Competition as a Public Health Problem
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Competition as a Public Health Problem
Competition as a Public Health ProblemBy Pauline Vaillancourt Rosenau. PhD. ProfessorManagement and Policy Sciences E-915 School of Public Health 1200 Competition as a Public Health Problem0 Herman Pressler Houston Texas 77030(713)500-9491 Fax: (713)500-9493 E-mail: pauline.rosenau@uth.tmc.eduPrepared for presentation at the Annual meeting of the APHA, Philadelphia, November 2002ABSTRACTThe objective of this paper is to review existing research and specify the known public health cons Competition as a Public Health Problemequences of various types of competition. The results of such a review suggest that competition is not as benign as has been commonly assumed. CertainCompetition as a Public Health Problem
forms of competition may have quite serious negative effects on human health and productivity. The dynamic by which they do so are known and have beeCompetition as a Public Health ProblemBy Pauline Vaillancourt Rosenau. PhD. ProfessorManagement and Policy Sciences E-915 School of Public Health 1200 Competition as a Public Health Problemlity among individuals, within societies, and between countries. Increased inequality is one of several social determinants of health. While commonly assumed to generate incentives for increased productivity, scholars in several academic disciplines have called the evidence for such an effect into q Competition as a Public Health Problemuestion. Organizations that restrict the level of internal competition are more productive and appear to have a more stable, more highly motivated worCompetition as a Public Health Problem
kforce. A substantial portion of the population has been found to be more likely to function to full capacity where the level of competition is moderaCompetition as a Public Health ProblemBy Pauline Vaillancourt Rosenau. PhD. ProfessorManagement and Policy Sciences E-915 School of Public Health 1200 Competition as a Public Health Problemn educational practices and workplace organizational structures. Similarly at the global level limiting destructive, winner-take-all forms of competition may be necessary' if all nations are to develop to full capacity in the long term and contribute to a healthy and productive international environ Competition as a Public Health Problemment. There is little evidence that the current forms of unrestricted global competition maximize the health of populations or improve productivity.1CCompetition as a Public Health Problem
ompetition as a Public Health ProblemBy Pauline Vaillancourt Rosenau. Ph.D."The invisible hand conjures ill health along with wealth" (Burris. 1997. pCompetition as a Public Health ProblemBy Pauline Vaillancourt Rosenau. PhD. ProfessorManagement and Policy Sciences E-915 School of Public Health 1200 Competition as a Public Health Problemng the most goods available at the least price (Osborne & Gaebler, 1992; Scherer, 1994). Competition is assumed to yield the best, meanest, leanest systems of production with the least waste, whether it is among individuals, groups, organizations, corporations, or nations (FitzRoy, Acs, & Gerlowski, Competition as a Public Health Problem 1998: Van Hooff, 1991). It is praised for increasing productivity, rewarding innovation, encouraging each individual to perform to his or her utmost,Competition as a Public Health Problem
wringing out excess market capacity, lowering costs, increasing organizational efficiency, raising standards, distributing what a society produces moCompetition as a Public Health ProblemBy Pauline Vaillancourt Rosenau. PhD. ProfessorManagement and Policy Sciences E-915 School of Public Health 1200 Competition as a Public Health Problem 1998; Cronbach, 1963: Horowitz, 1968: Rich & De Vilis, 1992). It is thought to bring about needed change and to end bureaucratic rigidity (Osborne & Gaebler, 1992). Competition is even said to build character and improve interpersonal relations (Shaw, 1958). Experts agree that competition works its Competition as a Public Health Problem magic without reference to ethics or philosophy.But even if this view is true, none of it is without costs including public health consequences. ThisCompetition as a Public Health Problem
is especially the case if public health is defined in broad terms. Public health’s mission as Charles-Edward Winslow put it in 1920 is the “fulfillmeCompetition as a Public Health ProblemBy Pauline Vaillancourt Rosenau. PhD. ProfessorManagement and Policy Sciences E-915 School of Public Health 1200 Competition as a Public Health Problems means everyone has a standard of living appropriate to the maintenance of health and the condition in which every citizen may realize her or his birthright ol health and longevity (Hanlon & Pickett, 1984). ĨI brings into public health a population health perspective. It introduces socioeconomic st Competition as a Public Health Problematus.inequalities, early childhood development, educ ation, employment conditions, and SCK ial support systems into tire public health equation (TerriCompetition as a Public Health Problem
s. 1986. see p. 55 for cite).Certain forms of competition interfere with the achievement of public health goals in several ways. These are examined beCompetition as a Public Health ProblemBy Pauline Vaillancourt Rosenau. PhD. ProfessorManagement and Policy Sciences E-915 School of Public Health 1200 Competition as a Public Health Problem others are destructive. Much depends on how competition is employed to allocate society’s resources: how it rewards winners and sanctions losers. Competition was not designed to redistribute society’s wealth. Where that is the public-health-relevant goal other means are better suited to the task.So Competition as a Public Health Problemmetimes the effect of competition on health is direct. This is the case with regard to stress. But the ways in which destructive competition constitutCompetition as a Public Health Problem
es a public health problem are often overlooked because die dynamic involved is often indirect and subtle. For example, destructive forms ol competitiCompetition as a Public Health ProblemBy Pauline Vaillancourt Rosenau. PhD. ProfessorManagement and Policy Sciences E-915 School of Public Health 1200 Competition as a Public Health Probleme social determinants of health.Winning and losing at each level, be it die individual, die group, the organization, the corporate entity, or the nation, is not random (Gorney, 1972). Under conditions of unrestrained competition, results are predictable. Ulis is because at the outset, competitors se Competition as a Public Health Problemldom starts at a point of equality. Some have more resourc es, attributes.3https://khothuvien.cori!and wealth than others. Even those attesting to theCompetition as a Public Health Problem
virtue of the invisible hand in the marketplace agree that “one cannot explain the pattern of output or results in any market system by pointing exclCompetition as a Public Health ProblemBy Pauline Vaillancourt Rosenau. PhD. ProfessorManagement and Policy Sciences E-915 School of Public Health 1200 Competition as a Public Health Problem01, p.171). The rewards of winning are often cumulative (Frank, 1985, p. 4).Eventually, and in the absence of any outside interventions, competition increases differences and sustains a negative spiral of winning or losing, thus generating even greater levels of inequality. As the process moves alon Competition as a Public Health Problemg over lime, it leads to big winners and continual losers. Competition continues, and too often, the winners, often at the expense of the losers in prCompetition as a Public Health Problem
evious competitive encounters, influence the terms of play. People become discouraged when they repeatedly lose (Campbell, 1982; Drucker, 2001, p.ll).Competition as a Public Health ProblemBy Pauline Vaillancourt Rosenau. PhD. ProfessorManagement and Policy Sciences E-915 School of Public Health 1200 Competition as a Public Health Problemy individuals, organizations, or societies, have poorer health (Lynch, Kaplan, & Sheina, 1997) and lower productivity. Lower societal productivity is a matter of public health concern when it means that a substantial portion of the population cannot maintain a standard of living sufficient for healt Competition as a Public Health Problemh and longevity. In the end everyone is worse off, because even when a minority of the population is unable to work to their full capacity, because ofCompetition as a Public Health Problem
psychological or physical health impediments, the quality of life is compromised for all members of society. The same dynamic plays out at the globalCompetition as a Public Health ProblemBy Pauline Vaillancourt Rosenau. PhD. ProfessorManagement and Policy Sciences E-915 School of Public Health 1200 Competition as a Public Health Problemo define competition and to distinguish among its various forms are few. Certain types of competition are more likely to have negative health effects rather than others. Competition can be structured in various ways and each has significant but different consequences. Goal-oriented competition encou Competition as a Public Health Problemrages each player, each person, to do their best and to work with others to achieve an objective. An example is how the World Health Organization encoCompetition as a Public Health Problem
urages each country to set time-specific national goals for improving population health and then strive to attain those goals. Each country is competiCompetition as a Public Health ProblemBy Pauline Vaillancourt Rosenau. PhD. ProfessorManagement and Policy Sciences E-915 School of Public Health 1200 Competition as a Public Health Problem benign because it emphasizes doing better than others, winning over others for its own sake (Morey & Gerber, 1995).Johnson and Johnson suggest that there are important differences as well between zero-sum competition and appropriate competition (Johnson & Johnson, 1989; Johnson & Johnson, 1994; Sta Competition as a Public Health Problemnne, Johnson. & Johnson, 1999). Zero-sum competition involves the distribution of rewards on a “winner-take-all” basis. This means that 1 win, you losCompetition as a Public Health Problem
e. Appropriate competition seeks to maximize personal well-being, improve overall societal productivity, and advance global community. It is associateGọi ngay
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