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Daniel S Goldberg, Against the Medicalization of Public Health (Ethics), Public Health Ethics, Volume 14, Issue 2, July 2021, Pages 117–119, https://doi.org/10.1093/phe/phab024
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Since 2007, social epidemiologist Paula Lantz has repeatedly warned about the dangers of medicalizing public and population health (Lantz et al., 2007). Tracking Zola’s classic definition, she defines medicalization as ‘the expansion of medicine as an institution and the use of a medical lens to view human processes and behavior’ (Ibid. at p. 1254). In a 2019 commentary, she noted specifically that medicalizing public and population health problems risk shrinking the denominator, thereby reducing the scope of the communities who are affected by a given health hazard (Lantz, 2019). Medicalization also shifts the framework of the problem itself away from ‘upstream institutional, systemic, and public policy drivers of population health problems and distributional disparities’ (Ibid. at p. 38). Unsurprisingly, processes of medicalization tend also to emphasize downstream, micro-level (biomedical) interventions to health problems experienced by entire communities.
Medicalization is also damaging from the perspective of global public health. As Vicente Navarro trenchantly remarked in 2004, the dominance of a ‘categorical’ (disease-by-disease) approach to global health that has emphasized ‘silver-bullet-type solutions’ has eroded the ‘infrastructure of public health services … that degrade rather than improve countries’ public health situations’ (Navarro, 2004, at p. 5). This framing is of course pushed by wealthy countries in the Global North—most obviously the USA—in which the forces of medicalization and the capital attached to it are deeply entrenched in all manner of social institutions and structures.
