Health systems in an era of biophysical limits: the wicked dilemmas of modernity

Abstract

Modernity is characterized by social complexity, the development of the nation state, disembedded processes of market exchange, an intrinsic logic of growth, increasing throughputs of energy and materials, and an expanding range of environmental impacts. Modern health systems reflect, at every level, the process of ‘disenchantment’ associated with reductive scientific rationality, as well as an ontology of methodological and analytical individualism, which privileges the integrity of the ‘body’ as opposed to networked ‘figurations’ of linked individuals within nested ecological systems. Biophysical limits to growth present a systemic challenge to all aspects of modern society, including health systems. Opportunities for an alternative ‘low-throughput’ health system would center on reconciling wicked dilemmas of modernity, including (1) the increasing vulnerability of high-overhead, materially and energetically intensive global healthcare systems funded through the welfare state in a future defined by ecological limits to economic growth, and (2) the diminishing returns of a curative health system that treats individual human bodies while incurring negative health outcomes at the level of society and ecology.

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Correspondence to Katharine Zywert.

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Zywert, K., Quilley, S. Health systems in an era of biophysical limits: the wicked dilemmas of modernity. Soc Theory Health 16, 188–207 (2018). https://doi.org/10.1057/s41285-017-0051-4

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Keywords

  • Modernity
  • Limits to growth
  • Degrowth
  • Health systems
  • Wicked dilemmas
  • Karl Polanyi