No, it's not public health versus the economy

Jonathan Moreno
·3 min read

One of the fallacies being circulated in this pandemic is the idea that public health principles conflict with economic growth. That might be true in the very short run while economies are stalled, but the long run shows exactly the opposite. Public health measures — clean water, sanitation, more access to protein, vaccinations — have actually laid the groundwork for global increases in prosperity for the last 200 years.

Here is my favorite graphic on the web, representing global GDP growth since the year 1.

If you drill down you’ll see 1776 was a symbolically important year in the bend of this “hockey stick.” Not only because of U.S. independence, but also because in that year Adam Smith published Wealth of Nations, enshrining his remarkable insights into the way capital can reproduce.

Seventeen years before that work of genius, he published The Theory of Moral Sentiments, another great book that focused on the psychology underlying capitalism: We are creatures that have the capacity for “moral sympathy” with one another, who have the ability to see things from the other’s point of view. This is critical everywhere, from singles bars to theater to making business deals. Those who lack moral sympathy are, in a word, psychopaths.

In other words, capitalism flourishes not only because of iron laws and invisible hands but also because we are interactive creatures. That is why so many of us are struggling with isolation now. Pixelated faces of our friends are better than nothing but, like the song says, ain’t nothing like the real thing, baby.

There are many reasons for the hockey stick, but one is certainly that improved public health has made it possible for so many of use to engage in relationships that would have killed us before we could make a deal, or even reproduce in vast numbers. The train traveler in 1820 saw vastly more human beings in one rail journey than she would have seen only 20 years before in her entire lifetime. Today we see the collapse of travel reverberating through the global economy. The internet can’t fully replace it.

How does better public health help us trace the hockey stick curve? Consider for example the incidence of smallpox deaths from 1774 through Jenner’s vaccine and its implementation and a fairly rapidly managed mid-19th century pandemic to 1900.

Or just take measles cases in the United States in recent history.

U.S. Centers for Disease Control via Wikipedia
U.S. Centers for Disease Control via Wikipedia

Now compare that to GDP growth in the U.S. and other wealthy countries

One could go on with these graphics all day. Am I cherry-picking the data? Am I confusing correlation with causation? To some degree, of course, but only if my point is overinterpreted.

I am NOT saying that the successes with historical scourges like smallpox and measles are directly related to economic growth, but they have facilitated the growth of a global economy. They illustrate Adam Smith’s great insight that our need for human connection is the mother’s milk of economic activity, from market days to stock markets.

The lesson: If we proceed to ignore the need to squash this pandemic, there will be short-term financial gain, a bounce back that will be a sugar high. But once the sugar wears off, we will be in still worse shape when the waves of infection return.

There’s really no trade-off here.

Jonathan Moreno is a professor of medical ethics and health policy at the University of Pennsylvania.

Cover thumbnail photo: Anton Petrus/MomentRF/Getty Images


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