Personal Responsibility for Public Health

Your health is in your hands. With these words, CDC Director Rochelle Walensky captures the essence of flawed thinking about public health. These words also capture the pervasive bias that gets in the way of coping well with both the COVID-19 pandemic and with obesity. This is the presumption that personal responsibility will take care of public health.

But we are learning the hard way that it doesn’t.

Blaming the Covidiots

Writing in PLOS One recently, Gabriela Capurro and colleagues described moral panic about covidiots in Canadian newspapers:

“Following public health guidelines was construed as a moral imperative and a civic duty, while those who failed to comply with these guidelines were stigmatized, shamed as ‘covidiots,’ and discursively constructed as a threat to public health and moral order.”

Turning public health into a battle that’s all about personal choice and personal responsibility is a fatal flaw for dealing with a pandemic like COVID-19. Talking to Brooke Gladstone for On the Media, Ed Yong explains:

“Firstly, it’s an infectious disease. It spreads from person to person. So my health in the context of an epidemic is never fully in my hands. It also depends upon the decisions of my neighbors.

“But also, your ability to make choices about your health are constrained by your circumstances. So if you work in a low income job where you earn hourly wages and you don’t have paid sick leave, you might not be able to isolate if you start having symptoms. You might not be able to find the time to go take a test or to make a vaccine appointment.

“This is something that public health officials more than anyone should understand. Because the entire discipline is about protecting the health of entire communities.”

So honestly, if we mock people who make bad choices about COVID, we’re making a mistake and missing the point. Those bad choices can easily reflect issues of inequity. People often don’t have access to good information and trusted sources for healthcare. They live in communities that get nothing but substandard care and misinformation. This is a systemic problem. Not a personal failure.

Failing People with Obesity, Then Blaming Them

The failure of the personal responsibility construct is evident in public campaigns to “tackle obesity,” such as the UK recently embarked upon. The presumption seems to be that picking up a veggie wrap will solve a systemic problem which has been incubating for decades.

In the Sociological Review, Tanisha Jemma Rose Spratt describes a “neoliberal imperative” of personal responsibility “to follow state-mandated weight loss advice.” This becomes an excuse for devaluing people and rationalizing systemic inequities.

Thus, the personal responsibility framework doesn’t support public health. It undermines it. Instead, we should come to terms with fixing the systems that are causing these problems.

Click here for the study of moral panic about covidiots, here for the interview with Ed Yong, and here for the sociological analysis of personal responsibility in obesity campaigns.

Hand with Fir Cone, woodcut by M.C. Escher / WikiArt

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April 12, 2022