Health and the Pursuit of Joy

Public health is all about trying to create a healthier world. In the course of doing this, we should at times point out our own shortcomings in promoting health, and then the effect of creating a system that is totally health-related may seem to be so fundamental to disease. Thus, we often find ourselves discussing the disease, its causes, and consequences, and this conversation is necessary for the work of public health.

However, the question is: Could this focus our attention on the challenges at the expense of focusing on the most positive aspects of health and ways to lead a happy life?

It's worth taking a moment to discuss how public health can refine its focus to illustrate the positive side of it, which lies at its core.

Sometimes this positivity can be missed and misunderstood by people. Some messages seek to curb behaviors that can lead to illness, prevent harm, and include statements starting with: "You shouldn't do this", "You shouldn't drink alcohol, you shouldn't smoke, or you shouldn't overeat."

Such statements are intended to provide a model of behavior that supports a long healthy life. However, they can also be seen as taboos that hold back pleasure, joy, and contentment that are the very essence of life.

Some may dismiss it as a secondary issue in comparison to more important priorities. Yet, there may be risks using the wrong tone, ending up in excluding the audience it is supposed to serve, thus weakening the effectiveness of public health.

After what we witnessed during the COVID-19 pandemic, the threat it posed showed that people were accepting public health messages during the past year as never before. But even under these circumstances, there's still resistance to public health, which indicates that for some it's an attempt to limit freedom and enjoyment, even in the midst of the pandemic, and that it should be resisted.

The irony is that limiting freedom and enjoyment is the exact opposite of what public health keeps an eye out for. The real intention is to ensure that as many people as possible live a long, free, and active life with interactions that bring them happiness. However, such a life is only possible if we are healthy by preventing the disease standing between us and the pursuit of a happy life.

So, is there a better approach for public health to take? Could it adjust its image to align with its mission to promote happiness and meet human needs?

Of course, by adopting three ideas:

First, it can provide a definition of health that is essentially positive:

This means bringing into view that the advice of public health is, at its core, aimed at enjoyment, not at limitation.

To illustrate, we can compare the advice provided by public health with that of safety signals in swimming pools. The latter mention phrases such as “Do not drink pool water”, “Do not swim alone” or “Avoid diving in shallow places”.

Such prohibitions may be necessary and realistic, but the way they are presented in the form of a series of strict statements makes them as easy to ignore as most people do.

Imagine the difference it could make to include a friendly request on the off-limits list, which is the essence of why people came together in the first place? Adding a nice phrase like "Have fun in the water" without annulling any of its other important warnings can ensure that the sign is observed and that the warnings ultimately working for all swimmers are adhered to.

We can promote public health just the same and maintain the key messages that it tries to communicate but with positive elements that explain why we care so much about health, for us to have more fun in life.

This leads to a second idea. We have to promote health not as an end in itself, but as a means to live a happy life:

When we talk about health as a prevention of diseases only, it means that disease is actually the thing that dominates our conversation about health. When health is not an end but a necessary step in the journey towards a full life, then the conversation about health becomes associated with all the positive factors that enrich this life.

Talking about health in this way would be a major departure from the way most people discuss health. This is because our significant investments in physicians and medicines in the United States reflect the great value we place on health as an end in itself, as it is priceless.

Changing course means a fundamental shift in what we talk about when it comes to health, and the key to making this change in storytelling will be as a way to broaden our imagination of what health is.

Using the analogy of investing in a car can often be good to illustrate the idea:

imagine buying a fancy car, spending loads of money maintaining it, ensuring it can run smoothly, and then keeping it in the garage forever.

This car is like our health. We strive to keep it in good shape, but we forget that its purpose is to travel. Public health aims - if we use the same analogy - to keep the car in good shape, build good roads and beautiful scenery at the same time, and do everything in its power not only to have a nice car, but also to have a nice trip. This is the positive story that we should tell in order to best deal with the public.

Finally, we can revisit the language of public health measures to focus more on the positive side of health as a means of living a long and happy life:

The meaning of the term Disability Life Year Rate (DALY), a common public health term, is defined as the number of years of life lost due to some form of disease or injury, and the years spent living with a disability or deterioration in health as a result of this circumstances is illustrated below.

It's also a powerful tool for calculating the effects of various health challenges, but its focus is also on the disease that we aim to prevent at the expense of the joy and pleasure that we hope to provide. A useful counterpoint is measuring the number of potential years of life gained and the number of years spent in prime health as a result of adhering to public health guidelines.

This could shift our attention from focusing on death and disease to also focusing on the positive aspects of life that we hope to support through our work.

Public health, when it focuses on preventing disease rather than promoting pleasure and joy, runs the risk of people becoming convinced it seeks to deprive them of activities that bring pleasure and joy.

In disease prevention, we should not lose sight of the fact that pleasure is everyone's right, and the celebration of pleasure should be at the heart of public health work. This positive focus is necessary to interact more effectively with the people it serves.

By balancing the focus of public health on disease prevention with the emphasis on promoting joy, public health can become better at doing both, so that it can take appropriate measures to achieve the goal of supporting health.