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Both/And: Personal & School & Social Responsibility for Health

Many people are promoting a false dichotomy for who/what to “blame” for decades of pervasive inactivity & unhealthy nutrition--the key preventable factors which have led to the majority of adults developing chronic disease.

Some believe that people with preventable chronic diseases made a series of unhealthy choices for decades, for which they need to accept personal responsibility for the consequences.

On the other side, a growing number of policymakers focus on the “social determinants of health.”  In other words, there are many things beyond your control, which impact what you eat & drink and how active you are.  This includes factors such as your family, neighborhood, school, employer, transportation, public safety, housing, community layout, etc. etc.  It’s those external social factors which determine your health destiny.  

Actually, the personal and social are inextricably connected--not opposite ends of the spectrum.  Let’s consider the role of schools.

Schools can help build up our personal agency--our ability to make our own individual decisions to improve our lives, even when other people are doing the opposite.  That has always been part of schools’ role--supplementing what parents are assumed to be doing.  This includes developing critical thinking and more broadly the ability to succeed in work, citizenship & life.  Increasingly, this needs to include building physical & social-emotional health “literacy” and healthy habits.  

With so many kids not developing healthier habits at home, as demonstrated by historically high prevalence of child & young adult chronic disease, schools are the only other realistic choice.  They alone are scalable & cost-effective enough, when the entire population is at-risk.  Indeed, schools are an indispensable place to develop agency systematically & sustainably for an entire society.  

Since so many parents & schools are not doing this, everyone’s health care bill is skyrocketing.  Families can’t pay for it, so healthier people and the government are picking up the tab.  Since the government won’t pay the full amount, it passes costs on to the next generation with deferred state spending (“pay now or pay later”) and federal debt.

Fortunately, in spite of decades of neglect, we have a both/and alternative future:  As healthier students join the workforce & electorate, have a family, and hopefully volunteer their time in the community, they can use their personal agency to responsibly help improve the social influences on our health & lives, too. 


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