Why health is central to a sustainable economy.

How are we to live well on a finite planet?

In his fascinating new book Post Growth, Professor Tim Jackson, director of the Centre for the Understanding of Sustainable Prosperity, asks a disarmingly straightforward question: how are we to live well within the limits of a finite planet? What might prosperity for the world’s population look like, given how close we are to the hard limits of our resources? As with many such questions it is far easier to ask than to answer. But in guiding us toward a response, Professor Jackson asks us to think about something very familiar indeed – namely our health, specifically the idea of health as a kind of balance.

But some preamble is required. Go looking for reasons why the world’s leaders have shielded their eyes to the gathering data about climate and the answer is likely to be: it’s the economy, stupid. Or, more specifically, the apparently inescapable requirement for economies to grow. There is a moral imperative here. In so far as rising affluence is linked to human flourishing – and I’ll come back to this – then, on the face of it, growth looks like a good, even a necessary thing, (although this sets aside what cannot be set aside: that if economic growth is linked to increased material throughput we cannot continue to grow indefinitely. To continue to grow in the face of hard resource constraints tips a potential moral good into an incalculable harm.)

Photo by Ehud Neuhaus on Unsplash

There is also a suite of economic imperatives behind our commitment to growth. I am no economist but among them is the absolute dependence of capitalist economies on debt, which becomes radically unstable in times of low or negative growth; and the requirement for growth to offset the tendency for innovation to improve efficiency. Without growth, efficiency will drive unemployment – fewer hours required to produce the same quantity of goods – and rising unemployment means fewer wages, declining retail spending, cutbacks in investment and further reductions in unemployment – and so on and on in a vicious spiral. (For a far better account of this than I can muster, see Professor Jackson’s earlier, hugely influential, Prosperity Without Growth – from which the above is borrowed.) This brings us to the two propositions that structure what Professor Jackson calls the dilemma of growth:

  • Growth is unsustainable – at least in its current form. Burgeoning resource consumption and rising environmental costs are compounding profound disparities in social well-being.
  • ‘De-growth’ is unstable – at least under present conditions. Declining consumer demand leads to rising unemployment, falling competitiveness and a spiral of recession.

In Prosperity Without Growth, Professor Jackson outlines the requirement for macro-economic change to address this dilemma. But in the more recent Post Growth, which he describes as a prequel, he takes a step further back, into the sources of human motivation and wellbeing. And this is where health makes its entrance.

Despite a long tendency in economics to conflate human happiness with rising income, there is an irresistible – and still growing – weight of evidence that suggests a paradox. While it is incontrovertible that increased income drastically improves happiness where income is very low – improving the income of the poorest in the world is an urgent moral requirement – once income increases beyond a certain limit – in the region of $20,000 dollars – the link with reported happiness falls away. In some countries, notably the US, it begins to go into reverse – greater wealth starts to immiserate. Nor are we talking about transient unhappiness. As Professor Jackson writes:

It’s one of the calamities of modern capitalism that mental ill health now accounts for one of the largest and fastest-growing categories of disease worldwide. Depression costs the global economy more than $1 trillion each year. The human cost is even higher. In the US the suicide rate has risen by almost a third since the beginning of the century.

Despite what the champions of growth will have us believe, beyond a necessary floor, growth is not associated with improved wellbeing. And in some cases, counterintuitively perhaps, the reverse.

Behind the disturbing figures concerning global mental health lies a foundational vice of consumer capitalism. Just as economists are wont to collapse the complex constituents of human flourishing into a single (measurable) financial proxy – income – so consumer capitalism grotesquely exaggerates the acquisitive, status-driven and competitive sides of our natures. To the complex interplay of our needs and longings – material, relational, purposive and, dare I say it, spiritual – capitalism offers a single imperative: consume.

By engorging our acquisitive desires, by equating our deepest sense of ourselves with our material status, we are chained to a hedonic treadmill that dooms us to a state of perpetual frustration.

It is against this distortion and impoverishment of human flourishing that Professor Jackson argues. The imperative to move beyond consumer-driven growth arises not just because the environment cannot support it. Change is urgently needed because the economic system to which we are in thrall throws us out of balance. By failing to meet some of our most essential needs it is doomed to immiserate and, ultimately, sicken us. We urgently need to regain a richer, more satisfying understanding of ourselves and our place in the world.

Perhaps, as Richard Powers, author of the superb environmental novel The Overstory puts it in a recent interview in Emergence Magazine, it is not the world that needs saving, it is us.

This review was originally posted as a blog at the British Medical Journal. https://blogs.bmj.com/bmj/2021/06/24/julian-sheather-post-growth-why-health-is-central-to-a-sustainable-economy/.

Leave a Reply

Your email address will not be published. Required fields are marked *