Health as a system, not luck

Health is often thought of as luck: lucky with your genes, you are healthy; unlucky, you are ill. There is a grain of truth in that, but a small one. A far larger part of health is a system, not a lottery.

Medicine treats diseases, but health is mostly created outside the hospital. It is shaped by everyday things: sleep, movement, food, clean water, air, the level of stress, and even whether there are people nearby who care about you. A doctor matters when something has broken; but most breakdowns are laid down years before the visit.

From this follows an uncomfortable conclusion: health is largely a matter of environment and habits, and therefore partly a matter of justice. Someone working three jobs and living by a highway objectively has less “default health” than someone with time and a park outside the window. So caring for a nation’s health is not only hospitals, but cities, food, and working conditions.

My opinion: the most underrated medicine is prevention and common sense. Small daily decisions are boring and unheroic, but it is they, not a miracle pill, that decide what your health will be in twenty years.