Why 'Health' is not a Central Category for Public Health Policy

We normally think that public health policy is an important political activity. In turn, we normally understand the value of public health policy in terms of the promotion of health or some health-related good (such as opportunity for health), on the basis of the assumption that health is an important constituent or determinant of wellbeing. In this paper, I argue that the assumption that the value of public health policy should be understood in terms of health leads us to overlook important benefits generated by such policy. To capture these benefits we need to understand the ends of public health policy in terms of the promotion of 'physical safety'. I then go on to argue that the idea that 'health' is an important category for evaluating or estimating individuals' wellbeing in the normative context of social policy is confused. I then clarify the relationship between my arguments and QALY-based accounts of health assessment. In the final section of the paper, I defend this surprising conclusion against various attacks.