We Don’t Have a Health Problem, We Have a Village Problem

Post-industrial societies often lack the social embeddedness that citizens require to fully participate in the civic, environmental, and economic life of their communities. Such erosion of the social fabric represents a social and health hazard. Growing awareness, among clinicians and their health allies, of this social malaise and its correlation with poor health outcomes has led to an increased focus on population health and community approaches. It has also given rise to some new health programmes aimed at demedicalising and relocating the emphasis towards socialisation, such as social prescribing, which is concerned with referring patients into community-based activities.

While reversing medical overreach and promoting a social model of public health [1] is to be strongly endorsed, in this paper, however, I contend that social prescribing falls significantly short of challenging the dominant medical model, which is primarily focused on managing sickness [2], not health promotion or the broader agenda of population health. Community building following the principles and practices of Asset-Based Community Development is, I propose, a more comprehensive and compelling alternative. The community building approach advocated here views health as tied to socio-political, economic and environmental conditions, and while not discounting the value of individual agency, it asserts the need for collective agency for health creation and the pursuit of social and economic justice for all. Hence, I argue we do not have a health problem per se, we have a village problem.

 

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[1,2] Cormac Russell, (2020) Community Medicine, Vol. 1, Chapter 1, pp. 1-12.