Towards An Ontography of Public Health - Part 1: Possibilities

One aspect I enjoy at this stage of my career is developing tools (training algorithms, materials, procedures) that demand and instantiate more practical complex-ecological thinking among those I work with, and at all levels of decision-making and practice. I consider this at the core of public-health assemblage design. And in the context of the work I do I suggest that we desperately need to enact more ecological modes of thinking, representing and health-relating if we are to cultivate more eudemonic public education, health-care and prevention systems.

And this is where my interest in ‘speculative realism’ meets my everyday work. Contemporary public health and education systems are pervaded by what Mark Fisher has called “capitalist realism”. This pernicious ethos and regime of practice often preempts crucial insights and innovations from flowing into public life from various sources viz. both representation (knowledge expression) and application.

By taking an ontographic approach to health and education systems I suggest a rethinking of the foundations of our public health assumptions and a mapping out of inherently subversive trajectories for community design and re-assembly relative to the dominant admixtures of capitalist realism currently at work. 

Philosophy broadly conceived is an important resource for just such a rethinking and redesign. So for me speculative realism is a particular set of strange attractors which help confront crucial questions. Therein we are cued to consider what kinds of speculation might be required to move into more participatory, ecological or truth-full conceptual spaces? What kind of “realisms” can we co-create that might enact more equitable, just and sustainable ways of being in the world?

In brief, I argue that many Western health-care cultures still sorely lack an attention to several critical factors impacting communal and individual life. For starters:

1. There is still an under appreciation for the ever-present qualitative (sensual, psycho-aesthetic, symbolic, experiential) aspects of public health. The existentiality of health-care and education - including its developmental dimensions – is institutionally excluded from systems design (even in the domain “mental health” services in my opinion).

2. A far-reaching inability to implement (or generate) a deeper appreciation of the particular ‘agencies’ or efficacy (duration, intensity, affect) of the myriad of sub-personal and non-human materials/properties which compose any particular community matrix. As an example I would simply point to asbestos in school construction, pesticide in public parks, or fluoride in community water supplies. At the level of the clinic we can see aspartame in use in the lobby, improper use of antibiotics and much more.

3. The implicit (subconscious and nonconscious) and pathological assumptions coded into contemporary health practices (interrogated along the lines initiated by Michel Foucault, R.D Lang, Arthur Kleinman, Paul Farmer and others).

These are only three strains of consideration we might entertain, but I would suggest that the basic deficiency of current education and health-care assemblages is an inability to enact modes of participation and operation which address the imperatives of various biophysical, existential, semiotic and ecological aspects concurrently.

What interests me in the short-term, then, is exploring the possibilities for moving towards an ontography of public health that offers up our most basic metaphysical assumptions for scrutiny.

Starting seemingly arbitrarily from Heidegger’s questioning of the meaning of Being we can then plunge full-bodied into the cave of experience and interrogate the appearance of objects and relations, events and procedures, assemblages and flows, and trace them back to their ancestral roots within the dark ecology of matter and intensity. In this subterranean infrastructure we find ourselves among all sorts of uncanny processes, flows, entities and meshworks capable of forcing us into novel negotiations with reality and perhaps prompting us to build our habitats in ways that better sustain and nourish the life-tide of our own being and becoming in addition to the achievements of other materials. 

Can we have a general theory of objects that enriches civilizational design? Can we have a model of dynamic process that appreciates the pure difference and individuation of things? What is the essential nature of reality upon which any infrastructure of public health is built? And will these most basic ontological inquires move us and affect us enough to become more authentic and creative beings? I hope to find out.