Sustainable health and degrowth: Health, health care and society beyond the growth paradigm

The extraordinary economic growth rates of the twentieth century are historically exceptional and a continuation into the future seems neither possible nor desirable. Consequently, it is in the interest of public health to actively shape a socioeconomic transformation towards a system that is not based on growth. "Degrowth'' provides coherent guidelines for such a system. Combining existing scholarship from the degrowth and the public health fields, this paper makes seven suggestions for a public health agenda towards sustainable health: (1) to develop an index of health status in relation to present and future health burden; (2) to reduce the resource burden of medical therapy; (3) to translate increased productivity to fewer working hours and more free time instead of more income and material consumption; (4) to make use of non-conventional knowledge and non-commercial forms of work and product exchange; (5) to make knowledge freely available, making use of innovative research frameworks such as open source drug research; (6) to relocalize economic life and health-related organization and to reshape citizen participation and (7) to reduce socio-economic inequality through redistribution. Generally, this paper argues that it is time for discussions on degrowth to enter the mainstream medical and health community and for doctors and other health workers to acknowledge that they have a significant role to play and important experience to contribute when our societies face the upcoming challenge of no-longer-growing economies.