I’ve recently been thinking about what makes a person ‘healthy’. There’s a much wider debate that needs to be had on what being healthy means in the age of long term conditions and multimorbidities, but aside from that it’s easy to forget that the factors that can impact a person’s health go beyond the medical.
Yes, sometimes health is genetic; my childhood asthma and allergy to cats are as much a part of my family tree as my height and eye colour. And yes, we know that health can be behavioural too; spending Saturday at a cheese festival drinking beer certainly had an impact on my health come Sunday. But this isn’t the whole story.
Beyond the clinical
Science, medicine and population health have often focused heavily on these factors, but what about the other more broader determinants of health? What about the politics of good health?
The facts in this area are bleak. A boy from one of the wealthiest areas of the UK will on average outlive one from the poorest areas by around eight years and five months. People who are unemployed for more than 12 weeks are between four and ten times more likely to suffer from depression and anxiety. And research from America suggests that those with a degree are nearly four times less likely to smoke than those with a lower level of education.
The core principle that founded the NHS is that everybody, no matter who you are or where you’re from, deserves to have good health; but we’re failing on this very point. Collectively, we need to look far more at the social factors that influence health – and this is where the third sector has a role to play.
The strength of our sector
Government siloes its work into neat little departments. And when the issue is something bigger, something that lays across those carved up social lines, it risks being overlooked.
But charities and voluntary organisations don’t just represent topics like government departments do, we represent people. We represent the whole person and the issues that impact them. We know that when our supporters’ PIP payments are stopped, their health suffers. We know that their neighbourhood community being gentrified has impacted their social care. And we know that when their local supermarket closes, they struggle to afford getting their five a day.
The Voluntary, Community and Social Enterprise (VCSE) sector has the ability to go across government boundaries and bring together all the people needed to find solutions to the big health issues of our day. We have the ability to make sure that topics like climate change, crime, housing and poverty are seen as health issues too.
Government needs to engage with us as a sector and in return we need to pull them out of narrow agendas and get them to look at the bigger picture. Because what makes us ‘healthy’ goes beyond what can be treated by a doctor.