ABSTRACT
This chapter in the Routledge Handbook of Degrowth (2025) reviews current literature on challenges and opportunities for health and healthcare in degrowth futures through the lenses of ‘voluntary’ planned degrowth and of protracted recession or collapse. Voluntary, planned, degrowth – whether utopian or pragmatic – offers important opportunities to improve physical and mental health, through reducing overconsumption, improving ecological outcomes, and restoring value and meaning to our lives and societies. Extended recession or collapse, by contrast, will have overwhelmingly negative impacts on human health through many pathways, including hunger, ecological collapse and loss of societal capabilities. Successfully preparing public health and healthcare systems for future degrowth requires concerted and deliberate planning and preparation in advance. Six key action areas are recommended: stop harming health through conflict and ecological damage; take ‘no regrets’ actions now that will strengthen today’s healthcare systems while preparing for future transition; transform the culture of healthcare; prepare national health system assessments; plan for recession and collapse; and establish ‘institutions of resilience’ in advance of a crisis. The process of preparing systematically for both voluntary degrowth and enduring recession or collapse is an opportunity to address intractable problems that have stymied health reform across the world in recent decades.
