Shift the paradigm from disease to wellbeing

Associate Professor of Digital Health & Education, Co-Director of the Centre for Health Technology and Head of Digital Education at the University of Plymouth, on how a preventative approach to health and care needs to be part of post-Covid recovery

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Marcus Aurelius, the prolific Roman emperor, was faced with the deadly Antonine Plague in 165 AD. He is often hailed for his handling of the pandemic and the economic recovery that followed. His decisions were informed by the belief that history repeats itself and events like pandemics repeat in patterns. He believed we should learn from these patterns to adapt. 

Unfortunately, society seems to ignore such patterns and face consequences which could have been mitigated to a greater extent. Regrettably, the comparisons between the Covid-19 and 1918 influenza pandemic demonstrate this perfectly through the fatality rates of non-white (BAME) and low-income populations, disproportionately higher in both the cases.

We cannot control how or when such events happen, but our preparedness and resilience will determine how successful we will be at overcoming such adverse events and their devastating impact on our communities and the economy. The Covid-19 pandemic has surfaced many policy vulnerabilities at a central and local level in terms of coordination and preparedness to deal with a health crisis. What happens next will be determined by the evidence-informed policy approach we adopt and the ability of the population to respond swiftly. With the shadow of Brexit looming, the risk of a slow, prolonged economic recovery is highly likely. 

In the UK, current policy is still tied to the notion of health and social care being about biological diseases to be cured after diagnosis, rather than being holistic and human-focussed, placing equal importance on preventative aspects of care. In 2018, roughly 5 per cent of the UK healthcare budget was spent on preventative care, compared to 80 per cent on curative, rehabilitative and long-term care. Across the European Union, the scenario is no different, coming in at only 3 per cent. A recent study of 36 members of the Organisation for Economic Co-operation and Development (OECD), the European Union and G20 countries suggests that effective policy interventions to improve diet and physical activity alone could help save up to 58 billion euros on total health budgets by 2050.

‘The Economy of Wellbeing’ approach inextricably links the wellbeing of the general population to productivity, economic recovery and growth. Support for this policy is increasing, and during the Finnish Presidency of the Council of the European Union in 2019, it was recognised that the wellbeing of the population is a key factor for economic growth and social stability. As a consequence, in October 2019, the Council of the European Union adopted the notion of ‘The Economy of Wellbeing’ as a new policy orientation and governance approach. Such an orientation calls for the need to change the narrative of health budgets from being perceived as an expenditure to one that positions it as an investment for future economic growth and prosperity.

The significant loss of lives could have been reduced had we learned the lessons from the past. If, along with other relevant economic measures, we adopt a policy focussing on significant investment in the wellbeing of the population, this will not only give impetus to a rapid short-term economic recovery but also contribute towards social cohesion, enhanced productivity and resilience to future pandemic events.

 

This article is part of a series from the University of Plymouth. For the second in the series, '"Peripheral" economies and the crisis', click here.

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