A vision for the role of governments in supporting the public's health: Learning from the past and expanding our imaginations for the future

Governments in Canada and elsewhere play a very significant role in shaping the health of populations, but the main ways in which they do so are largely hidden because they lie outside of the health sector and are thus under-leveraged. Neoliberal economic and social policy has eroded upstream determinants of health, with profound consequences for health equity. The current polycrisis—a predictable outcome of neoliberalism—provides an opportunity to re-imagine a role for governments in supporting the public’s health. Anchored in a broad version of public health, I consider three levels where we, as a community of health professionals, could start to envision such a version of government, focusing primarily on federal government: (1) public spending; (2) overall orientation of government vis-à-vis the well-being of the population; and (3) the broader political economic paradigm and its dynamics of power. Collectively, these offer opportunity to learn from our past while expanding our imaginations for the future. Such a vision will require the support, and the humility, of healthcare leaders.