Intended for healthcare professionals

Rapid response to:

Analysis Health, Wealth, and Profits

The economy of wellbeing: what is it and what are the implications for health?

BMJ 2020; 369 doi: (Published 16 June 2020) Cite this as: BMJ 2020;369:m1874

Health, wealth, and profits

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The perplexing pursuit of an economy that promotes wellbeing not growth

Rapid Response:

Planetary Health underpins an economy of wellbeing

Dear Editor,

I was both excited and disappointed to read the article “The economy of wellbeing: what is it and what are the implications for health” in the BMJ this week. Excited to see that the BMJ had commissioned an article on the important issue of centreing the economy on wellbeing rather than an arbitrary measure such as GDP and disappointed that the article failed to consider the most pressing and urgent determinant of human wellbeing – planetary health.

Despite being widely reported as a crisis and emergency, and acknowledged by the WHO as the most urgent threat to human health in the 21st century1, the climate and ecological crisis does not even feature in this article in terms of how we should devise an economy of wellbeing.

Human wellbeing is deeply connected to and dependent on planetary life-support systems that provide us with the fundamental determinants of health (clean air, freshwater, conditions that enable us to grow and harvest food) as well as preventing disease through healthy ecosystems.

Economists have given this thought. In ‘Doughnut Economics: How to think like a 21st century economist’, Kate Raworth describes an economic model which allows for human flourishing using a diagram in the shape of a doughnut.2 The inner ring represents the social foundation of human rights below which no-one should fall (food, water, education, healthcare, social equity, peace, political voice etc.) and the outer ring represents the ecological ceilings of planetary boundaries (air pollution, biodiversity loss, ocean acidification, freshwater withdrawals etc). In between these two rings is what she calls the ‘safe and just space for humanity’.

It is important that as we build back our economy from the Covid-19 crisis, that we put human wellbeing at the centre of all our decision making. To do this, requires a clear understanding of health determinants, the most fundamental of which depend on planetary health.

1. WHO calls for urgent action to protect health from climate change- sign the call. Accessed 1st July 2020.
2. Raworth K. Doughnut economics: seven ways to think like a 21st-century economist. Chelsea Green Publishing; 2017

Competing interests: No competing interests

01 July 2020
Aarti Bansal
Burngreave Surgery, Founder of Greener Practtice
5 Burngreave Road, Sheffield.