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Recently, It has been observed that there is a strong tendency in public health to prioritise individual-oriented interventions over societal-oriented population-based approaches, also known as individualism in public health.
About Determinants of individualism
- Reasons for the dominance of individualism in public health.
- The dominance of biomedical knowledge and philosophy in the field of public health with a misconception that what is done at an individual level, when done at a population level, becomes public health.
- Aspect of ‘visibility’ of health impacts among the general public.
- Health effects are more visible and appear convincing at the individual level, wherein improvements at the population level will be clear only after population-level analysis;
- The public, and to a large extent, those public health experts who take individual experiences at face value, will make the same mistake of judging a population’s characteristics based on individual experiences; popularly known as an atomistic fallacy in public health.
- the market’s role and the effect of consumerism in public health practice.
- The beneficiaries for a programme become the maximum when 100% of the population is targeted.
- On the contrary, from a population perspective, the actual beneficiary will reduce to only 5%-10% in case of hospitalisation services and 20% of those affected with COVID-19 for treatment needs.
Issues and Concerns Linked to it
- A failure to examine and interpret public health problems from a population perspective is leading to ineffective and unsustainable solutions as far as complex public health problems are concerned.
- Pradhan Mantri Jan Arogya Yojana (PMJAY) under Ayushman Bharat is the largest health insurance scheme in the country covering hospitalisation expenses for a family for ?5 lakh a year.
- The goal is to ensure ‘free’ curative care services for all kinds of hospitalisation services so that there is no financial burden to the beneficiary.
- But the scheme has not focused on the need for hospitalisation services per year for any population.
- This is an individualistic response to the problem of hospitalisation expenditure faced by populations.
- Giving assurance to every individual without ensuring the necessary healthcare services to the population is not really helping in a crisis.
- COVID-19: Instead, by focusing on a vaccination programme for the entire population, again an assurance and a promise to every individual that even if you get COVID-19, you will not need hospitalisation and not die.
- All these operate in combination and, hence, can be detrimental to public health practice.
Conclusion and Way Forward
- Propagating individualism has always been a characteristic feature of a consumerist society as every individual can then be a potential ‘customer’ in the face of risk and susceptibility.
- All forms of individualistic approaches in public health need to be resisted to safeguard its original principles of practice, viz. population, prevention, and social justice.
- Despite the contrasting philosophy and approaches of clinical medicine and public health and the evidence that supports the latter and must be based on population characteristics and economic resources.
- Population-level analysis needs a certain level of expertise and orientation about society — an important skill required for public health practitioners
Mains Practice Question [Q] Explain the reasons and Impacts of the dominance of individualism in public health. |
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