Journeying Home

Latent within each of us lies a knowledge of what home feels like.

Of being at home on this planet. Within a human culture. Inside a body.

To build a viable human future on earth, we need to remember how to become at home in it again.

Part 4: How to Keep Our Focus [1970 - Present]

Cultural Evolution as a Praxis of Public Health is a series exploring the role played by Western cultural narratives in our current social problems. Over four posts, it questions our notion that the forward march of technological progress is a force of social salvation, using bodily health as a metric for success. It asks what it would take to change our cultural narrative, and what a more effective Western cultural narrative might look like.


In Parts 1, 2 and 3 of this series, we explored the ways in which our bodies reflect and reveal the prevailing state of our society. We have evolved as an integrated part of a living system, and our state of health reflects our relationship to it. When we live in ways harmonious with that whole, we are in the aggregate healthier; when we deviate, disease and degeneration multiply. [1-3] 

It's hard to know exactly what constitutes 'ways harmonious.' Diversity, after all, is nature's rule. One approach to discovering it is to track large-scale patterns in health and disease, and then use them as clues to what is and isn't working in our chosen way of life. Wherever illness and stress increase, they point toward living conditions that are dysfunctional for our bodies. The good news is that we can change those conditions. Health, viewed in this way, becomes an ongoing practice of adaptation to the environment, in search of harmonious ways of life. [4]

Western modernity has a good-news story to tell about this sort of adaptation. In the past 150 years, the health of the majority of Westerners skyrocketed. Life expectancy has essentially doubled. [5,6] The evidence suggests that this came as a result of comprehending and correcting some of the worst excesses of the Industrial Revolution in particular and of civilization more generally. We amended our societies over the course of a little more than a century, taking steps to reduce both environmental pollution and social stratification, and reaped huge gains in well-being as a result. [7,8] 

In this final instalment of the series, we'll explore how and why, in the last 40 years, this progress seems to have stopped and turned around. That regression has begun to show up, of course, in large-scale statistics of health and disease: the United States Centers for Disease Control, for example, estimates that the current generation of children may live shorter lives than their parents. [9,10] We need to be able to take this seriously as a broad critique of our way of life.

In previous posts in this series, we tracked how our social conditions are influenced by our stories of who we are. We saw how our old narrative of progress, innovation and conquering limits led us toward the problems that we face today. We saw the birth of a new story of mass social welfare start to turn the tide. In the past 40 years, as these gains stall and reverse, myth once again has had a role to play. Beneath the events that led to this reversal, a reversion toward the old story has taken place as well. Let's look at what happened, and what it will take to turn back in a positive direction again. It may be that it has already begun.

A Mobilization of Myth

The social reforms of 19th-century public health, picked up and powered by 20th-century grassroots social activism, were crystallized and institutionalized in the welfare state. Though miles from perfect, this edifice spread high levels of health and welfare across Western societies, more broadly than any civilization on record had done before. It was an expression of what Mark Nathan Cohen -- the archaeologist we met in Part 1 -- envisaged as the singular redeeming virtue of civilization: its capacity to centralize resources, and the possibility that it could choose to direct these resources toward mitigating the social problems it creates. [11]

In the 1970s and 1980s, the welfare state began to be dismantled. Margaret Thatcher's famous declaration that "[t]here is no such thing as society" laid waste to the notion that we become healthy or ill as a group. [12] No other structure has appeared in its wake to support health and social welfare as effectively. What happened? How did such positive progress go off the rails? 

In the social progress of the '60s and '70s, the ownership class of society had reason to fear for its historic privilege. In 1971, Lewis Powell, a corporate lawyer and future Supreme Court justice, wrote a classified memo to the U.S. Chamber of Commerce urging a co-ordinated strategic campaign to turn back the tide. Major corporate leaders invested large sums of capital to create a network of policy think tanks and a political lobbying infrastructure to spread their views. [12.1,12.2] 

At root, I believe, they went down to the level of myth-making. They refreshed and resurrected the old story of progress and civilization, which had for so long justified their class ownership of a disproportionate share of resources. Their mobilization of the deep psychic resources of myth, I think, accounts for the staying power of the neoliberal idea.

___________________

The father of the recourse to myth was Leo Strauss, a professor of political philosophy at the University of Chicago from 1949 through 1969. He grew famous for his faith in the importance of mythology for holding a community together, drawing inspiration from Plato’s Republic. Strauss’ interpretation was deeply cynical: he encouraged an intellectual elite to construct a ‘noble lie’ to occupy the masses, while that elite went about doing whatever it thought should be done.[13,14] 

Strauss’ work was an inspiration to a generation of regressive right-wing thought. [15] His influence can be seen in the rhetoric of a string of United States Republican presidential candidates who ran in his wake. Each resurrected the old progress story of civilization, appealing to the glory of the kingdom over the well-being of its members. Ronald Reagan ran on the slogan, Let's Make America Great Again. Donald Trump’s slogan is the same, save for the inclusionary pronoun. John McCain ran under the banner of Country First, and George W. Bush, as sitting president, sold wars of conquest under the pretext of spreading the greatness of Western civilization. Shadia Drury, a political scientist and noted expert on Strauss, writes that his work “is the key to understanding the political vision that has inspired the most powerful men in America under George W. Bush.” [16]

Strauss’ work was received in Canada by an idiosyncratic group of political scientists at the University of Calgary, who became known as the Calgary School. Shadia Drury taught for a while alongside them in the same department. Drury describes one Canadian who showed such fealty to Calgary School principles that they labelled him “their product.” He was a taciturn young man by the name of Stephen Harper. [16.1a]

Mr. Harper, turned Prime Minister of Canada, brought a focus on mythology to his reign. Under his tenure, Canada would shift away from the social-welfare mythology established by Robert Baldwin and Louis-Hippolyte Lafontaine in the mid-1800s, and cemented under Prime Ministers Pearson and Trudeau in the 1960s and 1970s, toward an old-style narrative of the glory of the crown. [16.1b] He championed grandeur-and-conquest imagery in the military, in the frontier Arctic, in brash foreign policy rhetoric, and in pursuit of oil-soaked 'energy superpower' status. Famously, he ended the long-form census -- that enabler of social-welfare measures and central legacy of epidemiology’s methods.

Through the past 40 years, I believe, this concerted effort by wealthy elites has reversed the dominant narrative in Western society. It undercut the force of the social welfare story, and implanted a version of the old progress story -- now called neoliberalism -- in its place. With the progress myth once again dominant, appeals to social welfare have little in our deep psyches to grab hold of.

Neoliberalism tells us to make the success of the market the prime goal, and that if we do, we will benefit secondarily from its success. Social welfare is presented now as a by-product of social success, and no longer its definition. Once social success has been redefined -- from the health of individuals to the health of the stock market -- the dominant story has changed.  We may call this ideology neoliberalism, or economic globalization, and think of it as modern. But see how it calls upon our faith in the progress of technology, and asks us to subsume our own welfare to the carrying strength of an abstract ideal: it’s the same story we’ve been telling ourselves, to our disservice, for the last 10,000 years.

How to Fight Back

A political reversal of this magnitude, one would expect, would not take place without a fight. There has certainly been protest. But it seems not to have been able to slow the march of harmful social policy to any significant degree. Protest works best in support of messages that have already penetrated the collective mind. Once the ownership class had taken their campaign down to the level of narrative, proponents of the social-welfare approach seem not to have met them effectively there. Without a hook into the collective unconscious, the protestations of social movements registered much less force.

As we saw in Part 3, much of the intellectual work of advancing this sort of penetrating message was done by epidemiologists of the 19th century. They took Enlightenment ideals of equality and worked them through society, giving them practical depth and force. So mightn't epidemiology be able to do heavy lifting agian? Where has it been in these past 40 years, during the assault on its historic gains?

For a long time, radical epidemiology went to sleep. The positions for which it was justly famous had been universally accepted — such staples of contemporary common sense as public sanitation, universal education, and safe working conditions. Perhaps it lost sight of the need and the knack for narrative-level debate. The historian Simon Szreter explains that Thomas McKeown, one of the best-known 20th-century scholars of public health, simply “took for granted the protracted political and ideological battles that had been fought over the previous century or more to establish this viewpoint as the orthodoxy of his mid-20th-century generation, and he discounted the vulnerability of its victories.” [16.2]

As the economic structure of Western society changed through the middle of the 20th century, from industrialism to the mass consumer society, the nature of disease changed as well, and epidemiology was caught flat-footed. Gone were the great infectious diseases that epidemiologists had effectively tracked back to the conditions of the Industrial Age. In their place, a suite of chronic diseases had arisen -- heart disease, diabetes, and mounting rates of cancer. It failed to bring to the new epidemics of chronic disease the radical and radicalizing lens it had developed in grappling with the infectious ones.

By the middle of the 20th century, epidemiology was thoroughly integrated into the state health system. It seemed to prefer the comfort of the lab to the rough-and-tumble of the streets where it began, and where the Greek root of its name — epidemios, literally ‘among the people’ — suggests it might belong. [16.3] It borrowed heavily from the biomedical model of its new allies in medical research. It studied individuals rather than the collective, through a linear lens more than a systemic one. The field buried its nose in a search for 'individual risk factors' for individual disease (exercise, smoking, saturated fat), rather than the social and ecological factors (poverty, pollution, corporate abuses) that were its former province. [17,18]  

In the 1990s, a counter-movement in epidemiology began. [19-19.2] It has gathered momentum and moxy, and today, we can say that critical epidemiology has been re-born as eco-social epidemiology. It moves beyond sewer systems and factory floors, the sites of its 19th-century forebear, to engage a fuller range of the stresses of contemporary life. It makes use of powerful new statistical methodologies. Its data is expansive and robust. It has space in elite university departments, and sanction from the World Health Organization. [19.3, 19.4] A new epidemiological moment has arrived.

Alas, its practitioners are deeply frustrated. They know that their research is good, and their analysis revealing, but they find themselves with little access to power or influence. They have made some allegiances and substantive gains, like their partnership with urban planners to build healthier cities. [19.5] But they can boast nothing like the fame or force of their forebears a century prior.  And they can't figure out why. [20]

What allowed the first 100 years of public health to cut so deeply into the laissez-faire social fabric of its day, while today’s eco-social epidemiology can’t get neoliberal economics to budge? In the 19th century, I believe, public health worked so well for the same reason that neoliberalism stole its lunch money in the 20th: because it had penetrated to the level of myth. Today’s social epidemiology cannot shift the zeitgeist because it has not yet taken its critique to that same cultural depth.

How to Find the Source of the Fumes

What would it look like if epidemiology went down to the level of myth in our contemporary world? There are grounded and discernible differences between political practices that do and don't approach the level of myth, and distinguishing between them can teach us something about narrating our culture in a new way.

Today, eco-social epidemiology points to a list of 14 primary social determinants of health, focused on the damaging effects of poverty, racism and social exclusion. [21-23] It’s a good list. But it differs in one important way from the 19th-century approach. In 19th-century epidemiology, marginalized populations were part of the analysis but not the focus. Instead, the focus was something that affected everyone in society – the epidemics of infectious disease themselves. We might think that the approach focused explicitly on marginalized peoples would be the more politically radical, but I think that, in this case at least, the opposite is true. Let's see why.

The early epidemiologists also paid attention to who was sickest, but they did so in order to decipher the general causes of sickness. They presented the idea that there were broad-based stresses in society that made everyone susceptible to disease. For people whose social conditions were worse, exposure to those generalized stresses was greater, and more sickness would result. Leading figures like Villermé and Parent-Duchâtelet spent time with child labourers and sex workers, but saw them as canaries in the coal mine. [23.1] They wanted to move beyond empathy, and into analysis. They wanted to search for the source of the fumes.

Imagine a long line of people stream into a doctor’s office. Most of them are soaking wet. Two epidemiologists are on hand. Both are politically aware enough to notice the pattern that some people are much wetter than others. The first one takes the contemporary, marginalized-communities approach. He walks straight over to the people who are really soaking wet, notices that none of them have umbrellas or raincoats, and tries to find a way for anyone without rain gear to gain access to it.

The second epidemiologist takes the 19th-century, broad-spectrum approach. She sees the pattern of inequality, but she asks a comprehensive question: ‘Why is nearly everyone wet?’ She goes and talks to people of varying levels of wetness. She learns that all of the wet people were outside, and differed in wetness according to their rain gear only by degree. So she walks out the door to see what's outside. She looks up. And she sees that it’s raining.

We are all caught in the same storm. This was the radical realization made possible by the broad-spectrum lens. The 19th century epidemiologists discovered how the ill health of the most vulnerable people resulted not simply from their lack of access to material goods, but from their exposure to a broader pattern. Studying in this way, eventually they could name that pattern: the patterns of urban growth during the Industrial Revolution.

Using their broad-spectrum social lens, they demonstrated that even while the economic boom produced net gains in health for the wealthy, it could eventually threaten the health of the whole populace if it continued relegating others to misery. Leading epidemiologists unearthed some of the basic conditions and structures of economic growth at the root of epidemic disease. They argued that those structures that needed to be adjusted, rather than only compensating for their effects. [23.2] When the whole social problem in view, and not only its most objectionable effects, this kind of complex, unified story can emerge. With such a story in hand, general pronouncements can be made that approach the depth of myth.

Getting Back to Myth

A mythological epidemiology is something we need again today. In historian Simon Szreter’s view, there is little doubt that the rise of contemporary eco-social epidemiology has been prompted by “the epidemic-scale health problems once again unleashed by unrestrained global economic and urban growth.” [23.3] A revived mythic epidemiology would give us a broad explanation for the diseases of our day, set within the social contexts of our daily lives. It would restore a voice to our bodies, so they could once again tell their stories in the service of everyone's health.

Contemporary eco-social epidemiologists can explain with remarkable precision and skill what percentages of respiratory illness emerge from poor air quality, or how much hypertension comes from economic inequality, or how much diabetes is caused by racism. This is seriously amazing. But lacking a whole-of-society approach, they are much less able to tell you a story of why or how those stories all weave into one. They can tell you a dozen explanatory stories of diet-linked heart disease, but not the single, structural story about the industrial food system that explains them all. [23.4]

We are all caught in the same rainstorm. It is the rain that makes us wet. Only when we walk outside and look up toward the source of the water are we able to do the things that the 19th-century public health movement did. Only at that depth can we speak to the underlying narrative, build cross-class consensus, and spur paradigm-shifting social change.

Eco-social epidemiology, focusing on the vulnerable, depends for its political force upon the prior existence of benevolent empathy, or a belief that the welfare of all members of society is interconnected, or that caring for the welfare of citizens is the prime measure of social success. In short, it depends for its momentum upon the existence of the social-welfare story. Where that story is not ascendant — as in the case of the contemporary West — it has no power. It cannot at the same time depend upon a particular narrative for its power and have the power to change the narrative in which it exists.

Where the Industrial Revolution grew illness in crowded factory floors, post-industrial trade deals emptied them out. Where Industrial-era wages could purchase too little food, we have too much food of too little substance. Where the Industrial Age clogged the atmosphere with soot, making it hard to breathe, our consumer society is clogging the stratosphere with carbon, making it hard to keep ice on the poles and water in the ground. In order to be effective at the depth of changing a myth, eco-social epidemiology would need to demonstrate which features of our own era are poor biological adaptations, which structures of society worsen our health. 

Our epidemics of cancer and heart disease, of diabetes and allergies and asthma — they contain these stories. With a broader lens, epidemiology could give voice to our ailing bodies to tell them. It could pierce the contemporary myth that illness is apolitical, that visible patterns and trends have no unifying story, that epidemic-level disease is an inevitable fact of life. The evidence in our bodies is the ultimate level of proof. This is the potency of epidemiology, of an epidemiology with the courage and foresight to speak from one side of its mouth in data, and from the other side in myth.

The praxis of storytelling is to see the whole pattern at once, and to draw links between the broad pattern and all people’s daily stresses. It is to feel less sympathy for the poor and the sick, and more solidarity with them instead, for it recognizes how we are all in the same circle. And our well-being must be our goal. The stylus that scratches out the peaks and valleys of the stock market prices is the very same as the hospital stylus scratching the beats and pauses of the heart. They write different parts for different instruments playing from the same score. As the Grand Chief John Kelly said, quoted at the start of Part 1, we are all in the same circle. This insight is the heart of the social-welfare story, and without its explicit invocation, pro-social actions cannot withstand countervailing winds. [24]

Making a Story Stick

Perhaps it should surprise us that after 100 years of enormous social success, the social-welfare story was still vulnerable to a rear-guard attack. What does it take to make a story stick? What more could the social-welfare story have done to convince the public that it served them better?

Well, how did the progress story cement itself so deeply? It mythologized a solution for a basic and enduring structural problem. The problem was rising population and declining stocks of food. The solution was agriculture. The progress story, notwithstanding its problems, solved a basic social problem in a convincing way. The social-welfare story has grown up as a response to the liabilities of the progress story, and it may not arrive securely to dominance until it provides an answer to all or most of them.

It earned its place of dominance in the welfare state because it had convincingly addressed one of the problems of civilization: the epidemics of infectious disease. But it had not yet made nearly the same impacts on the others: racism and class exploitation, imperialism, and the over-use of resources. As the social-welfare narrative neared the very end of its dominance, President Lyndon Johnson was tied up between two of them, his War on Poverty derailed by the imperial expedition in Vietnam.

Bringing a story to maturity requires keeping your focus. It takes a long time to follow a new insight about organizing human life all the way to the ends of its implications. Had it continued to develop, the social-welfare narrative could have further driven down race and class stratifications, and maybe made space for deeper solutions. Jimmy Carter considered weaning the United States off of fossil fuels in response to the 1973 oil shock, and installed solar panels on the White House roof.[24.1,24.2] From its early steps in the research of bodily disease, the social-welfare story could have matured into a robust answer to the problems of civilization. It lost its focus. It thought it was more secure than it was. Until the major social problems at hand are overcome, a developing cultural story needs to keep its focus -- to clearly and explicitly make the links between actions and myth.

New Inspirations, Toward a New Story

There is at least one group in Canada prominently calling us back to narrative depth. Slowly but surely, it is making political inroads. I am talking about Canada’s indigenous peoples.

Their appeals are explicitly political and mythological at the same time. They make clear connections among their demands for stewardship of their land, their philosophies of relationship with the land, and their opposition to social policy that jeopardizes the health of the land for everyone.

Noted political analyst Naomi Klein calls the indigenous approach the last line of defence against climate change. [25] She contrasts it with the mainstream environmental movement, which long avoided voicing a competing cultural narrative. [26] Said Jay Hair, former president of the National Wildlife Federation, in 1987: “[o]ur arguments must translate into profits, earnings, productivity, and economic incentives for industry." [27] The rest of the Canadian and American environment movements, Klein tells us, are taking notice of the integrity and the efficacy of the myth-linked indigenous approach, and putting alliances with indigenous peoples at the heart of their strategies for change.

Perhaps it is perfectly fitting that indigenous peoples — who most often chose not to go down the path of control and complexity we have called civilization — would help us understand how to undo its most grievous mistakes. Perhaps, with the important inspiration of First Nations, Inuit and Métis philosophy, we can regain our focus on the mythic long arc of our evolution. Perhaps we can continue to evolve our Western story until it is comprehensive and robust enough to roll back some of the errors of 10,000 years.

We know now what to do. We set down a new vision down as a collective goal, evaluate our social success against it, and build power, in the face of elite resistance, for the explicit and much-repeated purpose of realizing that goal. And we keep going, from action to myth-linked action, until we have found a way through - at which point, we would look back and realize that we have become a new people, with a new story.

We may yet be able to realize the promise of the social-welfare narrative: that we comprehend and live out our fundamental interdependence with one another and with all of life. We could correct at last the basic mistakes of civilization, and begin to see our purpose in symbiosis with other living things rather than in dominance over them. Building an economy could be a humble work of listening and adaptation. These things are within our capability. We must tell their story.

Perhaps, in the way of this new story, we can find a manner of living here on Earth that does not compound our problems. Perhaps we can find the solutions that re-engage us with the organic whole; that take us over and beyond the paradox of civilization; that do not solve one problem only to create another. "[P]erhaps,” wrote the great agricultural philosopher Wendell Berry, “it is not until health is set down as the aim that we come in sight of the [good] kind of solution: that which causes a ramifying series of solutions... all involved in the same interested, interlocking pattern – or pattern of patterns.” [28] Crafting a new story takes a very long time. These, I think, are some of the steps.

The need is to discover and reform those aspects of the physical and social environment which have brought about an increase in the particular diseases relevant to our time.
— French microbiologist and public health theorist René Dubos [29]

[1] Why Are Some Healthy and Others Not? The Determinants of Health of Populations. Eds. Robert G. Evans, Morris L. Barer, Theodore R. Marmor. New Jersey, Transaction Publishers, 1994.

[2] Cohen, Mark Nathan. Health and the Rise of Civilization. New Haven: Yale University Press, 1989.

[3] Armelagos, George J. and Mark Nathan Cohen. "Preface to the 2013 Edition." Paleopathology at the Origins of Agriculture. Eds. George J. Armelagos and Mark Nathan Cohen. Gainesville: University Press of Florida, 2013, pp. xvii-xxxi.

[4] Dubos, Rene. Mirage of Health: Utopias, Progress, and Biological Change. New Jersey: Rutgers University Press, 1987.

[5] Szreter, Simon (1988). The Importance of Social Intervention in Britain’s Mortality Decline c. 1850-1914: A Re-Interpretation of the Role of Public Health. Social History of Medicine (1), p. 12. Data are for England and Wales.

[6] The World Bank Group. Data: Canada. 2012. Link. Data are from 2012. Data for United Kingdom, from same source, for more accurate comparison: 82. Link.

[7] Szreter, Simon (2003). The Population Health Approach in Historical Perspective. American Journal of Public Health: (93), 3, pp. 421-31.

[8] Szreter, Simon (2002). Rethinking McKeown: The Relationship Between Public Health and Social Change. American Journal of Public Health: (92) 5, pp. 722-725.

[9] Ontario Medical Association. It’s Time to Start Taking Obesity Seriously: Ontario’s Doctors. 14 February 2012. Link. This press release is cited as support for the contention that the disease states mentioned may reduce life expectancies. I do not support the equation it makes between body fat and those disease states.

[10] The Guardian. Fat Chance. 11 September 2002. Link. Comment in [9] applies here as well.

[11] Cohen, Health and the Rise, p. 142.

[12] The Spectator. “Margaret Thatcher in Quotes.” 8 April 2013. Accessed 24 July 2016. Link.

[12.1] Scott, Peter Dale. The Road to 9/11:  Wealth, Empire, and the Future of America. Berkeley: University of California Press, 2007, pp. 28-30.

[12.2] “Lewis F. Powell Jr.” Wikipedia. Accessed 26 July 2016. Link.

[12.3] Scott, Road to 9/11, p. 30.

[13] Zuckert, Catherine and Michael Zuckert. An Excerpt from The Truth about Leo Strauss: Political Philosophy and American Democracy. The excerpt contains pages 1-20, and the book was published in 2006 by the University of Chicago Press. Link.

[14] Walsh, John. Lies of the Neocons: From Leo Strauss to Scooter Libby: The Philosophy of Mendacity. Counterpunch. 2 November 2005. Link.

[15] Drury, Shadia. The Political Ideas of Leo Strauss. New York: St. Martin’s Press, 1988. Qtd. in Walsh (2005).

[16] Ibid.

[16.1a] McDonald, Marci. The Man Behind Stephen Harper. The Walrus. October 2004. Link.

[16.1b] Saul, Jonathan Ralston. Reflections of a Siamese Twin: Canada at the Beginning of the Twenty-First Century. Toronto: Penguin Books, 1997, passim.

[16.2] Szreter (2002).

[16.3] “Epidemiology (n.).” Online Etymology Dictionary. Accessed 26 July 2016. Link.

[17] McKinlay, John and Lisa D. Marceau (2000). “To Boldly Go….” American Journal of Public Health90, (1), pp. 25-33.

[18] Wing, Steve (1994). “Limits of Epidemiology.” Medicine and Global Survival1(2), pp. 74-86.

[19] Krieger, Nancy (1994). Epidemiology and the Web of Causation: Has Anyone Seen the Spider? Social Science & Medicine: (39), 7, pp. 887-903.

[19.1] Susser, Mervyn and Ezra Susser (1996). Choosing a Future for Epidemiology: I. Eras and Paradigms. American Journal of Public Health: (86), 5, pp. 668-73.

[19.2] Susser, Mervyn and Ezra Susser (1996b). Choosing a Future for Epidemiology: II. From Black Box to Chinese Boxes and Eco-Epidemiology. American Journal of Public Health: (86), 5, pp. 674-77.

[19.3] Why Are Some Healthy and Others Not?

[19.4] “Commission on Social Determinants of Health.” World Health Organization. 2016. Accessed 26 July 2016. Link.

[19.5] “Public Health and Planning 101: An Online Course for Public Health and Planning Professionals to Create Healthier Built Environments.” Ontario Professional Planners Institute. Accessed 26 July 2016. Link.

[20] Raphael, Dennis. “Social Determinants of Health: The Canadian Facts.” 5 August 2011. Accessed 24 July 2016. Video. Link.

[21] Public Health Agency of Canada. What Determines Health? 21 November 2011. Link.

[22] Raphael, Dennis. “Social Determinants of Health: The Canadian Facts.”

[23] Why Are Some Healthy and Others Not?

[23.1] Szreter (2003).

[23.2] Ibid.

[23.3] Ibid., p. 422.

[23.4] Exceptions, happily, do exist. See, for example:

Labonté, Ronald and David Stuckler (2015). "The rise of neoliberalism: how bad economics imperils health and what to do about it." Journal of Epidemiology and Community Health70, pp. 312-318.

Teelucksingh, Cheryl and Blake Poland (2011). "Energy solutions, neo-liberalism and social diversity in Toronto, Canada." International Journal of Environmental Research and Public Health8(1), pp. 185-202.

[24] Kelly, John. "We Are All in the Ojibway Circle." Testimony before the Royal Commission on the Northern Environment, Kenora, Ontario, 1977. Qtd. in Saul, John Ralston. The Comeback. Toronto: Penguin Canada Books, 2014.

[24.1] "Jimmy Carter on Energy & Oil." On the Issues. 30 December 2015. Accessed 7 August 2016. Link.

[24.2] Biello, David. "Where Did the Carter White House's Solar Panels Go?" Scientific American. 6 August 2010. Accesses 7 August 2016. Link.

[25]  Klein, Naomi. This Changes Everything: Capitalism Versus the Climate. Toronto: Alfred A. Knopf Canada, 2014, pp. 192-229.

[26] Ibid., pp. 367-387.

[27] Ibid., p. 192.

[28] Berry, Wendell. Solving for Pattern. The Gift of Good Land: Further Essays Cultural and Agricultural. North Point Press, 1981. Link.

[29] Dubos, Rene. Mirage of Health: Utopias, Progress, and Biological Change. New Jersey: Rutgers University Press, 1987, p. 164.