Addictions and social compassion

Addictions are, to a considerable extent, born of disadvantage and deprivation. That is not the whole story; there are other factors in place, some of which are in individuals as individuals. In terms of the social determinants of ill-health, addiction and poverty are highly correlated. There is also a literature that investigates whether additionally inequality is bad for our health. The hypothesis put forward in this paper is that in a caring society being poor is not good for health but it is not so bad as being poor in an uncaring society. Societies that claim to be based on social solidarity, as do the Scandinavians, tend to be highly taxed with consequent large public sectors. In Australia, taxation is very low relative to most OECD countries. The idea of tax for redistributive purposes is not seen as politically palatable to the Australian electorate. There is a need to rethink the public health response to addictions. Epidemiology and biostatistics dominate too much. Public health needs to accept the depth and width of the challenge that a concern for and acceptance of the role of social capital offer. The paper discusses this in the context of community autonomy and public compassion and the need for societies to 'own' addictions and addiction policy in public discourse. More compassion will not 'solve' problems of inequalities and addictions. The point is rather that it is a good place to start.