Month: December 2024

I have written just over 500 columns over the past 10 years.This is my last weekly column, from now on I will be writing monthly colums, the last Sunday of each month

A goal worth pursuing: “achieving equitable health now and for future generations without breaching ecological limits.”

Dr. Trevor Hancock

23 December 2024

701 words

Throughout my career I have focused on the wellbeing of people in our communities and around the world, and on the state of the Earth’s ecological systems, which are the bedrock of our wellbeing. Recently, this has been encapsulated in the World Health Organization’s concept of a Wellbeing society, one that is “committed to achieving equitable health now and for future generations without breaching ecological limits.”

I strongly believe that this should be the highest aspiration of a society and the central purpose of governance.  As I noted in last week’s column, this requires a shift in the core values that underpin our modern society, and in particular our economy.

An important part of that shift is to re-align the private sector from its focus on making money to a focus on its role in achieving the societal purpose of wellbeing. In part that requires changing the purpose of a corporation. In a 2002 opinion piece in the independent news outlet Common Dreams, Robert Hinkley, an American corporate securities lawyer, wrote that after 23 years he realized that corporate law, “in its current form, actually inhibits executives and corporations from being socially responsible.”

His proposed remedy was simple; he suggests adding “26 words to corporate law”, which would create a “Code for Corporate Citizenship.” While a corporation “would still have a duty to make money for shareholders”, he would add “but not at the expense of the environment, human rights, the public safety, the communities in which the corporation operates or the dignity of its employees.”

But more broadly it also means changing the purpose of government and the broader process of societal and community governance, where governance, as UN Habitat puts it, is the “the sum of the many ways individuals and institutions, public and private, plan and manage the common affairs of the city” – or any other level of society.

Recently the International Standards Organization created “the first ever international benchmark for good governance.” Applicable to all organisations, including governments and corporations, it is intended to ensure that “organizations act with purpose, sustainability and society in mind.” It should be made a requirement for all governments and corporations in Canada.

The federal, provincial and territorial Cabinets should take as their central purpose the role of ensuring sustainable and equitable wellbeing for current and future generations. They should establish SHE (sustainable, healthy, equitable) policy units at the Cabinet level and in each Ministry to guide wellbeing policy – including a Wellbeing budget – and follow the lead of Wales by adopting a Wellbeing of Future Generations Act.

This Act establishes the right of future generations and puts planetary health and human wellbeing at the heart of governance. It requires ministries and national, regional and local authorities to establish and report on their sustainability goals, and creates the position of a Commissioner of Future Wellbeing to monitor and report on progress.

However, I am not confident that we can expect action will be led from the top, given the close ties between business and government. Much of my work has focused on the local level, on helping communities across Canada and around the world think about how to become healthy and sustainable.

Locally we have the example of One Planet Saanich, which works with organisations in Saanich on ways to reduce their ecological footprint to be equivalent to one planet’s worth of biocapacity, instead of the approximately four planets we use today, and to meet the ten criteria for One Planet Living established by Bioregional, a UK-based non-profit consultancy. But we are not really talking seriously about this.

At the regional level, here and across Canada and around the world, we need a well-organized and ongoing community-wide conversation about the future we want. What do we have to change to ensure a healthy, just and sustainable future for all who live here, for our descendants and for others around the world?

That is the aim of a small local NGO I have established, Conversations for a One Planet Region, and it is one of the areas I will focus on in my monthly columns. I can think of no more worthwhile and important task, and invite you to contribute to that work.

© Trevor Hancock, 2024

thancock@uvic.ca

Dr. Trevor Hancock is a retired professor and senior scholar at the                                            University of Victoria’s School of Public Health and Social Policy

• Published as ‘True wealth is much more than money and material goods

It includes the richness of our collective human development, the strength of our social capital and the health of our planetary systems

Dr. Trevor Hancock

17 December 2024

703 words

Last week I pointed to neoliberal ideology and economics as the fundamental flaw that has led us to ignore all the warning signs – in particular, that there are limits to growth – and instead pursue economic growth and increased wealth at all costs. That ideology also leads to a hyper-individualized, hyper-competitive, dog-eat-dog society that denies the benefits of community, the public sector, the environment and the common good.

Unfortunately, our current economic system is rooted in a narrow, short-sighted and incomplete understanding of what constitutes wealth. True wealth is not just the money and the stuff we accumulate, but three other forms of wealth or capital – human, social and natural capital. Together, they form what the UN calls inclusive wealth.

Human capital is the sum of our individual capacities, which includes not only our health status but our knowledge, skills and experience, our capacity for innovation and creativity, our capacity for caring and compassion. But while human capital is important, it does not stand alone, any more than individuals stand alone. We are a social species, and that sociability has been a key factor in our evolutionary success.

So a second form of wealth, closely linked to human capital, is social capital. While human capital is vested in individuals, social capital is all about the connections between us. Those connections begin with the informal web of social ties to family, friends, neighbours, work-mates and others that knit us together into communities.

There are also more formal forms of social capital: The massive investments we make in social programs – education, health, social services, unemployment insurance, recreation services and so on – that underpin our daily lives. Then there is what I call ‘invisible’ social capital’; the legal, political and constitutional infrastructure that previous generations spent centuries creating, helping us govern ourselves largely peacefully.

But all of this is underpinned by what is beyond doubt the most important form of wealth: the Earth’s natural systems that are the bedrock not just of our existence, but of life on Earth.  Scientists have identified nine Earth systems that are critical to life, but have also found we have crossed six of the nine planetary boundaries, meaning we have been depleting this vital form of wealth.

So our true wealth is much more than money and stuff, the stunted, distorted, narrow understanding of wealth extolled by neoliberalism. It includes the richness of our collective human development, the strength of our social capital and the health of our planetary systems. Real capitalists don’t just build one form of wealth – economic capital – by exploiting and harming the other forms of capital; they build all four forms of capital – human, social, natural and economic – simultaneously. Unfortunately, there are not many real capitalists out there.

But a healthy future for all requires us to reject the harmful values and ideology of neoliberalism and find alternative values and a way of life that is fit for purpose in the 21^st century. We need to recognize and apply the wisdom and truth of these words from the World Wide Fund for Nature, in their 2014 Living Planet Report: “Ecosystems sustain societies that create economies. It does not work the other way around.”

Living in accord with this simple principle will require a transformation in the distorted core values that underpin our modern economy, society and way of life, as I noted in a series of columns in June and July. The core values we need are, first, a reverence for the Earth and all it contains, an awareness of a connection to nature that is, at its heart, spiritual.

Second, we need a re-awakening of our sense of kinship with and shared responsibility for our fellow humans, a renewed sense of community. Third, we needto recognise that the economy is subservient to and in service to people and the planet, not the other way around.

These are the value shifts we need if we are to achieve a wellbeing society in which everyone thrives while we remain within planetary boundaries. Next week, in my final weekly column before I transition to a monthly column, I will look at how that might be achieved as a society and locally, here in the Greater Victoria Region.

© Trevor Hancock, 2024

thancock@uvic.ca

Dr. Trevor Hancock is a retired professor and senior scholar at the                                            University of Victoria’s School of Public Health and Social Policy

This is my 500th column After 10 years of weekly columns, I will switch to writing a monthly column in the New Year.

• Published as “Life expectancy has grown since 1970, but so has inequality”

In 2023, the bottom half of the world’s population got less than 10 per cent of global income, while the richest 10 per cent captured more than half

Dr. Trevor Hancock

10 December 2024

701 words

As I noted last week, I am committed to helping to create a healthy future for all. But I am greatly concerned that we are not on the right path to do that.

When I look back over the length of my career, it is clear that in many ways we have created a healthier future. One important indicator is life expectancy. According to Our World in Data, in 1970, when I was still in medical school, life expectancy at birth was 56.3 years globally and 72.6 years in Canada. Just over fifty years later, in 2023, it was 73.2 years globally, a gain of almost 17 years, while it was 10 years longer, at 82.6 years, in Canada.

While some of that gain is due to better health care – especially, globally, in improved maternal and child health – most of that gain is due to other factors: Improved sanitation, clean drinking water, adequate, safe and healthy food, improved education, better housing and so on. Together, these factors constitute the social determinants of health.

These gains largely result from economic development. World Bank data, cited by Our World in Data, shows the world GDP (in constant 2017 dollars) grew from $26.23 trillion in 1970 to $139.26 trillion in 2022, a 5.3-fold increase. So even though the world’s population roughly doubled over that period, from 4 billion in 1974 to 8 billion in 2023, global average GDP per person nonetheless grew; from $7,100 in 1970 to to $17,527 in 2022, an increase of almost 2.5 times.

But while this meant that many people, communities and nations could afford the better food, housing and education they needed, it has also resulted in a great increase in demand for those and other products. As a result, economic development has been an uneven two-edged sword – we have reaped the benefits, but we have sown a set of costs for future generations. Or as the Rockefeller-Lancet Commission on Planetary Health put it, we have “mortgaged the health of future generations to realise economic and development gains in the present.”

One of those costs has been high levels of inequality, both between and within countries. The latest data from the World Inequality Lab (WIL) shows that in 2023 the bottom half of the world’s population got less than 10 percent of global income, while the richest 10 percent captured more than half. In regional terms, the average income in North America is fifteen times greater than in Sub-Saharan Africa,

In Canada, the WIL reports, the top 10 percent earned 36 percent of national income in 2023.  While better than the global average, that level of inequality is “far higher than during the 1970s and even into the mid-1980s”; In 1985, for example, “the top 10 percent of earners earned 29 percent of national income.” So there has been a marked concentration of income – and thus of wealth and power – in the past 40 years or so.

Another important consequence of both population and economic growth and the resultant increase in demand is what the UN calls a triple planetary crisis of climate change, biodiversity loss and pollution. That is in turn part of a wider crisis in which, leading Earth systems scientists tell us, we have crossed planetary boundaries for six of nine key Earth systems (including the three in the triple crisis) and are approaching two of the remaining three.

Moreover, the world’s Ecological Footprint, which was equivalent to one Earth’s worth of annual bio-productive capacity in 1972, had risen to an un sustainable demand for 1.7 Earth’s worth by 2022.

So while economic development and growth have been a great benefit in many ways, that is no longer the case except in low-income countries, where many people still live in poverty, with their basic needs unmet. Indeed, what now stands in the way of a healthy future for all is continued old-school economic development in high and middle-income countries, and the distorted societal values that underlie this unhealthy neoliberal economic system.

That, and the creation of a positive alternative society and economy, is my focus for the next couple of weeks, and in the monthly columns that I will be writing, starting in the New Year.

© Trevor Hancock, 2024

thancock@uvic.ca

Dr. Trevor Hancock is a retired professor and senior scholar at the                                            University of Victoria’s School of Public Health and Social Policy

• Published as ‘Desire for better public policy sparked early ‘green’ parties’

The Values Party in New Zealand and the Ecology Party (initially called the People Party) in the U.K. were the world’s first two ecological political parties

Dr. Trevor Hancock

3 December 2024

699 words

Last week I wrote about three major shifts in perspective that took me from being a family physician to a broader concern with the health of communities, of societies and indeed of the global population and the planet itself. In my concluding major paper for my Master’s degree at the University of Toronto in the late 1970s, I identified two major principles that have guided my career ever since.

The first is ecological sanity. If you understand that there really is only one Earth, that we are one hundred percent dependent on the Earth’s natural systems for our very existence, and that there are indeed limits to growth – key points to emerge from the First UN Conference on the Environment in 1972 – then it would be insane to damage or destroy those natural systems. And yet, we do. So protecting and improving the health of the population – which is the raison d’être of public health – means protecting and restoring the Earth’s natural systems

The second principle is social justice, which has long been a guiding principle in public health. After all, public health’s goal is ‘Health for All’, where ‘All’ implies equity, fairness and inclusion. It means that while working to improve the health of the population or the community as a whole, public health particularly seeks to improve the health of the least healthy. And that means protecting the most vulnerable from health hazards, be they environmental, social or commercial.

Incidentally, looking back a few short years later, I realised I should also have included peace and non-violence as a third principle. There is no health in the midst of conflict, violence and war, as we so readily see today all over the world.

But I also became very aware of the role of public policy and governance – and ultimately, of political thought and action – in the creation of the conditions for health (or for illness). That led me to help develop what became internationally important ideas about ‘healthy public policy’ – public policy in all sectors, including in particular economic policy, that is good for health – and Healthy Cities; how to organise the governance of cities in ways that improve the health of the population.

That awareness also led to me becoming politically active in the 1980s. In its 1972 report ‘Blueprint for Survival’, The Ecologist noted: “Governments . . . are . . . refusing to face the relevant facts”, and called for “a national movement to act at a national level, and if need be to assume political status and contest the next general election.”

That made sense to me, and so when this call was answered in 1973, seven years before the German Green Party was founded, by the creation of the world’s first two ecological political parties – the Values Party in New Zealand and the Ecology Party (initially called the People Party) in the UK – I was there.

I became an area organiser for the People Party and attended the founding convention in Coventry in 1974, before coming to Canada in 1975. Here I began to look around for the equivalent and became part of a network of people working to establish an ecological political party in Canada. Eventually we succeeded and I became the first leader, helping to run the 50 candidates we needed in 1984 – I was one of them – to become a registered party (although I did not remain involved in the Green Party after about 1986).

There is one final important shift in perspective that I underwent in the mid-1970s, when I was introduced to ‘futurism’ by a fellow activist in the People Party. I quickly came to appreciate that good futures thinking is not about predicting the future, but in helping people think about the future they want (and the future they want to avoid) and then helping them to try to realise that future. 

In one way or another, then, I have been involved in thinking about and working on the health of the population and the environmental, social, economic, political and other determinants of health for over 50 years, and I remain committed to helping to create a healthy future for all.

© Trevor Hancock, 2024

thancock@uvic.ca

Dr. Trevor Hancock is a retired professor and senior scholar at the                                            University of Victoria’s School of Public Health and Social Policy

This is my 498th column and I am grateful for the platform the TC has provided me. But even though it has been a lot of fun — and a lot of work — all good things must come to an end.

Dr. Trevor Hancock

26 November 2024

700 words

Ten years ago, the Times Colonist (TC) published an editorial on preventive health care. As a public health physician focused on the health of the population I responded with a commentary in which I praised their focus on prevention but suggested that it did not go far enough. “Health care”, I wrote, “even preventive health care, is a relatively small contributor to the health of the population. This is because the main determinants of health lie beyond health care, in our communities and in our environmental, social, economic and political systems.”

I also suggested I could write more on this topic and Editor in Chief Dave Obee invited me to come in and talk with them. The result was this weekly column, which began on December 17^th 2014. The deal was sealed with a handshake, we never had a formal contract, and I have been very impressed both with that approach and with the fact that the TC has never once tried to push me to write about something, or not write about something, or even edit my work.

This is my 498^th column and I am grateful for the platform the TC has provided me. But even though it has been a lot of fun – and a lot of work – all good things must come to an end. I have decided that I will stop my columns at the end of the year, soon after I hit the 500 mark.

So in my remaining columns I want to first look back to the influences that have shaped my thinking and thus this body of work. Then I will look at what gets in the way of a healthy future for all, ending by laying out an agenda for a healthy future. This will require the creation of a wellbeing society that works within planetary boundaries, and at the local level the creation of healthy One Planet communities.

If you have been a regular reader of my columns you will know that while I trained in medicine, I later expanded my work to community health, healthy communities, societal wellbeing, planetary health and governance for health – public health, in short. Three major shifts in perspective took me there.

Looking back, I realised almost 30 years ago that one major shift in perspective lay in the year I spent in 1966/7 as an 18-year old volunteer teacher in Lundu, a small town in Sarawak, before I went to medical school. Only after I had spent over a decade as an international consultant helping cities and towns around the world learn how to create healthy cities and communities did I realise – when I went back to Sarawak in 1996 – that Lundu was where I first learned that health did not come from medicine alone, but from the community as a whole.

A second major shift in perspective came while I was still a medical student in London. I had started reading a new and somewhat radical magazine, The Ecologist. That made me very aware of the First UN Conference on the Environment, which was held in Stockholm in 1972.

A key conference book told us there is ‘Only One Earth’, while the Club of Rome told us there are ‘Limits to Growth’. But even more important, for me, The Ecologist published a special report for the Stockholm conference, Blueprint for Survival.

In it they were blunt in stating “if current trends are allowed to persist, the breakdown of society and the irreversible disruption of the life-support systems on this planet, . . . certainly within the lifetimes of our children, are inevitable.” That helped me to begin to recognise the health implications of global ecological changes.

A third major shift came when I came to practice family medicine Canada in 1975. The year before, the federal government’s Lalonde Report recognised that health care was not the most important determinant of health, stating “future improvements in the level of health of Canadians lie mainly in improving the environment, moderating self-imposed risks and adding to our knowledge of human biology.” That helped open my eyes to the importance of looking beyond health care and moved me towards a career in public health.

© Trevor Hancock, 2024

thancock@uvic.ca

Dr. Trevor Hancock is a retired professor and senior scholar at the                                            University of Victoria’s School of Public Health and Social Policy