Redistributing power, money and resources will improve wellbeing

(Published as “A progressive tax on all forms of wealth would reduce inequality”)

Dr. Trevor Hancock

22 March 2022

700 words

A few weeks ago, before Russia invaded Ukraine and began committing war crimes that have shocked the world (in a way that should have but, to our shame, did not shock the world when Russia did the same thing in Chechnya and Syria), I was writing about inequality and health, in the context of creating a Wellbeing society.

So even though innocent people are still being butchered by Putin and his terrorist army, I will return to this topic because the problem remains and must be addressed, both in Canada and globally.

To refresh your memory, the World Health Organization (WHO) is championing the creation of what it calls Wellbeing societies, in which equitable health is achieved within the ecological limits of the Earth. ‘Equitable health’ is not the same as equal health, but is about ensuring we all have a fair opportunity to be healthy, minimizing inequality as much as possible.

Inequality has health consequences: As the WHO Commission on the Social Determinants of Health memorably put it in 2008: “Social injustice is killing people on a grand scale”.  Thus high levels of inequality are incompatible with a Wellbeing society.

But inequality does not just happen. Instead, as the World Inequality Report 2022 (WIR) noted: “Inequality is a political choice, not an inevitability.”  That political choice is not only killing people on a grand scale, it is creating much social strain and mental and physical ill health through poverty, marginalisation, social exclusion and alienation, resulting in what Nobel Prize-winning economist Sir Angus Deaton calls the ‘diseases of despair’. 

The WIR notes “the period from 1945 or 1950 till 1980 was a period of shrinking inequality in many parts of the world”.  But at the same time, and perhaps contrary to our usual modern expectations, these were also times “of fast productivity growth and increasing prosperity, never matched since” for the countries of the West.

The report goes on to note: “The reason why that was possible had a lot to do with policy—tax rates were high, and there was an ideology that inequality needed to be kept in check, that was shared between the corporate sector, civil society and the government.”

That all changed with the advent of neoliberalism as the dominant ideology, first implemented by Margaret Thatcher in the UK and Ronald Reagan in the USA. As a consequence, the report notes, “contemporary global inequalities are close to early 20th century levels, at the peak of Western imperialism”. The result, says Deaton, a self-professed believer in social democratic capitalism who is now chairing a review of rising inequalities in the UK, is that “I think that today’s inequalities are signs that democratic capitalism is under threat”

To address this, as the 2008 WHO Commission put it in one of its three key recommendations, we have to “tackle the inequitable distribution of power, money, and resources”. Thirteen years later, the WIR made much the same point: “addressing the challenges of the 21st century is not feasible without significant redistribution of income and wealth inequalities.”

 So how should that be done?  The World Inequality Lab, source of the WIR, has what is really a very simple proposition: “a modest progressive wealth tax on global multimillionaires.” They point out that wealth – or at least, one form of it, namely property – is already taxed pretty much all over the world. But they point out it is a flat tax, not progressive – the very rich pay the same rate on their property as the average citizen. Moreover, much of the wealth of the very wealthy is in stocks and bonds and other forms of wealth, not property.

So their recommendation is to expand the property tax to encompass all forms of wealth, not just real estate, and to make it progressive. Such a tax, they find, ranging progressively from 0.6 percent to 3.2 percent of total wealth, would generate $1.74 trillion each year, or 1.6 percent of total global incomes, that could then be “reinvested in education, health and the ecological transition”.

As they note, “it would be completely unreasonable not to ask more of top wealth-holders in the future, especially in light of the social, developmental and environmental challenges ahead.”

© Trevor Hancock, 2022

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

Freedom for the sharks, not the minnows

(Published as “Freedom from regulation helps sharks at the expense of minnows”)

Dr. Trevor Hancock

15 March 2022

696 words

Last week I wrote about ‘healthy’ and ‘unhealthy’ freedoms in the context of the Ukrainian fight for freedom from tyranny, compared to the so-called ‘freedom convoy’ that is seeking, Putin-style, to impose their idea of freedom upon us. But there is a level of ‘unhealthy freedom’ that is far worse, in terms of direct health impacts, than that exhibited by these ‘freedom convoys’; the freedom of people and corporations to make money by harming others.

The most obvious example is the tobacco industry, which has until recently been left free to make money for its investors by selling an addictive product that, when used as intended, kills and sickens people in large numbers. But we have seen similar stories in many other industries, most notably in the recent epidemic of drug overdoses, due in large part to the massive marketing of opioids.

Then there are the alcohol, fast food and other industries that have large adverse health impacts; the fossil fuel industry that keeps trying to expand and still tries to confuse the public on the science of climate change – a technique they took directly from the tobacco industry; the pesticide and other chemical companies whose products harm the ecosystem as well as human health, and a whole host of other industries and products that quite legally do harm.

The freedom to harm others for profit is the sort of freedom espoused by libertarians and neoliberals. These freedoms, which Guardian columnist George Monbiot, in an April 2016 column, called the freedom of the pike (I would say ‘sharks’), often come at the expense of what he calls the minnows.

He wrote: “Freedom from trade unions and collective bargaining means the freedom to suppress wages. Freedom from regulation means the freedom to poison rivers, endanger workers, charge iniquitous rates of interest and design exotic financial instruments. Freedom from tax means freedom from the distribution of wealth that lifts people out of poverty.”

These ‘freedoms’ have another consequence; we have become obsessed with the need to get stuff cheap – at any price. As Monbiot notes, it leads to driving down wages and benefits to reduce costs and increase profits. Bizarrely, the ‘right to work’ movement beloved of American Republicans and their supporters involves weakening the power of unions to protect the rights, wages and working conditions of workers, attracting investors to their state to employ people in low wage, low benefit jobs.

The minnows are seduced into supporting such laws, which create jobs but make them worse off while feeding the sharks. But it also strengthens their need to get stuff cheap, because their wages are low, making this a self-reinforcing and self-fulfilling process.

Another consequence of the need to get stuff cheap is shipping jobs off-shore to low-wage economies to reduce costs; the result is not just low wages, but no wages. But it’s not only jobs that get shifted offshore, so too are toxic production processes and dangerous work. Following the logic of neo-liberalism, they go to places where regulations are less stringent and less enforced, thus avoiding the expense of safer production, to the detriment of the health of the local population and the environment.

The neo-liberal sharks, it seems, have been successful in pulling off a neat trick. In the name of populism, they have established a powerful political movement that encourages the minnows to support policies diametrically opposed to their own interests. This is what happens when money becomes the prime value in society. We facilitate and support the system because we save or make money from it – and we don’t really care where it comes from or who gets hurt in the process, as long as it’s not us.

But as Monbiot warned: “Perhaps the most dangerous impact of neoliberalism is not the economic crises it has caused, but the political crisis. As the domain of the state is reduced, our ability to change the course of our lives through voting also contracts.” Neoliberalism erodes democracy, and it erodes the power of the state to aid the weak and vulnerable, to support their freedom to achieve a good life, to thrive. It is the freedom of the sharks, not the minnows.

© Trevor Hancock, 2022

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

Freedom: The real deal v infantile foot stomping

8 March 2022

Dr. Trevor Hancock

700 words

For the past two Sundays I have joined thousands of others in rallies to stand with Ukraine, support the Ukrainian people and condemn the war criminal in the Kremlin. And on both occasions, we have also seen members of the ‘freedom convoys’, the people protesting vaccines, masks and other mandates. (I won’t call them truckers, that would blacken the name of the vast majority of truckers who have paid attention to the science, understand their social responsibility and have been respectful of the law.)

So I have been musing on these very different aspects of ‘freedom’. On the one hand, the freedom of the Ukrainian people from war, invasion and true tyranny; on the other, freedom from “being asked to wear a piece of paper over their nose and mouth to protect others”, as Dee Snider, former frontman of the heavy metal band Twisted Sister, recently put it. In the 1980s he wrote a song, We’re Not Gonna Take It, that has recently become a resistance anthem for the Ukrainians. But it has also been used by anti-maskers: Mr. Snider approved of the former using his song, but not the latter.

When asked why, he tweeted: “Well, one use is for a righteous battle against oppression; the other is infantile feet stomping against an inconvenience.” In a recent interview on CBC Radio’s ‘As it Happens’ he elaborated further: “One group are fighting for their lives against oppression and tyranny for real. It’s a life and death situation”. The other group, as I already noted, are upset about wearing masks: “It’s just so ludicrous”, he added.

From a public health perspective, I find it useful to distinguish between what might be called healthy and unhealthy freedom. Healthy freedom enables people to fulfil their potential, to flourish. It includes freedom from hunger, fear and, of course, war. But it is rooted in a sense of community. It recognises that one has an obligation to protect the freedom, lives, health and safety of others – and not just others in one’s own family and community, but in humanity is a whole.

Thus it is a constrained freedom, linking freedom with duty, responsibility and obligation. Healthy freedom is not absolute; you do not have the right to harm me, and as a society we have a duty to protect people from the harmful activities of others. You can’t drive on the left because you feel like it, you can’t drive while drunk or ignore stop signs and red lights. Your freedom to smoke, we used to argue, stops at my nose. Or more relevant today, your freedom to make noise stops at my ear.

Unhealthy freedom is when people feel they are free to act in ways that harm others. At its simplest, you are not free to kill others, it is against all moral codes and laws – although there are clearly exceptions even to that; legitimate defensive war, self-defence and where it still exists, legally sanctioned executions. And you don’t have the right to endanger others by ignoring mandates for mask-wearing, vaccine passports or immunisation.

Society, in the shape of public health officials and governments, have put these restrictions in place because, based on what is known, they are likely to protect the majority of the population, including especially the more vulnerable members of society. Where possible, there have to be reasonable accommodations, and nobody wants to restrict freedom any more or for any longer than is deemed necessary. However, freedom is not absolute, there are reasonable limits in a democratic society.

These two sorts of freedom are about to be vividly contrasted in Victoria, it seems. According to a March 7th CHEK News story, a ‘freedom convoy’ is on its way to Victoria from Thunder Bay. The story quotes James Bauder, one of the organizers of the Ottawa occupation, stating “We’re coming to defend your lawful freedom of choice”, adding “We’re going to be occupying that area for two to three months” because the NDP and Liberals have “had their way for too long.”

Sounds disturbingly familiar? This is the same arrogant and shameful rationale behind Putin’s criminal invasion of Ukraine. We can do without that sort of ‘freedom’ being imposed on us!

© Trevor Hancock, 2022

Dr. Trevor Hancock is a retired professor and senior scholar at the

University of Victoria’s School of Public Health and Social Policy

No health without peace

Published as “Here’s how you can help Ukraine — and the world”

1 March 2022

Dr. Trevor Hancock

701 words

I write my weekly columns a week or so before they are published, and submit them five days ahead. So when I wrote my column last week, while there was always the possibility of Russia invading Ukraine, there was still some hope that the Madman of Moscow would not actually do so.  But as I write this the invasion is in full swing, and who knows what the situation will be when it is published – but it does not look good.

I cannot possibly write a column right now about anything else to do with the health of the population, when we are faced with one of the gravest threats to peace I have seen in my 73 years.  A threat to peace is not only a threat to health but to life itself, whether locally or, in the event of nuclear war, globally. Which is why peace is listed first in a short list of prerequisites for health in the 1986 Ottawa Charter for Health Promotion, which is the key founding document for the work that has been the focus of my career.

What is happening in Ukraine is horrifying, as is all war. Indeed, we should not forget that there are equally horrifying international wars underway in Yemen and Ethiopia and numerous other smaller or internal wars around the world. But what makes the Ukraine war so troubling is that Vladimir Putin has compounded his war crimes by fairly explicitly threatening the use of nuclear weapons.

I was 14 at the time of the 1962 Cuban missile crisis and recall the real fear we all had that nuclear war would be unleashed. While we avoided it then, the fear was omni-present, and was crystallised by a 1966 mock-documentary called The War Game, which I saw in my final year of high school. It graphically depicted the run-up to and aftermath of a nuclear attack on Britain and it made me a supporter of nuclear disarmament.

Fifteen or so years later, as a public health physician working for the City of Toronto’s Department of Public Health, I helped the Department undertake a health impact assessment of a one megaton nuclear airburst above Toronto, as part of an international project coordinated by International Physicians for Prevention of Nuclear War (IPPNW). The findings were horrific, as one would expect, and were of course the same around the world. The public awareness that resulted helped move the USA and Russia towards some degree of nuclear disarmament, and won the IPPNW the Nobel Peace Prize in 1985.

These large global geopolitical issues, this violence on the other side of the world, can leave us feeling over-whelmed and helpless, fearful and anxious – although it is of little import compared to the enormity of the fear and stress Putin has imposed on the people of Ukraine, of course, nor the stress experienced by their families and friends around the world.

So on the basis that the antidote to our fear and anxiety – and our outrage – is action, what can we do at a personal level to help the people of Ukraine, and in the process help ourselves? Here are some ideas. Attend rallies in support of Ukraine. Boycott all Russian goods until Russia withdraws – and beyond that. Donate to recognised disaster relief charities  – check with the Ukrainian Congress Canadian or donate through Canada Helps, which manages donations for thousands of legitimate charities –  

Write, phone or e-mail your MP and the Prime Minister  insisting the government support Ukraine in every way possible, including by supplying lethal armaments, and that it seek to brand Putin a war criminal and hold him accountable.

If you have friends or contacts in Ukraine, ask them what you can do. And if you have friends or contacts in Russia, help them understand what Putin is doing and how the world is reacting, because he is keeping them in the dark. If you are a member of an organisation of any sort with international links, see if there are ways to work through that organisation to support Ukraine and to reach out to and inform ordinary Russians about what is happening.

Because there is no health without peace.

© Trevor Hancock, 2022

Dr. Trevor Hancock is a retired professor and senior scholar at the

University of Victoria’s School of Public Health and Social Policy

Increased inequality was a political choice we must reverse

22 February 2022

Dr. Trevor Hancock

701 words

Given the well-documented relationship between high levels of inequality and poor health and social outcomes in high-income countries, which I discussed last week, high levels of inequality cannot be tolerated. But as I also noted last week, the World Inequality Report 2022 states simply: “Inequality is a political choice, not an inevitability.”

The Report’s authors tell us that in the countries of the West, the period between the end of the Second World War and about 1980 was one of “fast productivity growth and increasing prosperity”, and at the same time “a period of shrinking inequality in many parts of the world”. What kept inequality in check, the Report notes, was policies that ensured minimum wages, promoted unions, kept taxes on the wealthy high and regulated business and the economy.

But “income and wealth inequalities have been on the rise nearly everywhere since the 1980s, following a series of deregulation and liberalization programs which took different forms in different countries.” This, of course, was the neoliberal revolution spearheaded by Margaret Thatcher in the UK and Ronald Reagan in the USA, which rolled back the policies that had contributed to low levels of inequality

As a result, we now find inequality rising to levels not seen since the early 20th century. Around 1900, globally, the ratio of the income of the top 10 percent and the bottom 50 percent was more than 16 to 1, but by 1980 this had fallen to 8.5 to 1; today it is back up to 15 to 1, notes the Report.

Things were considerably better here in Canada: In 1900 the ratio was a bit more than 3 to 1, dropping to 1.5 to 1 by 1980. But nonetheless, the Report notes, “income inequality in Canada has been rising significantly over the past 40 years”, and now sits at about 2.5 to 1, due to a combination of “financialization, deregulation and lower taxes.” (Financialization, states Investopedia, is “the increase in size and importance of a country’s financial sector relative to its overall economy”, adding that it “has played a major role in the decline of manufacturing in the U.S.”)

In a 2016 article critiquing neoliberalism, George Monbiot – an eloquent social critic and a columnist for The Guardian in the UK – notes that the neoliberal era has been characterised by a transfer of wealth from the poor to the rich. This is accomplished through “the smashing of trade unions, tax reductions, rising rents, privatisation and deregulation.”

A political ideology that favours privatisation, he notes, results in the rich acquiring public sector resources “such as energy, water, trains, health, education, roads and prisons”, and then charging ‘rent’ (a form of unearned income) for their use, either by private individuals or by the state. Similarly, he writes, the wealthy “acquire increasing control over another crucial asset: money”; they can then charge interest for loans, another form of rent that transfers wealth from the poor to the rich.

Another important but less recognised consequence of neoliberalism is pointed out in the World Inequality Report: “Nations have become richer, but governments have become poor.” In fact, the Report points out, “The share of wealth held by public actors is close to zero or negative in rich countries.” This amounts to a transfer of wealth from the public to the private sector, with serious consequences: “The currently low wealth of governments has important implications for state capacities to tackle inequality in the future, as well as the key challenges of the 21st century such as climate change.”

The creation of rising levels of inequality was a clear political program, a set of policies explicitly intended to increase private wealth and offload responsibility on to the individual. This must be reversed, for the sake of societal wellbeing and future generations.

One obvious way is to re-introduce higher and more progressive levels of income tax; another is to bring in or beef up a wealth tax; a third is to increase corporate taxes. While these may seem radical ideas, in reality they would simply be a return to the way things were in the 1970s, prior to the disaster of the neoliberal revolution. Next week, I will explore some of these proposals for reform.

© Trevor Hancock, 2022

Dr. Trevor Hancock is a retired professor and senior scholar at the

University of Victoria’s School of Public Health and Social Policy

High levels of inequality incompatible with a Well-being society

15 February 2022

Dr. Trevor Hancock

698 words

Alongside an ecologically unsustainable economic system and way of life, the world faces a second grand challenge; a socially unsustainable level of inequality within and between nations and communities. High levels of inequality are incompatible with a Well-being society, which the World Health Organization’s Geneva Charter for Well-being defines as one with equitable health.

Health inequalities are greatly influenced by the level of inequality in society, as noted by Richard Wilkinson and Kate Pickett in their 2009 book ‘The Spirit Level’. They showed clearly that in high-income countries, for a range of health and social outcomes, it is not the level of GDP that affects how well they do, but the degree of inequality within the country; the more unequal they are, the worse they perform.

Inequality is corrosive: As French philosopher Raymond Aron has said: “When inequality becomes too great, the idea of community becomes impossible.” That is also true globally: “bonds across countries do not work when bonds within them are broken”, noted the UN’s recent report ‘Our Common Agenda’.

Which brings me to the World Inequality Report 2022, released in December 2021. The report is published by the World Inequality Lab, based in France, whose major funders include the European Research Council, the Paris School of Economics, the Ford Foundation and a number of universities and research centers.   

The report focuses on several aspects of inequality, including both income and wealth inequality as well as gender inequality; unusually, it also focuses on inequalities in carbon emissions, which of course ties inequality directly back to an unsustainable way of life, especially when much of the world seems to want to emulate the ‘lifestyle of the rich and famous’.

Globally, the richest 10 percent of the population takes 52 percent of global income and holds 76 percent of total wealth. Meanwhile, the poorest half of the population earns 8.5 percent of global income, while holding a mere 2 percent of global wealth.

Moreover, the report notes “Income and wealth inequalities have been on the rise nearly everywhere since the 1980s, following a series of deregulation and liberalization programs” – in other words, neoliberalism. The authors also point out that “wealth is a major source of future economic gains”, so this increasing concentration of wealth “presages further increases in inequality.”

Indeed, if we look at the top 1 percent globally, we see an extreme concentration of wealth and economic power: “between 1995 and 2021, the top 1 percent captured 38 percent of the global increment in wealth, while the bottom 50 percent captured a frightening [that is to say, frighteningly low] 2 percent.”

This inequality is also reflected in the share of carbon emissions: “the top 10 percent of emitters are responsible for close to 50 percent of all emissions, while the bottom 50 percent produce 12 percent of the total.” More dramatically, the top 10 percent in North America not only emit more than seven times the emissions of the bottom half, per person, they also emit more than twice the amount of the top 10 percent in Europe.

The situation for Canada is only marginally better. The top 10 percent took 40 percent of income and held 57 percent of wealth, while the bottom 50 percent took a mere 15 percent of all income and held not quite 6 percent of total wealth. At the very top, the top 1 percent took almost 15 percent of all income and held one quarter of all wealth.

Canada’s carbon emissions are telling: While the bottom half in 2019 emitted 10 tonnes per year, the top 10 percent emitted 60 tonnes, and the top 1 percent an astonishing 190 tonnes, ten times the national average. Even worse, while the bottom 90 percent have reduced their emissions by about 4 tonnes per person, the top 10 percent actually increased their emissions by the same amount!

But perhaps the most important statement in the report is this: “Inequality is not  inevitable, it is a political choice.” So it does not have to be this way. Next week, I will explore some of the policy responses needed to quell this obscene increase in inequality and the resultant extreme imbalance in power and influence.

© Trevor Hancock, 2022

Dr. Trevor Hancock is a retired professor and senior scholar at the

University of Victoria’s School of Public Health and Social Policy

A Wellbeing society requires achieving equitable health

Published as “When it comes to health, inequality is inevitable, but inequity isn’t”

Dr. Trevor Hancock

8 February 2022

701 words

The World Health Organization’s December 2021 Geneva Charter for Well-being expresses “the urgency of creating sustainable well-being societies, committed to achieving equitable health now and for future generations without breaching ecological limits.” So far, I have mostly focused on the need to stay within ecological boundaries and to create an economy that takes such boundaries into account, while still ensuring a social foundation for all.

Here I turn to the second key element of such a society: Equitable health. Equity refers not to equality in health but to fairness in creating the pathway to health. We will never have equality in health, if by that we mean equal levels of health throughout our lives, for a variety of reasons.

To begin with, there are genetic differences – we are not clones – and sex-based differences; as a man, I don’t experience all the risks of pregnancy and childbirth, or face the possibility of ovarian cancer, for example. Then we all have different formative experiences growing up in our families, among our peers and in our communities, which may be shaped by discrimination based on gender, race, income or other factors. On top of that we have different life experiences; some of us have tragic accidents or meet up with infectious diseases that others do not, and so on.

But one of the most important factors determining our health is our level of wealth and income and all that comes with that; the quality of our environment, housing and neighbourhoods, the quality and availability of education, health care and other services, the opportunities and privileges we get or the barriers and exclusions we face. It is in the area of these socio-economic and related inequalities that equity becomes important.

Both globally and within nations, health inequity – unfair and unjust inequality – is rooted in inequitable economic and social arrangements. We see it in higher mortality rates and lower life expectancy between rich and poor both within and between countries, as well as in inequalities in health between Indigenous and non-Indigenous people in Canada and many other countries. “Social injustice”, the 2008 final report of the World Health Organization’s Commission on the Social Determinants of Health stated, “is killing people on a grand scale”.

Health equity, then, means having equal opportunity, a fair chance to have good health and a good life; given that we will never have equal health, it also refers to inequalities that are considered socially acceptable. Addressing inequity often entails a hand-up of some sort, social support and affirmative action programs intended to level the playing field. And that is another key point about equity and inequity in health; while inequality rooted in genetic and other biological differences may not be remediable – we will always have inequality in those circumstances – inequity is or should be avoidable, preventable.

A classic illustration of an equitable response to inequality is the image of three children – tall, average height and short – trying to see over a wooden fence to watch a baseball game; only the tall child can see over the fence. If we have three boxes and treat the children equally by giving them each a box to stand on, the average size child can now see over too, but the short kid still can’t. To make it equitable, we have to give two boxes to the short child, one to the average height kid and none to the tall one; now all three can see. (In a final refinement of this image, if we replace the barrier of the wooden fence with a chain-link fence, all can see and no boxes are needed – the removal of systemic barriers for all.)

The World Inequality Report 2022, released in early December 2021, is directly relevant to the idea of equitable health in a Well-being society. Noting that “contemporary global inequalities are close to early 20th century levels” and that “inequality is a political choice, not an inevitability”, the authors stress that “addressing the challenges of the 21st century is not feasible without significant redistribution of income and wealth inequalities.”

This includes the challenge of creating Well-being societies that enjoy equitable health. So next week, I shall look in more depth at this important and troubling report.

© Trevor Hancock, 2022

Dr. Trevor Hancock is a retired professor and senior scholar at the

University of Victoria’s School of Public Health and Social Policy

Towards a Wellbeing economy for Canada

(Published as “GDP needs to be replaced with more meaningful indicators”)

Dr. Trevor Hancock

1 February 2022

700 words

Last week I described the growing global attention to the concept of a Well-being society and economy. The latter has already been the focus of work by several national governments. In particular, Aotearoa New Zealand was the first country in the world to develop and present a Wellbeing budget, as I noted in my June 9, 2019 column.

At that time Prime Minister Jacinda Ardern commented “while economic growth is important – and something we will continue to pursue – it alone does not guarantee improvements to our living standards”. This theme was taken up by the Finance Minister, who noted that instead of focusing on “a limited set of economic data”, with success defined by “a narrow range of indicators, like GDP growth”, this new approach measures success in line with New Zealanders’ values – “fairness, the protection of the environment, the strength of our communities”.

These themes have continued, with Budget 2021 “continuing to place the wellbeing of current and future generations of New Zealanders at the heart of everything we do”. The Budget starts by reporting on the wellbeing of New Zealanders, which “is underpinned by stocks of the four capitals as set out in the Treasury’s Living Standards Framework: human capital, natural capital, social capital, and financial and physical capital”.

Note that wealth is understood here in the same terms as is proposed by the UN and other important groups, in terms of inclusive wealth – it’s not just about the money.

Since then, several more governments have started down this path. An October 2021 update from the Wellbeing Economy Alliance (WEAll) notes “the Wellbeing Economy Governments (WEGo) group now consists of five key governments: Scotland, Finland, Iceland, Wales and New Zealand”. The update also mentions that both Canada and Norway have started some work on a wellbeing framework.

Here in Canada a start has been made by the federal government, which included a report, “Toward a Quality of Life Strategy”, in the April 2021 Budget papers. This was a result of the Mandate Letter for the Associate Minister of Finance directing them to “better incorporate quality of life measurements into government decision-making and budgeting, drawing on lessons from other jurisdictions such as New Zealand and Scotland.”

Gratifyingly, the Budget paper reports that public opinion research conducted by the Department of Finance in August 2020 (amidst the first wave of Covid) found that while just over half of Canadians “feel that stronger growth in Canada’s GDP is important to their day-to-day life”, more than 4 in 5 “feel that measures beyond economic growth” are important.

These other factors include “health and safety, access to education, access to clean water, time for extracurricular and leisure activities, life satisfaction, social connections, and equality of access to public services”, the Department noted.

So not surprisingly, “nearly three quarters (71%) of respondents feel it is important that the government move past solely considering traditional economic measurements like levels of economic growth, and also consider other factors like health, safety, and the environment when it makes decisions.” Clearly, the Canadian public is well ahead of the political and business elite when it comes to measuring progress and understanding what matters.

Of course, the government can also lean on and learn from many years of work on a Canadian Index of Wellbeing (CIW), now housed at the University of Waterloo. The Index creates a single number based on performance across eight domains of wellbeing and quality of life. Its most recent report, published in 2016, covered the period from 1994 to 2014. Over those 20 years, it found that while GDP grew 38 percent, the CIW only grew by 10 percent. Clearly GDP growth does not translate very well into improved quality of life.  

While the development by the federal government of a quality of life framework is a useful start, what now needs to happen is for the government to replace the GDP with these more meaningful indicators, and start producing proper Wellbeing budgets

As the recently established Wellbeing Economy Alliance for Canada notes, “A well-being economy depends on a re-imagination of societal purpose that enshrines what makes life worth living and a thriving planet.” That is the sort of society we must strive for.

© Trevor Hancock, 2022

Dr. Trevor Hancock is a retired professor and senior scholar at the

University of Victoria’s School of Public Health and Social Policy

A well-being society needs a well-being economy

24 January 2022

Dr. Trevor Hancock

702 words

Last week I discussed the first of three actions that are needed in order to create a Well-being society, according to the World Health Organization’s (WHO) Geneva Charter for Wellbeing: Valuing, respecting and nurturing nature. This week I turn to the second: Design an equitable economy that serves human development within planetary and local ecological boundaries.

In the face of growing disquiet that our current economic system massively harms the Earth’s natural systems while creating excessive inequality and insecurity for many, there is growing interest in the idea of an economy that puts people and planet first. While long the focus of the work of ecological economics, such an approach to economics has been marginalised and largely ignored in mainstream economics, business operations and government policy until recently.

Instead, neo-liberal economics has become the orthodoxy, especially since the era of Margaret Thatcher and Ronald Reagan. Neo-liberal economics enshrines selfishness and greed as the driving forces of the economy, and material wealth, GDP growth and shareholder profit as the goals of a society where the economy is the centre of concern.

Impacts on people’s health and social wellbeing and on the environment that sustains them, whether locally or globally, are of secondary concern. In fact, they are considered ‘externalities’ and largely excluded from consideration “for no better reason than because we have made no provision for them in our economic models”, noted the respected ecological economist Herman Daly.

This leads to a fantasy economy, where GDP can grow both by selling tobacco and treating illnesses caused by tobacco; where profit can be made both by ignoring pollution regulations and by cleaning up the mess afterwards; where growth can continue even though we already exceed the limits of the Earth’s natural systems; where the rich get richer while the poor have a decreasing share of wealth and income.

But if we make money by making people sick or even killing them, by damaging or destroying communities or undermining the Earth’s natural systems that underpin our existence, in what conceivable way can we be said to have profited? How has our well-being been improved?

Happily, a growing number of key institutions recognize the limitations of the current model. Of particular interest are recent developments at the UN and among some national governments, perhaps including in Canada (the jury is still out on that). Here I will deal with recent UN reports, next week I will discuss national developments in Canada and elsewhere.

In a September 2021 speech introducing his report ‘Our Common Agenda’ to the UN’s General Assembly, UN Secretary General Antonio Guterres noted: “GDP fails to account for the incalculable social and environmental damage that may be caused by the pursuit of profit”. The report itself went further, commenting: “Absurdly, GDP rises when there is overfishing, cutting of forests or burning of fossil fuels. We are destroying nature, but we count it as an increase in wealth.”

Guterres also called for a new way to measure progress, one that values “the life and wellbeing of the many over short-term profit for the few.” A UN Environment Program report from February 2021, ‘Making Peace with Nature’, goes further, spelling out some of the ways in which we need to re-design the economy.

This re-design includes incorporating full natural capital accounting, so when we deplete the Earth’s natural resources we count it as an economic loss, not a gain. That is one part of switching to measuring ‘inclusive wealth’, which is “the sum of produced, natural, human and social capital” – real wealth means increasing all these forms of capital at the same time.

Other key steps include governments moving “away from environmentally harmful subsidies”; ensuring “investments in sustainable development are financially attractive”; taxing harmful things, such as resource use and waste, rather than socially beneficial things such as production and labour.

These and related social measures spelled out by the WHO, such as decent and secure work, fair trade and inclusive social protection systems, are the basis for creating a Well-being economy and society. It is a clear call to put people and planet before profit and to re-define what business we are in as a society – it must be the economy of the future.

© Trevor Hancock, 2022

Dr. Trevor Hancock is a retired professor and senior scholar at the

University of Victoria’s School of Public Health and Social Policy

What is a ‘well-being society’? For starters, one that values planet Earth

18 January 2022

Dr. Trevor Hancock

701 words

In the more than 40 years I have spent working in public health I have been guided by a key realization and two principles. The realization was that medicine, in which I was trained, while important, is not the main factor that contributes to good health. What matters most are our environmental, social and economic conditions and the cultural and political values that shape those conditions, which in turn shape our choices and behaviours.

The two principles that have guided my work came from thinking about the fundamental principles of public health. In an article published in 1980 I concluded they are what I then called ecological sanity and social justice; today we would say sustainability and equity. They deal with the two great external forces that shape our lives and health; the social (which includes the economic, because after all the economy is a social construct) and the environmental – both natural and built.

Medicine, meanwhile, is largely focused on the third great shaper of our health – human biology – and to a lesser extent on mental and social well-being, largely at the individual level. This is not to say physicians and other health professionals in clinical practice are not interested in or working to address the broader social and environmental conditions, many of them are. But it is not the main focus of their work, as it is for me and most other public health professionals.

Thinking this way led me to work on what we call the ‘upstream’ social and environmental conditions in which we lead our lives, whether at the local or the global level. At the local level, this is all about how we create ‘healthy communities’, while at the national level it is about how we create what the World Health Organization, in the Geneva Charter for Well-being, is now calling a ‘Well-being’ society.

This means focusing on “creating sustainable well-being societies, committed to achieving equitable health now and for future generations without breaching ecological limits”. There are several important points to note here: The focus is on health and well-being as the outcome of such a society; health status within the society is equitably distributed (which is to say, socially just and fair); there is a concern for future generations, and all this is done within the ecological limits of the one planet we have.  

The Geneva Charter goes on to propose five key areas for action, two of which are concerned with achieving universal health care and addressing the impacts of the digital transformation of society now underway.  But I want to focus here on the first three action areas, which are valuing, respecting and nurturing planet Earth and its ecosystems; designing an equitable economy that serves human development within planetary and local ecological boundaries, and developing healthy public policy for the common good. All three of these are dramatic departures from our current practices, and are essential if we are going to ensure good health for all on this planet, now and for future generations.

Starting with the first, valuing, respecting and nurturing nature will require us not only to put nature at the heart of all our decision-making, but at the heart of all our thinking. We have become divorced from nature, we have lost sight of the simple fact that all the things we need for life – air, water, food, materials, fuels and much else – ultimately come from nature. As the Geneva Charter states, “a healthy planet is essential to the health and well-being of current and future generations.”

Thus we need to re-establish a reverence for nature, to see it not simply as a set of resources put there for our benefit and to make money from, but as a sacred trust that we must pass on in good condition to future generations. There are also spiritual dimensions to this; most if not all faiths include some form of reverence for creation and it is a core belief for Indigenous people around the world.

‘Valuing nature’ can also mean putting an economic value on nature, and indeed that is one of the key elements of the second action area, the creation of a well-being economy, to which I turn next week.

© Trevor Hancock, 2022

Dr. Trevor Hancock is a retired professor and senior scholar at the

University of Victoria’s School of Public Health and Social Policy