The World Health Organisation defines health as a state of complete physical, mental and social well-being. The conditions in which people live, the air they breathe and the salary they earn all influence this state. A broken window that lets in disease transmitting mosquitoes, drinking water rich in heavy metals, and social exclusion have all been strongly linked to poor health outcomes. The research behind these factors, the environmental and social determinants of health, has increasingly widened our understanding of what health is and how health can be maintained and promoted.
Economic determinants of health refers to “strategies and approaches used by the private sector to promote products and choices that are detrimental to health”, this includes tobacco advertising or the lobbying of big soda. It is a term inherently critical of the neoliberal paradigm of individualism and the unfettered availability of choice so dominant in the Western world.
It is clear the impact of health stretches into every aspect of public life, politics and even economics. Yet, public discourse still lacks a strong health perspective, a major reason being the way media reports on the issue. Like the commentary on the spike in suicide rates in post-austerity Europe, health reporting tends to occur only after things have gone terribly wrong. They seldomly touch on health topics outside a narrow biomedical frame, for example, not considering how social housing or tax cuts may have unintended health consequences.
Many journalists have a background in political science, cultural studies or business but very few have technical expertise in health. Unsurprisingly, health perspectives are rarely included in editorial discussion, leaving critical gaps in our understanding of how policy decisions impact health outcomes. In response to this issue, doctors and health experts need to move beyond the clinic and begin to engage in discourse traditionally thought to be beyond the biomedical sphere. By actively engaging with the media (blogging or offering op-ed pieces to newspapers) health experts can push medical perspectives on to the editorial desk.
There is a need for doctors and health experts to engage and raise our voices more often, by doing so we can help inform and influence policy decisions. One could even think of writing as just another way for a doctor to meet their responsibility of improving patient and citizen health. Such voices, coming from such as respected profession, may even help to re-establish the trust in media and elevate the status of writing as a career.
I am a doctor who works as a medical journalist. When I disclose that, people very rarely say: “Well, great that there are doctors doing journalism”. Instead the reactions range from sheer curiosity to “Why on earth would you give up the most wonderful job in the world for … um … writing?” I hope that you’ll join me.
Medical Writer at the leading German weekly DIE ZEIT