Speculating on health: public health meets finance in ‘health impact bonds’

Excerpt from a paper in Sociology of Health and Illness:

“Where modern public health developed techniques to calculate probability,
potentiality, risk and uncertainty, contemporary finance introduces instruments that
redeploy these. This article traces possibilities for interrogating the connection
between health and financialisation as it is arising in one particular example – the
health impact bond. It locates the development of this very recent financial
innovation in an account of public health’s role within governance strategies over
the 20th century to the present. We examine how social impact bonds for chronic
disease prevention programmes bring two previously distinct ways of thinking
about and addressing risk into the same domain. Exploring the derivative-type
properties of health impact bonds elucidates the financial processes of exchange,
hedging, bundling and leveraging. As tools for speculation, the functions of health
impact bonds can be delinked from any particular outcome for participants in
health interventions. How public health techniques for knowing and acting on risks
to population health will contest, rework or be subsumed within finance’s
speculative response to risk, is to be seen.”


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