The Unassuming Economist

From a paper by Ted Schrecker:

“‘Polycrisis’ (1) has a good claim to status as the word of the decade, in a world beset by such phenomena as the fallout from the worst pandemic in a century; heightened geopolitical uncertainty and its economic impacts; and human-induced climate change and other disturbing manifestations of the Anthropocene Epoch. Yet another crisis, rising inequality, has drawn relatively less attention, although it compromises or eliminates the chances for large segments of the population to lead healthy lives.

In 2014, the then-managing director (CEO) of the International Monetary Fund (IMF) described the growth in inequality worldwide as ‘staggering’ and warned that ‘[i]f we are not careful, the ghosts of the 19th century will haunt the 21st century’ (2). Although the organization she led had over the decades done much to contribute to that pattern, she was correct, and the subsequent decade provided abundant evidence that the haunting she anticipated is already happening (3, chapter 3; 4).

Health promotion research and practice have yet to adequately take on board the consequences of this pattern. Concepts like health literacy that presume individuals have the material resources needed to lead a healthy life are of limited relevance, to put it politely, to populations like:

- The 2.8 billion of the world’s people who could not afford a healthy diet in 2022, according to the United Nations agency with responsibility for food security (5, p. xix);

- The 3.8 million people in the United Kingdom (UK) who experienced destitution, ‘where people cannot afford to meet their most basic physical needs to stay warm, dry, clean and fed’ (6) in 2022, up from 1.55 million in 2017 (7);

- The estimated 800,000 United States (US) urban residents who lacked a piped water connection between 2013 and 2017 (8), after cost increases associated with a decade of privatization and austerity.”