Health and wellbeing are community resources as well as the products of neighbors and neighborhoods. Individual and collective health are products of interactions at a neighborhood level. Health and wellbeing may be viewed a kind of doubled common pool resource–a resource which grows from both collaborative and collective efforts and which decreases when individuals take without giving back. This may be a stretch of Elinor Ostrom’s definition of a common pool resource but I think that it could be a useful stretch–if her insights into governance of common pool resources can help up improve our common wellbeing. Let’s explore this from her perspective. Common pool resources usually arise from nature, water, grass for grazing, forests, fisheries. The difference with health is that it is the users who are also the creators. Rather than veer away from Ostrom’s precepts it may amplify them since cooperation is needed in the creation as well as in the usage.
Health is more than the absence of illness. It is a different kind of thing. The absence of health may invite illness. But the absence of illness does not create health. Nor does the presence of illness necessarily prevent wellbeing. Our culture has invested heavily in diagnosing and treating illness and has under invested in supporting health and wellbeing. Our preoccupation with death has diverted attention from finding ways to live well.
The expertise and infrastructure needed for restoring health from a state of ill health may require resources beyond a neighborhood’s capability. The design of the relationship between the members of neighborhoods and such non-local institutions is of interest to me. I take my cue from Elinor Ostrom (governance of the commons) as well as Michael McGinnis (polycentric governance).
Light weight, inexpensive governance (without the costly overhead required by corporations and governments) operate by eight rules inside these two interdependent frameworks:
- A) The inexpensive and proximate governing power comes from local peer relationships: to create boundaries and rules, to enter into a network of peer-based communities sharing the same resources and obtaining freedom for local governance from more distant powers.
- B) Inexpensive arrangements for managing the input and withdrawal from the common pool is also provided by local peer relationships: to monitor compliance, to impose sanctions and manage conflict