Vijay Kumar Yadavendu Shifting Paradigms in Public Health From Holism to Individualism Shifting Paradigms in Public Health Vijay Kumar Yadavendu Shifting Paradigms in Public Health From Holism to Individualism Vijay Kumar Yadavendu Department of Psychology Magadh University, Bodh Gaya India ISBN 978-81-322-1643-8 ISBN 978-81-322-1644-5 (eBook) DOI 10.1007/978-81-322-1644-5 Springer New Delhi Heidelberg New York Dordrecht London Library of Congress Control Number: 2013956005 © Springer India 2013 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. 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Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) For Anchal You whom I gladly walk with , touch, Or wait for as one certain of good, We know it; we know that love Needs more than the admiring excitement of union; More than the abrupt self-confi dent farewell, The heel on the fi nishing blade of grass, The self-confi dence of the falling root, Needs death, death of the grain, our death, Death of the old gang; would leave them In sullen valley where is made no friend, The old gang to be forgotten in the spring The hard bitch and the riding master, Stiff underground; deep in clear lake The lolling bridegroom, beautiful, there. –Auden, W.H. P oems , 1934: 66 Foreword The world has never before been as rich as it is today. Yet, substantial populations of the world are bereft of resources to ensure a modicum of health. Nearly 1.3 billion people, overwhelmingly in the formerly colonised countries of the South, live on less than a dollar a day, and close to 1 billion cannot meet their basic calorie require- ments. More than 800 million people lack access to health services, and 2.6 billion people to basic sanitation. Although people are living longer today than at any time in the past, around 1.5 billion people are not expected to survive to age 60. Indeed, life expectancy in some countries of sub-Saharan Africa is only around 40 years. One familiar reason given for the widespread poverty and ill health in poor countries is, of course, overpopulation, which is a red herring. Despite population growth, global per capita food production increased by nearly 25 % between 1990 and 1997; the per capita daily supply of calories rose from less than 2,500–2,750, and that of proteins from 71 to 76 g. In other words, not one person in the world needed to go to bed hungry. Yet, given the fact that the overall consumption of the richest fi fth of the world’s population is 160 times that of the poorest fi fth, 840 million people, 160 million of them children, are undernourished. Close to 340 million women are not expected to survive to age 40. The overpopulation argument also elides the fact that there occurs a net transfer of close to 80 billion dollars annually from the countries of the South to those of the North. Indeed this fi gure has increased substantially over the last three decades. During this period, marked by the demise of actually existing socialism and of Keynesianism, and the rise of the neoliberal policies of Reagan and Thatcher, inequalities within and between countries have risen sharply: the income gap between the world’s richest and poorest has more than doubled. In 1960, 20 % of the world’s population in the richest countries had 30 times the income of the poorest 20 %; today, they command 74 times more. The same richest 20 % of the population command 86 % of world GDP, while the poorest 20 % command merely 1 %. More than 80 countries have per capita incomes lower than they were a decade or more ago; 55 countries, mostly in sub-Saharan Africa, Eastern Europe and the former Soviet Union, have had declining per capita incomes. ix