Personal Choice v. Social Lottery

A recent article from the New York Times touched on an interesting disease plaguing the wealthy more then the poor: melanoma. With most disease burdens, they are often linked to social lottery, which means that most diseases plague the poor more. With this, however, one’s lifestyle is directly affecting their health outcomes. The article touches on the fact that the wealthier are outside more often. I think this case is important because it can reflect a deeper examination of our understanding of personal choice and social lottery. In public health, understanding this fine balance is critical to making just decisions. Many argue that personal choice is almost always the reason for illness, which often puts blame on those already suffering. That being said, this case brings up an interesting point. Given that the wealthiest have the higher burden of disease, does that mean it is their personal choice driving this? If so, should we not have a preferential option to aid them with their disease?

I recognize that the wealthy have more personal power and ability to dictate health results, and thus there is an argument that they must take personal responsibility for their contraction of melanoma. That being said, I believe there is more to the issue. This examination illustrates the complexities of sayings one’s health outcome can ever be traced completely to personal choice. One, wealthy women often grow up in a culture that defines beauty through tanning, often in unhealthy ways. This pressure is a societal issue. In addition, I believe that there was not much research in prior years on the negative affects and cancerous affect of tanning without protection. This is also a societal issue.

Given this, I think it is difficult to put complete blame on each individual women for their contraction of melanoma. Although they are wealthy, and their contraction often comes from a life of luxury, it is difficult to place complete blame on the population. Societal pressures and lack of evidence resulted in this increase. A few weeks ago, we looked into the difference between personal choice and social lottery. There is not a clear-cut choice when deciphering between these options. Often times, there are many complexities to decide where the blame may lie. With this, the core tenet of public health to focus on the most ill makes sense. Passing personal judgment cannot fully be accurate. Even with a wealthy population, it is unjust to put complete blame on the individual person. With this, like all public health things, there is not a clear solution. In knowing this, we must act very carefully when choosing how treatment is allocated.


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