We are the ‘public’ in the public health approach to grief. So, why does this matter?

Photo by Timon Studler

Grief is having a moment. In Canada, at least.

We can thank Canadian Grief Alliance (CGA) for being an early adopter and pushing conversations about grief. CGA was formed by concerned Canadians who anticipated an avalanche of grief due to the COVID-19 pandemic. CGA lobbied successfully to get grief onto the 2023 federal budget for the first time in Canadian history. Amazing.

Grief is also having a broader global moment, too. Recently Gina Chick, a bereaved mother, brought grief into a public conversation in Australia when she competed in – and won – the survival reality television competition, Alone Australia, surviving 67 days in the wilderness. She writes beautifully about the lessons Blaise, her daughter, inspires in her daily.  

Grief Matters wants to be part of – and amplify – grief’s moments. We are dreaming of a world in which grief doesn’t need a moment at all, actually. And one way Grief Matters is doing this is by insisting that grief is a public health issue.

What is public health?

Public health is a practice that frames health issues as, first and foremost, public issues. Public health focuses on the health of a population, not directly on the individuals in that population. Public health issues are therefore, at one and the same time, medical, cultural, social, economic, and scientific. In public health, while medicine is important, it is but one of many complex interconnected forces competing and converging to affect the health of the population.

Why is grief a public health issue? 

One entry into this story can be told by tracing the history of the public health palliative care (PHPC) movement. Starting about a decade ago, PHPC put a stake into the ground to challenge how palliative and end-of-life care were being conceptualized and practiced in overly medical ways. The early adopters argued that while dying is partly an individual, medical event, is it mostly a community-based experience. Public Health Palliative Care International’s founder, Professor Allan Kellehear, did some rhetorical math to make this point: when we are dying, about 5% of our time will be spent with healthcare professionals, whereas 95% will be with our spouses, children, extended families, pets, neighbours, work colleagues, places of worship… that is, our communities.

In other words, our living as we are dying happens in our social lives. And that is why death should be approached as a public health issue.

Like palliative care more broadly, however, PHPC seemed to forget about grief in its early renditions. Palliative care still struggles with bringing grief fully into its models of care. PHPC followed those missteps, focusing on dying much more so than grieving. While recognizing how valuable the work around increasing death literacy is, this imbalance is what inspired the development of grief literacy.

At Grief Matters, we believe our social, public lives and spaces are an essential home for grief. And this is why we see grief is a public health issue. Grief deeply affects the health of our populations.

When grief is misunderstood – as it often is – there are negative health ramifications for those who are grieving. Research shows how grievers can cost workplaces when days are missed and productivity declines. When people grieve, sometimes they stop eating well, and their physical activity can decline. When grief is stigmatized, loneliness increases. Loneliness has recently been called ‘a silent killer,’ worse for health than smoking. When grievers are in poor health, so are their communities.

Fortunately, there are positive health ramifications when communities come together to support grievers. Talking about grief decreases stigma. Coming together breaks down loneliness. ‘Grief hikes’ encourage exercise. Grief gatherings over dinner nourish our bodies with both nutrients and company. Compassionate workplaces reduce absenteeism (missing work) and presenteeism (being unproductive when at work).

Seeing grief as a public health issue reminds us that grief is everyone’s issue. None of us will get out of this life without grieving, and without knowing other grievers. We are the ‘public’ in public health’s grief literacy, and that’s why it matters.