequal distribution of wealth and power across communities leads to health inequities. It’s also good to note that when effectively implemented, health promotion exists at all levels — for people who are already healthy, for those with risk factors, those with symptoms, and those with a known disease or health issue. Promoting health among individuals and communities and encouraging governments to support these efforts is aimed at ensuring that everyone lives longer, happier lives. This, in turn, reduces community and global level health, economic, and social problems, and fulfills everyone’s rights to health and well-being.

Here’s to wishing you — and your community — a long and healthy life!

Alice!

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