INTERNALIZED PUBLIC MORAL NORMS
Shared substantive visions and commitments are critical for health reform and implementation
WHAT IS IT?
A public moral norm is a value shaping our individual and collective morality. Values underlie, and create, public moral norms.
The health capability paradigm requires an ethical commitment by all to improve and maintain health capability for everyone. All individuals, providers, and institutions must embrace and internalize universal norms that health is worthy of social recognition, investment, and regulation.
Individual health capability is connected to the effective functioning of society. Promoting individual health capability requires shared substantive visions and commitments that promote fair standards, collective action and cooperation, and the common good.
WHY IS IT IMPORTANT?
There needs to be an internalization of public values at the individual, social, and political level. If this doesn’t happen, efforts to achieve health equity will continue to fail. This is because achieving health equity requires the action and inaction of individuals, groups, and institutions. It is impossible to mandate and micro-manage such attitudes and behaviors in every place at all times.
Our values and norms determine what we do, want to accomplish, and how we live individually and collectively. It provides a foundation for why we do certain things and helps solve collective problems. With positive internalized public moral norms of health equity, society as a whole will be healthier and more productive. We must work collaboratively to develop our individual and collective capabilities to address risks to health and well-being as equitably and efficiently as possible.
Internalized norms are often “taken-for-granted.” They govern our behavior sometimes without us even realizing it. Internalized public moral norms will propel action that will help meet needs for global and domestic health equity. They will provide a sustained and formidable foundation for individual and collective action.
In order to achieve health equity, health systems and institutions have to allocate resources properly, enact legislation, and promote individual and population health at multiple levels. Shared health values, objectives, and norms all matter for effective and efficient decision-making in an integrated and multifaceted system.
WHAT DOES IT LOOK LIKE?
A public moral norm is different from an individual moral norm, because it pertains to both individual and collective action in the public realm.
For example, in other countries, it is acceptable for individuals to give up some of their privacy in order to share knowledge and information that improves their health and the health of others. There is an underlying value about the importance and worthiness of giving up privacy, and this impacts norms about certain health care and public health programs, interventions, and responses. For instance, Taiwan’s COVID-19 response valued and required cooperation from their citizens. Citizens worked with authorities to build a knowledge base, even with individual data, about COVID-19 exposure, infection, and location to improve individual and collective health.
We need positive norms for health that respect everyone, focus on people’s flourishing, develop their capabilities, nurture their talents and growth, and build on their strengths. These attitudes about health will allow everyone to reach their potential and contribute positively to their communities and society.
Positive public moral norms should be internalized by the majority of people in a society, at a national, subnational and/or global level. Collective decisions in governments and legislatures must be based on these shared values of health.
HOW DO WE DO IT?
It is in all of our interests to create conditions for everyone to be healthy. Our global society and economy, and our domestic societies and economies, are mutually interdependent and share vulnerabilities. Furthermore, while we all share strengths together, we also share vulnerabilities together. For the chance for everyone to live objectively good lives, we must come to terms with what we value and prioritize. We must view health as an essential aspect of our lives.
Values and internalized public moral norms are critical to enacting legislation and reform and to the behavior of individuals and collectives. Social movements over time can also help fundamentally restructure values and norms within a society. Leaders and policymakers can generate consensus on values and norms underlying policies and practices.