Now, at the turn of the twenty-first century, a fourth era postmodern medicine is emerging, powered by the idea that injustice produces disease and political empowerment is the cure. But this era will not enhance health. It will blur the focus of the public health profession and dilute its resources. So socially constructed is health, they insist, that the individual can do little to influence his well-being. But the link between wealth and health is not necessarily fixed.
People have considerable control over the majority of threats to their health.
Three factors alone smoking, being overweight, and drinking too much alcohol account for the largest share of risk. Public health has always had a reformist spirit, but the currents of political correctness now flowing through the profession are generated not by pragmatism to change real circumstances but by an ideology intended to manipulate the way people think about the origins of disease and its remedies. The only acceptable remedies in postmodern medicine are social actions that would disrupt our prevailing economic and social systems. I am not defending the status quo of our health care system. It has too many uninsured individuals and gross inefficiencies.