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    Random thoughts, some science, and the latest research.

    Greed: Good or bad? Gordon Gekko or St Thomas Aquinas? It should be a simple question. But is it? And what does this have to do with health?

    Times change. There’s little doubt Gordon Gekko (aka Michael Douglas: ‘Wall Street’) was right for his time. Greed was good. It’s the way we got to where we are – not just the house and car, but the best health of any humans throughout history. And after all, isn’t human health and well-being what economics is all about?

    The answer is not so clear. We have to go back to find out how the growth system of economics, on which all our aspirations are based, works. Nineteenthth Century economist/philosophers like John Stuart Mill saw that an economy had to grow to provide benefits for all (‘a rising tide raises all boats’). And growth requires more people, more production, and more consumption. Individual greed was one way of getting this.

    But this came with a warning: In his Principles of Political Economy (1848), Mill stressed that once the work of growth was done, a stationary economy would be necessary. JM Keynes, in helping manage the great depression of the 1930s, said we may need to grow for up to 100 years but after that we would have to look to a different system because “…nothing can grow forever.” Kenneth Boulding, the great US economist of the late 20th Century said: ‘Anyone who believes exponential growth can go on forever in a finite world is either a madman or an economist.”

    As we have learned in recent years however, to discuss the economic system (in contrast to its bits), has been like discussing falatio to a nun. It has split economics schools, with anyone daring to mention the dreaded adjective ‘sustainable’ within a word of the noun ‘economics’, usually sent to Coventry. ‘Externalities’, or the cost of production to a third party (such as ill-health from pollution), has been confined to the appendices sections of economic texts, never to be uttered in public.

    Yet, those in the health industry know that obesity, diabetes and other lifestyle-related modern health issues are not simply due to lack of individual restraint, but are a side-effect of economic systems. Obesity, for example, is collateral damage in the battle for economic growth.

    The fact that such growth has a ‘tipping point’, beyond which negative returns occur, would seem obvious. Nothing can grow forever, as Boulding reminded us. And ‘growth beyond maturity is either obesity or cancer’. Contrary to expectations, most GPs will also tell you that bad times, such as the 2008 GFC, actually lead not to more cases of depression, but less. We await eagerly the evidence from Greece, but it’s a fair assumption that obesity (and consequent health problems) will have diminished in the light of their current economic malaise.

    So does the current Chinese stock market crisis/es signal the beginnings of the end of the growth era, and if so, is this good – or bad for the health of the (already rich) developed world? Was Napoleon right when he said: ‘China is a sleeping giant. Let her sleep, for when she wakes she will move the world.’ The current rise in obesity prevalence from around 2% in the 1980s to over 20% today is signalling that China is definitely awake. (Ironically, equivalent BMI levels pre this rapid growth spurt, were less dangerous than during or after this1).

    St. Thomas Aquinas and all his righteous buddies of the time were certainly onto something. Greed is bad. They even made it one of the seven deadly sins. But in contrast to G. Gecko, this statement not only reflects the past, but also the future. It signals the start of a new era, which must now capitalise on the gains of growth to date. This doesn’t mean human growth must stop. As UK Sustainability Commissioner Tim Jackson has shown, prosperity is possible without growth. 2 A truly sustainable economic system (if this is not an oxymoron) will no doubt develop in stages.

    But ultimately for humanity to survive, and for us to win the battle against the rising tide of lifestyle-related chronic disease, we must begin to look to a different system of economics. That will test our capacity for adaptability as nothing else since leaving the trees. It might also leave a few traditional economists still swinging through the branches.


    1. He Y, et al. Changes in BMI before and during economic development and subsequent risk of cardiovascular disease and total mortality: a 35-year follow-up study in China. Diab Care. 2014; 37(9):2540-7.
    2. Jackson T. Prosperity without Growth: Economics for a Finite Planet. Earthscan, London, 2009.