When we think of health care, we tend to think mainly in terms of patients, health-care providers and payers. In contemporary society, however, health can no longer be viewed solely through the lens of patients, providers and payers or even as purely an individual’s responsibility.

We believe that an essential component of health care that is often overlooked is political choice which affects social, cultural and economic indices of entire communities and nations. The acknowledgement of health as a political matter recognises the significant impact of governmental decisions, policies, and resource allocation on the health and well-being of citizens. This column delves into the concept of health as a political choice, highlighting the interconnectedness of political systems, public policies, and health outcomes, and emphasising the importance of collective action for improving population health.

Interdependence of politics and health

Health is intricately linked to politics, as political decisions can directly influence access to health care, the availability of material and human resources, and the social determinants of health. Policy choices such as health-care funding, health-care workforce recruitment, infrastructure development, medical equipment import and foreign exchange regulations, environmental regulations, and social welfare programmes play pivotal roles in shaping population health outcomes. A government’s prioritisation of health initiatives, investment in health-care systems, health-care workforce and commitment to public health measures reflect its stance on the health and well-being of its citizens.

Political determinants of health

Just as there are social determinants of health, political determinants also significantly impact health outcomes. Political stability, governance effectiveness, and transparency can directly influence the allocation of resources, the quality of health-care services, and the implementation of evidence-based health outcomes and quality measures. Moreover, political decisions related to education, employment, housing, and social welfare can either exacerbate or mitigate health disparities within a population. For example, policies aimed at reducing income inequality and providing equal access to education and employment can have long-term positive effects on health outcomes.

Health inequalities and social justice

Health as a political choice is closely intertwined with issues of social justice and health inequalities. Political decisions that perpetuate disparities in health-care access, health outcomes, and social determinants of health create inequitable conditions that disproportionately affect the elderly, women, poor and other marginalised communities. Disparities in health are often reflective of deeper societal inequities, including racial, socio-economic, age, and gender-based disparities. Recognising health as a political choice demands a commitment to social justice, aiming to eliminate health disparities and ensure equitable access to good quality healthcare and other essential resources.

Public health advocacy and citizen engagement

To achieve health as a political choice, it is essential for citizens to actively engage in political processes and advocate for health-promoting policies. Public health advocacy empowers individuals, communities, and organisations to bring attention to health issues, lobby for policy changes, and hold political and civic leaders accountable. Engaged citizens can drive collective action and demand policies that prioritise preventive healthcare, promote healthy environments, and address social, economic and political determinants of health. Through active engagement, citizens can shape political agendas that prioritise health and well-being.

Conclusion

Health as a political choice recognises the critical role of political systems, policies, and resource allocation in shaping population health outcomes. Acknowledging the interdependence of politics and health urges governments to prioritise health initiatives, invest in health-care systems, and promote equitable access to health care and essential resources. Moreover, it highlights the importance of addressing social determinants of health, reducing health inequalities, and ensuring social justice. To achieve health as a political choice, it is crucial for citizens to actively engage in advocacy for health-promoting policies, and work collectively towards a society that prioritises the health and well-being of all its members, including the most vulnerable.

Dr Ernest Madu, MD, FACC and Dr Paul Edwards, MD, FACC are consultant cardiologists for the Heart Institute of the Caribbean (HIC) and HIC Heart Hospital. HIC is the regional centre of excellence for cardiovascular care in the English-speaking Caribbean and has pioneered a transformation in the way cardiovascular care is delivered in the region. HIC Heart Hospital is registered by the Ministry of Health and Wellness and is the only heart hospital in Jamaica. Send correspondence to info@caribbeanheart.com or call 876-906-2107.