Public Health is the new bottom line

   Counting the blessings and lessons of the Covid-19 pandemic, I’d top my list with a renewed public appreciation of public health.

People around the world have been willing to quarantine themselves not just for self-protection but for the public good. We don’t know if we are carriers so if we can stay home, we do. It’s a stunning pause from me-first America. Suddenly we’re back in the territory – for a brief moment – of a national mobilization against a common enemy, with shared dislocation and mutual aid. Next thing you know we’ll be growing victory gardens for community security in a potentially extended recession.

Can this be bottled, like a sweet perfume of social love. Anchored somehow in culture or law? Can public health become the new normal?

The gifts of financial independence

In my recent post, FI, FIRE and Covid-19; are we better set for this virus, I explored the benefits of financial sufficiency, security and savings for weathering disturbances, be it pandemics or other threats. In it, after extolling all the virtues of FI (financial independence), I noted that this sub-culture is much better at personal responsibility than social responsibility. We put on our own oxygen mask, so to speak, and then head out for whatever private pleasures we desire.

What would an ecological economist say about systemic approaches and policies to prepare for pandemics and other upsets. I called Eric Garza, a student of Robert Costanza and Josh Farley. We recorded our conversation here. Note: it gets juicier in the second half. This post comes from our shared discovery of where and how economics and public health meet.

Governments are now implementing – albeit temporarily – policies considered, just weeks ago, too progressive. Bernie’s agenda of paid sick leave, Medicare for All and free college looks nigh on to centrist now that vulnerable people have avoided testing due to the cost, and have gone to work potentially already infected because they are too financially insecure.  Paid sick leave, free access to necessary testing and treatments – this is public health, not welfare doled out along with disdain and stinginess.

The need for public health agencies and research and rapid response teams could not be more vivid. Suddenly, government looks crucial. Leadership is crucial. Foresight is crucial. Science is crucial. Facts are crucial. Every man for himself doesn’t work in a pandemic. It makes us weak, brittle, cruel and desperate.

Public spirit is also on the rise. Through Facebook Groups, through crowdsourcing of ways to keep small businesses flush, needs are being met. I am stunned by the social learning going on, the clever workarounds, the spontaneous care for others, the willingness to serve. I just spent $90 at a local business I deemed too pricey just a month ago. Now I have gifts and greeting cards for the year.

Public Health. What is that, really? It’s not just the services of research institutions, public education, medical professionals, hospitals, equipment, medicines, emergency rooms, insurance and such. It’s a healthy public. The question arising now is: What can we do, as a society, to support a healthy public?

I’ve been grateful beyond measure for my financial resiliency. I have savings, multiple streams of income (some passive, some earned), no debt, skills, networks, freedom. I’ve modeled and taught this for decades, but financial independence is getting a stress test now and coming through with flying colors.

People who’ve used our tools develop attitudes and practices that I wish everyone had. They treat debt like the plague and get out as soon as possible. They have an emergency fund equal at least to 2 – 6 months expenses. They have passive income. They have foresight. They plan. They sacrifice impulse buying in service to longer term financial goals. They tell themselves the truth about their behavior and when they wander off the path, they get back on their financial pony and recalibrate. They ride the market waves better because they can see long term trends. This is especially evident now in the FIRE (financial independence retire early) community. Those invested in index funds have studied long term market trends and are calmly staying the course.

In the presence of Covid-19, they are not anxious, afraid, unable to cope. And they have plenty of toilet paper because they anticipate their needs and bought 2 dozen rolls when they were on sale. In January.

This can sound like gloating, but it’s meant to illuminate that financial stability is crucial for public health. It reduces anxiety, increases preparation and allows self-quarantining.

Stability, Sufficiency, Savings, Security

Stability, financial or emotional, has another public health benefit. People who own a home – or at least have a stable home base where they can nestle in – build social networks locally. They volunteer, serve on boards, provide services, join clubs, make friends, weave their lives into a fabric called community.  This builds social trust and a social safety net where mutual aid blossoms when people, families or the whole community is under stress. With this pandemic, my community is like an organism, intuiting needs and filling them, assuring local businesses they stay in business, double donating to local service and care organizations. This is the world I want to live in – minus a pandemic.

Public health, then, could be financial solvency and stability for everyone. It would lower public and private fear by many notches. Even without sane government policies – which we must have – people could pull money out of their rainy day fund to tide them over. How can such financial security be incentivized as a public health necessity? Here’s a sketch, coloring in TK:

1. Capitalism and consumerism should be seen for what they are – a public health threat much like drugs, alcohol and military style assault rifles. Since consumerism is what props up nearly 75% of our economy and keeps the whole stuff-machinery running, addressing this public health emergency won’t happen any time soon. However, governments can:
   1. incentivize saving money, and
   2. penalize institutions that deal unsecured debt to people who don’t have the wherewithal to pay, and
   3. mandate middle and high school competencies in basic money skills like;
      1. putting condoms on your credit cards,
      2. comparison shopping,
      3. creating a spending plan (everyone sign up for You Need a Budget App and software),
      4. keeping a spending diary
2. Welfare should return to it’s original meaning: health, happiness and good fortune for a person or a group. Everyone deserves welfare. The welfare state means well-being for its citizens. This is what Bhutan understood when it lifted its Shangrila veil and let the world in. The king declared that Gross National Happiness would define success in every decision in his country, not Gross National Product. Oh, may we have a flourishing of pro-active, not just defensive tactics, policies that promote well-being. Freedom Dividend, Single Payer affordable health care, free K-16 education, paid vacation without electronic leashes, citizen rights to life, liberty and the pursuit of happiness. Add in the measures now undertaken in the face of the virus – paid family leave, sufficient unemployment insurance, paid sick leave, paid vacation without electronic leashes, free testing no questions asked – and you start to see a public welfare policy that might not stop a virus, but will lower stress, facilitate compliance with contagion directives, and increase resilience.

Public health is inner calm and outer cooperation

Eric’s particular fascination is learning to self-regulate your nervous system to stay calm and compassionate. Watch the video for his deeper dive. Here I will point to this as a dimension of public health, of making sure everyone in society has maximal resilience.

There are many ways to self sooth, to back out of anxiety and calm yourself, meditate, observe rather than react – any and all of which makes you able to problem solve, attend to what matters most, regain the essentials for responding well: compassion, perspective, reason and a good sense of humor. Mindfulness based stress reduction techniques are already taught to vets and in recovery programs. Some schools teach a version of this. Even learning to take 3 deep slow breaths when anxious can do a world of good. Imagine graduating from high school knowing how to breath, observe thoughts without attaching to them, stretch, close your eyes for a minute, saying your self soothing phrase (like “this too shall pass”) and other anxiety first aid. Imagine teacher training including this.

This is public health as surely as coughing into your crooked elbow. One of the blessings of eastern meditation techniques coming to the west in the 20th century is that these techniques have been translated from esoteric language to simple practical tools that require no religious affiliation to use.

To these self-regulation techniques, we added the Social-Emotional Learning now entering the schools. SEL includes skills of self-observation but also skills of speaking about feelings without aggression, cooperation, compassionate listening, and other tools that allow people to work together and socialize without letting personal triggers hijack groups. Imagine future emergencies – floods, fires, environmental refugees – in which everyone had some training in communicating and cooperating skillfully, often in the absence of designated authority figures. This is surely public health.

A friend just wrote on Facebook about a conversation with a young person who refused to heed public health warnings because she needed her job for rent and food and couldn’t self-quarantine. They came up with a temporary income solution, and discussed how each of us matters and has a role in all of us surviving this.  Slowly the young person shifted from recalcitrance to willingness to do her important part in keeping everyone safe. Imagine if everyone had the skills, since grade school, of that kind of compassionate communication.

Public Health is a well society

To the left is a first fuzzy sketch of the elements we discussed that contribute to public health:

Public Health says, “You matter. We all do better when we all do better. We each have an important role in society that doesn’t inhibit our personal self expression but includes and focuses that.”

Public: we are a we, a society, a group of people together for a purpose, a group with habits, rituals, customs, laws that keep us together because we need each other. We are not just a random group of individuals competing for dominance. We are a we.

Health: our birthright and our aspiration. Well being, happiness, prosperity, ability to create and achieve such that we each add to the vitality of the whole – isn’t this the point?

Anything that violates Public Health should be restricted. Anything that promotes Public Health should promoted. My friend Stephan Schwartz studies the research on well-being. All indicators point to that with well-being as a bottom line, outcomes are improved. Make well-being the bottom line for all policies and choices and everything else – sufficiency, safety, health, happiness, prosperity, creativity, service, families, community vitality – will come.

Imagine if the respect for Public Health that Covid-19 has engendered grabs hold of our sense of who we are together and what we want from our society so we can all play a meaningful role for a more resilient world. Put public health at the center, and policies and practices array around it like a shining star.