The pitfalls of personalization rhetoric in time of health crisis: COVID-19 pandemic and cracks on neoliberal ideologies
The pitfalls of personalization rhetoric in time of health crisis: COVID-19 pandemic and cracks on neoliberal ideologies
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DOI：
10.1093/heapro/daaa112
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发表时间：
2021-06-01
影响因子：
2.7
通讯作者：
Cardona, Beatriz
中科院分区：
文献类型：
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作者：
Cardona, Beatriz
COVID-19疫情的兴起暴露了个体化意识形态的不协调，这种意识形态将个人置于医疗保健的中心，通过贡献、做出明智的决定以及对他们的健康选择和生活方式的考虑进行选择。当面临全球健康威胁时，世界各国政府都明白，个性化、个人责任和个人选择的言论只会导致灾难性的国家健康后果。换句话说，个人选择提供了一个糟糕的标准来指导人口的健康和福祉。这一现实迫使世界上许多发达经济体暂停其对“小政府”、个人责任和个人自由的承诺，转而选择一种更加平衡的经济和健康结果方法，并增加机构和共同化的作用。对于许多边缘化社区来说，个性化意识形态和个性化方法从未奏效。相反，它们使富裕的个人受益，这些人拥有行使“责任”、避免风险和采取健康保护行为所需的教育、文化和经济资源，从而加剧了社会和健康方面的不平等。风险管理的个人化也进一步使穷人蒙受耻辱，将健康状况不佳的责任从政府转移到个人身上。本文将探讨COVID-19大流行如何暴露新自由主义关于个性化的言论的裂缝，并开辟新的机会，将一个国家的健康视为由社会、经济和政治决定的，需要对健康的关键领域进行“上游”干预，包括住房、就业、教育和获得医疗保健。
The rise of the COVID-19 pandemic has exposed the incongruity of individualization ideologies that position individuals at the centre of health care, by contributing, making informed decisions and exercising choice regarding their health options and lifestyle considerations. When confronted with a global health threat, government across the world, have understood that the rhetoric of individualization, personal responsibility and personal choice would only led to disastrous national health consequences. In other words, individual choice offers a poor criterion to guide the health and wellbeing of a population. This reality has forced many advanced economies around the world to suspend their pledges to 'small government', individual responsibility and individual freedom, opting instead for a more rebalanced approach to economic and health outcomes with an increasing role for institutions and mutualization. For many marginalized communities, individualization ideologies and personalization approaches have never worked. On the contrary, they have exacerbated social and health inequalities by benefiting affluent individuals who possess the educational, cultural and economic resources required to exercise 'responsibility', avert risks and adopt health protecting behaviours. The individualization of the management of risk has also further stigmatized the poor by shifting the blame for poor health outcomes from government to individuals. This paper will explore how the COVID-19 pandemic exposes the cracks of neoliberal rhetoric on personalization and opens new opportunities to approach the health of a nation as socially, economically and politically determined requiring 'upstream' interventions on key areas of health including housing, employment, education and access to health care.