Putting All Our Eggs in One Basket While Dancing Around the Elephant in the Room: How Health and Economy Conversations Need to Better Align

Abstract

This commentary examines a critical paradox in contemporary policymaking that hinders effective action for health equity. On one hand, certain policymakers fixate on economic growth measured by GDP as the solution to societal challenges (putting all their eggs in one basket). Simultaneously, other policymakers acknowledge but ultimately avoid addressing how the economic system fundamentally drives health inequalities (dancing around the elephant in the room). This results in perpetuating a focus on downstream interventions rather than disrupting health's structural and economic determinants. While notable exceptions exist, sustained examples of upstream economic intervention remain scarce. Health promotion practitioners are positioned to challenge this paradox through their core competencies in policy influence, systems thinking, partnership building, and community mobilisation. By supporting policymakers to address power and wealth inequalities that underpin health disparities, health promotion practitioners can help move beyond approaches focused primarily on individual behaviour change. This commentary calls for creative collaborations, new language for conceptualising wellbeing economies, and broader public support to expand what is deemed politically possible in addressing economic causes of health inequalities.

Keywords: economy; health promotion; policy; prevention; social determinants of health; upstream change; wellbeing economy.