Part five
health of the people The health of the people is in many ways a reflection of the health of a society. Good health is a basic need, and access to good health care is a basic right. It is acknowledged as a central part of the contract between state and citizen in many countries, even if in much of the world it has no traction and no reality. The ability to provide proper health care is a sign that at least part of the energy of the society is put towards caring for its members. So in many countries, the inability – or in some, the refusal – to provide proper health care is a sign of how far society has to go before it is really upholding ordinary citizens’ well-being. The other side of this coin is less about collective action and more about the individual. For good health is not only a result of the care that people receive from properly trained personnel in properly equipped clinics and hospitals, it is also a result of the care we take of ourselves. Care for ourselves and care for others, when balanced, are intimately bound together. Even where large-scale provision for health care is possible and achieved, people’s health and longevity can still vary significantly. And countries that, if judged by wealth alone, have very different capacities for providing health care for their populations sometimes turn out to have very similar results, because of how resources are organized and how people take care of their own health. Malnutrition persists, and the number of undernourished people in a world that steadily gets richer has remained stubbornly steady for two decades – albeit in a rising population so the proportion of undernourished is falling. But the opposite problem, obesity, is now a global epidemic. It is one of the life-style ailments of a changing world, contributing to serious diseases. The deficiencies revealed by the persistence of undernourishment are largely about scarcity and inadequate resources to maintain a decent and healthy way of living. On the other side, part of the problem revealed by the obesity epidemic is the difficulty people have escaping the trap of their own appetites and patterns of consumption. These are often not just social habits but effective physiological dependence on the animal fats and sugars that cheap processed foods contain. 88