The simple and clear structure of these stories is something I have always enjoyed. But in reading them over more recently, in the context of Vessel’s work, I’ve discovered a brilliant layer of subtext which I can only now appreciate. You see, in many ways, the issues Thackara identifies can be seen as the social determinants of health, or rather, as their precursors.
While there is no single definition of the social determinants of health, they can be generally understood as the economic and social factors that influence individual and group health in different populations. The list of determinants is similarly fluid, with different organisations and policy documents paying attention to different features of their respective societies. For the sake of a simple example, in 2003 the World Health Organisation, Europe included the following as determinants —
- The social gradient
- Stress
- Early life
- Social exclusion
- Work
- Unemployment
- Social support
- Addiction
- Food
- Transport
That the ten chapters of Thackara’s book and the social determinants of health seem so compatible, is in my estimation no accident. It’s easy to see for instance how issues like pollination, deforestation, and climate change do in fact bear heavily on food security, work, and migration, which in turn lead us to consider more obvious issues like unemployment, social support, exclusion, and addiction.
I like to think about Thackara’s globally ‘crowdsourced’ solutions to environmental problems like deforestation and water potability as addressing the environmental determinants of the social determinants of health. The solutions he describes are therefore not isolated environmental interventions, but measures that we could take to insure our societies themselves, against the burden of disease brought on by our global economy’s metabolic rift with nature.
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