WHOSE RESPONSIBILITY IS IT?


Social progress and the individual’s potential for fulfilment is built upon the foundation of good health. Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. When you are healthy, the pursuit of dreams and aspirations is possible and indeed fulfilling. Without health however, dreams are likely to become nightmares on the bed of affliction and the potential for happiness slowly but surely ebbs out of the soul.

Clearly, good health is or should be a desirable goal. Longevity is a dream everyone aspires to and yet few people will debate the notion that longevity loses its appeal if a significant portion of it is spent bedridden and dependent on others for basic activities of daily living. Health therefore should be looked at not only in terms of longevity but also in terms of quality of life.

But on what factors does health depend? In our contemporary times, the dominant factor seems to be the availability of modern health care facilities. This is not surprising considering the fact that discoveries in medical science underlie the significant improvements in infant and under-five mortality rates as well as the general upward surge in the expected life expectancies at birth in many nations. It is also generally true that countries with the highest life expectancies at birth tend to have better health care facilities than those without.

The health care system, however, is only one of many ways of maintaining
and improving health. Of equal or greater importance in increasing the health-adjusted life expectancy (HALE) has been the raising of the general standard of living, important sanitary measures for protecting public health, and the adoption of healthy lifestyles.

Economic progress generally correlates with a higher standard of living and better health. But on the dark side of economic progress are counter-forces that collectively represent ‘diseases’ or the ‘social ills’ of affluence. They include environmental pollution, stressful city living, habits of indolence, the abuse of alcohol, tobacco and drugs, and eating patterns which put the pleasing of the senses above the needs of the human body. Eating, in particular, has become a social indulgence with a confused significance. One would have thought that the essence of eating would primarily be to replenish lost energy and equip the eater for work. The Preacher observes “Blessed are you, O land, when your king is the son of nobles, and your princes feast at the proper time – for strength and not for drunkenness!” – Ecclesiastes 10:17. But how do we explain the observation that we eat at parties, eat at funerals, we eat when we are happy and need to celebrate, we eat when we are depressed and need comfort, we eat when we are born and doctors recommend to the terminally ill – make him comfortable, let him eat whatever he desires. It seems whatever the occasion, you can never go wrong when you eat. The Preacher’s observation describes this well “All the labor of man is for his mouth, and yet the soul is not satisfied” – Ecclesiastes 6:7. One wonders why we behave like this. Of all the rights we cling to in our modern world, we seem to have stuck with the unspoken one – ‘the right to choose our own poison’.

Economic progress certainly presents us with a paradox – a higher standard of living that generally translates into better health but on the other hand we are presented with the opportunity to indulge our senses till we are robbed of the quality of life that should accompany the longevity. There is no denying the fact that the largest economy in our world also has the largest proportion of obese individuals.

A conceptual framework of health is therefore vital in our pursuit of longevity and a better quality of life. But whose responsibility is it? Is it the government, the health professional or the individual himself who must take responsibility for his own upkeep? A closer look at the health matrix suggests a combined approach. Health experts have suggested several avenues by which health may be improved. These include the environment, lifestyle, health care services and human biology.

It is also important to consider the fact that efforts to attain longevity and quality of life must address the three principal causes of death among humans and indeed all living things – disease, injury (usually from trauma) and aging. In contemporary times, the maximum human life span is held to be in the region of 120 years. The longest life on record in the modern world is that of a French woman, Madame Jeanne Calment, who died in 1997 at 122 years. It would appear then, technically, that death before 120 years should be considered premature. But disease is not the only agent that may rob us of valuable time on the planet. Of equal or perhaps greater importance is trauma – accidents, violence, disasters, terrorists, call it what you like but the world is loaded with it and the statistics bear testimony.

Of the three causes of death, aging, in terms of time spent on the planet, is not within our direct control but the others are. How then do we manipulate the factors upon which health depends in the midst of the causes of death to achieve the desirable result?