Why Health?

A deeply reflective and urgently argued book that asks a deceptively simple question: why do we, as individuals and societies, pursue health--and what does that pursuit say about who we are? The pandemic exposed challenges to our collective approach to health. Now, more than ever, it is important to connect with the core values that define public health and to do so in a way that is useful to those who are engaged both in thinking, and in practicing, in the field. In Why Health?, Sandro Galea interrogates the assumptions that underlie contemporary health discourse. Informed by the success and failures of the pandemic moment, and drawing from philosophy, history, and public health, he argues that health has become both a moral ideal and a social organizing principle--shaping policy, identity, and our sense of purpose. Rather than accepting health as an unquestioned good, the book explores how our understanding of health reflects broader anxieties about control, meaning, and progress. It situates today's thinking about health within the larger human story: from early theological understandings of illness as divine judgment, to Enlightenment notions of the rational body, to modern health systems as engines of moral worth. In doing so, it invites readers to reconsider health not as an endpoint but as a mirror of social values-an evolving construct through which we negotiate our obligations to self and others. Through essays that are at once analytical and humane, Why Health? challenges us to think beyond metrics and medicine, toward a richer understanding of what makes a good society. It offers a meditation on how health, rightly understood, can deepen rather than narrow our engagement with the world.

Sandro Galea is the Margaret C. Ryan Dean of the School of Public Health, the Eugene S. and Constance Kahn Distinguished Professor in Public Health, and Vice Provost of Interdisciplinary Initiatives at WashU Bursky School of Public Health at Washington University in St. Louis. He has been named an epidemiology innovator by Time, a top voice in healthcare by LinkedIn, and is one of the most cited social scientists in the world. His writing and work are featured regularly in national and global public media. He is the author of Well and The Contagion Next Time, among many other books. A native of Malta, he has served as a field physician for Doctors Without Borders and has held academic and leadership positions at Boston University, Columbia University, University of Michigan, and the New York Academy of Medicine.

- Introduction - Why think about health now? - Why health? - 1: Why does health matter? - 2: The moral, aesthetic, and intellectual case for health - 3: An imperfect health - 4: Having the right conversation, at the right time - 5: We may disagree - Foundational values - 6: Values, and the work of improving the health of all populations - 7: Centering proportionality - 8: Respect for human rights and autonomy - 9: Balancing our moral and empiric imperatives - 10: Admitting better, encouraging optimism - 10: Admitting better, encouraging optimism - 11: Avoiding self-satisfaction - 12: The obligation for humility and compassion - 13: Creating dignity as the ultimate goal of health - 14: A global health? - 15: On speaking freely to create better health - 16: Leaving behind values disguised as science - Health at all costs? - 17: Health at all costs? - 18: Reconciling context, ability, effort, and merit - 19: The integrity of the health mission - 20: Who speaks for health?: The role of communities, or not - 21: What we owe, and do not owe, the past - 22: What is reasonable? - The potential, and limits, of science - 23: The potential, and limits, of science - 24: Consequential, rigorous, inquisitive population health science - 25: "We must disenthrall ourselves" - 26: The biases that inform what we write and what we think - 27: The biases embedded in how health institutions are structured - 28: Certainty as the great enemy of tolerance - The actions that generate health - 29: The right amount of performance - 30: The right amount of paternalism - 31: The right amount of risk - 32: The problem of bad behavior - 33: Can we deal with everything all at once? Should we? - 34: The new radicalism, reclaiming core values grounded in reason - Uncomfortable ideas for health - 35: Re-engaging with complexity - 36: The ineluctable role of persuasion - 37: Making a moral argument without moral bullying - 38: Avoiding passion plays - 39: A rhetoric of trust and inclusion - 40: On creating structures that allow all people to live as they choose - 41: The importance of strategic restraint, avoiding the excesses of public health - 42: Why we should work with people whose governments we disagree with - 43: The astonishing privilege of living in a high-income country - What we need to think about when we think about health - 44: The healthiest time in human history - 45: "Not as a matter of charity" - 46: The input problem - 47: Health as a public and private responsibility - 48: The political decision that health matters - Conclusion: Thinking about health tomorrow