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Why Public Health Is Not About Public Goods.

Lovro Savić1

  • 1Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.

Public Health Ethics
|December 1, 2025
PubMed
Summary

The Public Goods Account incorrectly limits public health activities to providing health-related public goods. This paper argues the account is flawed because its core concept is implausible and doesn't accurately define public health actions.

Area of Science:

  • Public Health
  • Philosophy of Medicine
  • Health Policy

Background:

  • The Public Goods Account (PGA) proposes that public health activities should exclusively focus on providing health-related public goods.
  • This framework aims to define the scope and purpose of public health interventions.

Purpose of the Study:

  • To critically evaluate the adequacy of the Public Goods Account as a framework for understanding public health activities.
  • To challenge the central concept of 'health-related public goods' within the PGA.

Main Methods:

  • Conceptual analysis of the Public Goods Account and its core concept.
  • Examination of two potential interpretations of 'health-related public goods'.
  • Argumentation based on counterexamples to demonstrate the limitations of the PGA.

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Main Results:

  • The concept of 'health-related public goods' is deemed implausible.
  • On both analyzed interpretations, providing health-related public goods is neither necessary nor sufficient for an activity to be considered public health.
  • Examples exist of public health activities not producing health-related public goods, and non-public health activities producing them.

Conclusions:

  • The Public Goods Account is an inadequate framework for defining public health activities.
  • The PGA's reliance on 'health-related public goods' fails to capture the full scope of public health.
  • A revised or alternative framework is needed to accurately account for public health endeavors.