On its own, targeting high-risk populations can be considered a nec-essary but insufficient response to underlying inequities in the distribution of power, resources,and opportunity. In addition to implementing interventions targeting defined risk groups, moresystematic responses are required that would support the improvement of health literacy differ-entially across the social gradient; this concept is often referred to as proportionate universalism

Low or inadequate health literacy may be seen as arelatively stable patient characteristic, a risk that needs to be managed in the process of providingclinical care (44). The implications of this risk are that clinicians need to modify their commu-nication with patients in response to lower levels of health literacy and, where possible, reducethe organizational demands and complexity faced by patients in a clinical environment. In suchcircumstances, people need the knowledge and skills required to achieve outcomes that are deter-mined primarily by those providing health care.

The term well-being appears in both the final UN Charter and in early drafts from July1943 (Notter, 1949: 479), but unrelated to health. A letter from Gautier to Biraud revealsthat the term was added in response to the International Labour Office (ILO)’s ‘Phila-delphia Declaration’, which spoke about ‘the promotion of . . . health, education andwell-being’ (International Labour Organization, 1944). Gautier argued that the WHOshould ‘defend the ground’ against the intrusion of ILO, which happened at a time whenhe was trying to expand the WHO’s domain to include social security, housing, andnutrition.

Whenmedical perspectives increasingly define obesityas an illness (rather than a risk factor for diseasessuch as diabetes, cardiovascular disease, etc.),policies focus on solutions such as gastric bypasssurgeries, rather than examining the role of productpromotion by the food industry or the availabilityof healthy foods in neighborhoods with high ratesof obesity.

Faced with this situ-ation, health organizations may find that givingpatients a contested illness diagnosis and providingthem with inexpensive palliatives is the mosteffective means of cost containment.

Researchers use the con-cept of excess mortality—the difference between the number of all deaths in a given timeframe minusthe number expected under normal conditions based on prior years—to capture the pandemic’s broaderimpact. Any deaths over and above the expected number constitute excess deaths and can be attributableto both the direct and indirect consequences of the pandemic (e.g., deaths caused by an overburdenedhealth care system or when persons do not seek emergency care for other issues due to fear of infection).

Mary’s is a case of vaccine hesitancy, and sociologists would look beyond her individual beliefs tounderstand how those beliefs are socially patterned and socially produced. For example, research sup-ports the idea that persons who believe COVID-19 vaccines are unsafe are less likely to get vaccinated.But research also indicates that such beliefs are not random.