2 PART POLITICAL ECONOMY OF PUBLIC HEALTH 4 Ethics, Politics and Ideologies: The Invisible Hands of Public Health 5 Neo-liberalism, Globalisation and Health 102 79 There is much merit in economic progress, but there is also an overwhelming role for intelligent and equitable social policies. Amartya Sen, Nobel Prize-winning economist, 2001a, pp. 343-4 Public health exists to make people and their communities healthier through change. Few people would disagree with the goal of promoting health but most would argue about how it should be achieved. Part 2 considers the political economy of public health. Interpretations of political economy are informed by people's values, experiences and ideologies, which are defined by Evans and Newnham (1992, p. 135) as 'sets of assumptions and ideas about social behaviours and social systems'. Consideration of competing ideologies and values can help explain why public health strategies do or do not succeed, which can reduce the frustration of public health practitioners when a strategy that made perfect sense from their ideological perspective is not accepted or does not work in a particular setting. Tesh (1988) has argued that political beliefs and values have a defining influence on people's often implicit notions of disease prevention policy, and that this influence is exerted through 'hidden arguments'. She sees these implicit assumptions as fundamental: 'What is the legitimate source of knowledge? What is the nature of human beings? And what is the ideal structure of society?' She comments: 'Firmly, but often unconsciously, held answers to these questions guide scientists, policy makers, and ordinary citizens alike to different constellations of facts about the causes of disease and, hence, to different preferences for prevention policy' (Tesh, 1988, p. 3). Copyright @ 2015. Oxford University Press. All rights reserved. This idea about differing pathways leading to differing understandings affects all public health activity. The values and politics within a society help people to interpret and make sense of seemingly objective facts. Recognition of these values is important 77 Baum, Fran. The New Public Health, Oxford University Press, 2015. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/latrobe/detail.action?docID=4786467. Created from latrobe on 2022-08-07 01:40:05.
78 PART 2: POLITICAL ECONOMY OF PUBLIC HEALTH and their role in public health policy should be openly debated. Indeed, their central importance to public health suggests that practitioners would benefit from clarifying their own values, determining how they affect their world view and by being aware of the values and motives driving other players. Useful questions to pose in the analysis of public health situations are: 'who gains and who loses by any particular action?' and 'whose knowledge base is being used to support a particular course of action?' Some students may express frustration with the relativities and uncertainties expressed in this part of the book. It is clear that public health is as much an art as a science. Some public health practitioners have approached their work as though it were a value-free activity based on proven scientific 'fact' and tried and tested practice. Others, particularly those with some training in the