Agency and vulnerability
Public health often centers the notion of vulnerability as a fixed state: Populations are “at risk,” “marginalized,” or “exposed.” Yet human experience also includes agency — the capacity to act, adapt, and shape one’s circumstances even under constraint. The tension between these two ideas is central to public health. Overemphasizing vulnerability can obscure the strengths, strategies, and autonomy that individuals and communities exercise. Overemphasizing agency can minimize structural forces that limit choice and create harm. The interplay of the two raises foundational questions: How should public health represent the people it aims to serve? How do we design policies that acknowledge structural inequities while also recognizing the capacities of individuals and communities? And what does a balanced approach teach us about building a public health practice that avoids paternalism, respects dignity, and remains effective?
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