Social Capital, Social Determinants and the

(Solidarity) Right to Health

Social Capital - Defined

• Physical capital, human capital, financial capital

• Lean and mean: Social networks and associated norms of reciprocity and trust

• Has benefits for individuals, communities, and the people connected with them – Health promoting

• Public good: Non excludable and non-rivalrous

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Social Determinants of Health

• Social exclusion

• Inequality

• Poverty

• Childhood development

• Employment

• Stress

The Status Quo

• Self interest

• Individualism

• “Me first”

4

The Dark Side

• Homophily

• Tribalism and kinship – sometimes in the service of forming a group people exclude others.

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Free Rider Problem

• If people are strongly committed to the norm of self interest then the fact that others cannot be excluded from social capital may be reason to withdraw from activities that create it

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Credit: mattlemmon

The Ethics of Social Capital

• The moral principle of social capital

• Ethics:

• Conduct towards others

• Universalize

• Prescriptive

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Things that are moral are universal

• If social capital is universalized then people must cultivate it impartially

• Impartiality overrides the dark side of social capital

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Morality trumps the non moral

• If creating social capital is understood as morally obligatory, then it would trump mere self interest

9

Choice Architecture

• By treating social capital as a moral principle, we make it part of the choice architecture, and thereby contribute to its flourishing

10

Global networks and norms

• Global Governance

• Civil Society

• Transnational business

• Immigration Flows

• Financial and Cultural Flows

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Trust and Reciprocity

• International service

• Social Enterprise

• Global Philanthropy

• Doctors Without Borders

• Twitter Revolution

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Copyright: MSF

Question

Is the right to health also a solidarity right?

Third Generation Rights

• Third generation rights…are predicated essentially on the notion of solidarity among people. Such rights, in that they reflect a particularly human conception of community life, can as a result, be achieved only through the joint efforts of all those representing the social interests involved. UNESCO Paris December 29,1978

Solidarity Rights

• Right to self-determination

• Right to development

• Right to peace

• Right to a healthy environment

• Right to Health?

Public Health

• The public’s health can be achieved only through collective action, not through individual endeavor. Acting alone, persons of means may procure personal medical services and many of the necessities of living. Yet no single individual, or group, can assure the conditions needed for health. Meaningful protection of…the population’s health requires communal effort.

The Future of the Public’s Health in the 21st Century, 1988

Health as a Solidarity Right

• Health depends on the social determinants and on state protection

• The right to health would impose obligations on many entities: nations, pharmaceutical companies, transnational organizations, civil society, community, individuals, and philanthropists

• As a solidarity right we would need to enable solidarity through social capital

Policy

• Inclusive Immigration policy – healthcare and education for immigrants

• Improved mental health care – for global health

• Minimize the medical brain drain through international policy

• Philanthropy for health, including global health could be incentivized with tax deductions

Health as a

solidarity right