CENTRAL AND NON-CENTRAL HEALTH CAPABILITIES
Prioritize central health capabilities, then focus on non-central health capabilities
WHAT IS IT?
Central health capabilities take priority vis-à-vis non-central health capabilities in a balanced approach to evaluating health and public policies. Central health capabilities are a particular subset of health capabilities. They are of special moral importance in any human life.
Central health capabilities include the capability to 1) avoid premature mortality and 2) avoid and address morbidity.
Premature mortality is death before the highest average age of death in the highest performing populations. Morbidity is illness, sickness, and injury that can be avoided and/or addressed by the current state of knowledge, systems, and practices.
WHY IS IT IMPORTANT?
Central health capabilities are essential elements of our ability to be healthy and flourish. They should be universally valued and shared objectives. Society must have a special social obligation to develop and ensure central health capabilities and then non-central health capabilities.
Central health capabilities are prerequisites for other capabilities. Central health capabilities are essential to maintaining certain critically important health and other outcomes for individuals and population groups. Preventing premature death and avoiding and addressing morbidity should be of upmost importance in evaluating health and other structures, institutions, policies, and practices.
WHAT DOES IT LOOK LIKE?
For example, poor prenatal and obstetric care for women in low- and middle-income countries and communities leads to dangerously high levels of maternal and infant mortality and morbidity. Also, current malaria and tuberculosis mortality and morbidity in different transmission settings, as well as non-communicable heart disease, diabetes, cancer, and mental health disorders, impact a large portion of the world’s population. These all require treatments and interventions individually and societally.
These global and domestic health problems illustrate the importance of developing central health capabilities. In order to address preventable tragedies like these, and achieve health equity worldwide, we must commit to developing and ensuring central health capabilities for everyone.
HOW DO WE DO IT?
Prioritizing central health capabilities requires a shared commitment, effectuated through the structures, institutions, policies, and practices of each and every society. Public norms and guidelines should be in place that make central health capabilities a universally shared goal that is implemented in public health and health policy as well as in everyday life.
A commitment to developing central health capabilities requires designing and implementing structures, institutions, policies and practices equitably and ethically. People around the world should not have such drastically different experiences as they strive towards promoting central health capabilities. Accountability is necessary when ethical and equitable implementation fails to be met.
In order to reduce premature mortality and avoidable and addressable morbidity worldwide, we must eliminate disparities and inequities in the implementation of public health and health care interventions and social conditions. We must address, and overcome, barriers to implementation and produce effective, high-quality interventions and policies, especially among low- and middle-income countries and communities.