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Like this article, I’ve a problem with the use of “underlying conditions” and how it is that when we hear someone has died who had them the “phew ! Not me then, I’ll just carry on as usual” attitude it engenders. There are other problems with this term /1 https://www.theguardian.com/commentisfree/2020/mar/19/underlying-conditions-coronavirus-health
First, it is fuelling an expendability discourse. The devastating loss of people with an underlying condition is becoming seen - by the healthy - as an acceptable outcome in this awful crisis. This breeds an “us and them” mentality that emboldens non-adherence to advice / 2
Second, it reinforces a narrative that those with underlying health conditions are to blame and are responsible for their own health state. It divides the population into deserving and non-deserving camps using a view of disease as individual lifestyle not socially determined.
Third, the term “underlying” positions chronic disease as “below” a normal baseline of health, with covid-19 the rogue external entity that attacks the body from above this baseline. This reinforces the idea of health as ideal normal functioning and binary opposite to disease.
This binary view of health and disease (you’re either sick or healthy) creates a false sense of security amongst the healthy. When faced with a new risk, this denial narrative drives non-acceptance, avoidance and propagation, yet people are rarely either 100% healthy OR ill.
A better approach is to avoid the language of underlying conditions altogether. Instead, it is better to use indicators of personal and social RISK - to acquire AND spread infection - and CAPACITY - to know, detect, withstand and recover from the infection. With these indicators,
people can make smarter decisions about the risk to themselves AND others based on their health, social and environmental context as well as how to act and where to adapt their lives. This builds-up societal acceptance and adherence creating the right conditions to recover. END
