One Bridge to Collective Health: Neighborliness
by Carolyn Raffensperger, executive director
Consider the possibility that the bridge between your individual health and public health is neighborliness. By neighborliness I mean treating members of your community with care. Literally, “doing unto others as we would have done to ourselves.”
I’ve been thinking about neighborliness and what it entails ever since watching Minneapolis carry out the care of their neighbors with exquisite, dedicated compassion during the immigration raids. Need food? A Ride? Babysit kids? It was done, on a large scale and over a comparatively long time. It seems that Minneapolis has lessons for us about public health, because wasn’t that what they were practicing? True public health with every act of care. People who were hungry or scared had someone, often a stranger, step in to alleviate their suffering.
SEHN has worked at the nexus of medicine and public health since its inception in 1994, drawing the connections between toxic chemicals and rising trends of ill health including birth defects, cancer, and asthma. It is hard to prove that any single cancer is caused by an exposure to a carcinogen, but epidemiologists can begin to pin down cause and effect by looking at patterns of disease in populations, communities, and yes, neighborhoods.
We are dependent on a large web of life to sustain us. Our health depends on our animal (human and otherwise), vegetable and mineral neighbors. Wendell Berry said that “health is membership.” As members of a community, we have responsibilities to other members, and they to us. These responsibilities flow from the precept that we have rights with each other as much as we have rights to things like free speech. Actually, the right to a clean and healthy environment as recognized by the United Nations and several states in the U.S. cannot be fulfilled in isolation, cut off from each other and the natural world.
The idea of having rights held in common with other neighbors both human and the wider natural world is expressed in the U.N. Declaration of the Rights of Indigenous Peoples Article 7 that says that Indigenous peoples have the “collective right” to live in freedom, peace and security. Collective rights bind people together in a connected web of reciprocity: if our health is dependent on the health of the Earth and that of our next-door neighbor, then theirs is also dependent on ours. It is this sense of reciprocity that can guide our individual medical choices.
How so you might ask?
A place to start is to take opportunities to prevent disease in the first place. All cultures have disease prevention practices—things we all know from when we were little children, things like washing your hands after you go to the bathroom. In addition, we can make decisions about actions such as vaccination in light of our neighbors. My choice to get a measles vaccine is not only a choice to protect myself, but it is a choice to protect my neighbor.
Imagine making medical choices with an eye to how it might affect your elderly neighbor or the asthmatic baby across the street.
That leads to the age-old question of “who is my neighbor?” The philosopher Ivan Illich wrote about the parable in the New Testament where Jesus is asked that question. Illich answers it this way: “You can recognize the other (hu)man who is out of bounds culturally, who is foreign linguistically, who—you can say by providence or by pure chance—is the one who lies somewhere along your road in the grass and create the supreme form of relatedness which is not given by creation but created by you.”
We create public health through this supreme form of relatedness, by our choices: whether it is while we are sitting in the doctor’s office or advocating with a politician for clean air and clean water.