Individualism approach in Public Health

In News 

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