Radical incrementalism, the case for | The Healthiest Goldfish

On successfully achieving the goals of an aspirational public health.

It is not difficult to feel, these days, that we are living in a revolutionary moment that demands a re-ordering of the status quo and a re-thinking of how we structure our world. 2020 brought with it a novel coronavirus pandemic that claimed nearly seven million lives worldwide. The consequences of COVID-19 and the subsequent economic upheavals were not evenly felt, with their burden falling disproportionately on persons of color and persons with fewer socioeconomic resources, occasioning civil unrest that rivaled any the US has seen in the past 50 years. Three years on from the acute phase of the pandemic, we face again a presidential election with the potential to upend the status quo, with the perennially disruptive figure of Donald Trump possibly on the verge of a return to the White House. Living through this moment suggests indeed that much is awry with the world, that transformative change is needed to move us to a better place, and that the turbulence of the moment may provide a once-in-a-generation opportunity to bring about such a change.

Health, and the sharply felt divides that characterize it, has been at the heart of the storm we have lived through in the early years of the 2020s. The pandemic served as a powerful reminder of two long-ignored, yet fundamental, realities: Health is shaped by inequity, and poor health anywhere is—to borrow from Martin Luther King Jr.—a threat to health everywhere. It seems appropriate, therefore, to think of the pursuit of health as a catalyst for necessary transformations, for the creation of a world that is resilient to future pandemics, and one that apportions assets in such a way that the disproportionate burden of poor health does not accrue to a few groups, and that all have the opportunity to aspire to, and fairly achieve, a richly realized life, free of unnecessary and preventable illness.

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