The Productive Taxpayer
When we talk about the economic cost of chronic disease, the conversation almost always focuses on what the healthcare system spends treating it. That is a real and significant number, but it is only half the ledger. The other half is what does not get produced.
Chronic preventable illness does not just create healthcare costs. It often dramatically reduces the economic output of the person living with it. Absenteeism is the visible part: days missed, work not done. But the research consistently shows that presenteeism costs employers and economies considerably more than absenteeism does. Presenteeism means showing up while unwell and performing at a fraction of capacity. A person managing poorly controlled diabetes, chronic back pain, or significant sleep deprivation is not fully absent. They are just not fully there.
That lost productivity does not stay contained to the individual. Tax revenues fall. Pension contributions shrink. Output in every sector that depends on human attention, creativity, and physical capability is reduced. The Canadian economy, like most developed economies, is built on the assumption that a large working-age population will continue contributing. When a meaningful share of that population is managing chronic preventable conditions, the arithmetic quietly changes.
The inverse of this is the underappreciated argument: when you stay healthy, you are not merely avoiding being a cost. You are actively generating economic contribution. You are earning, creating, and paying taxes that fund the services others depend on: healthcare, education, social programmes, infrastructure. In a system of collective funding, your health is a kind of civic participation that rarely gets called what it is.
This is not a reason to feel guilt when you get sick. Illness is not a moral failing. It is simply a reason to take the preventable seriously. The behaviours that keep you economically active are not just good for you. They sustain the system that everyone around you relies on.
The Invisible Carer
There is a vast category of economic and social value that never appears in GDP figures: informal caregiving. The parent managing a child's complex needs. The adult child caring for an aging parent. The spouse supporting a partner through a long illness. The neighbour quietly checking in. This care is unpaid, untracked, and largely invisible when it functions. When it breaks down, the consequences are very visible indeed.
In Canada, estimates suggest that informal caregivers provide hundreds of billions of dollars of care annually that would otherwise fall to the formal healthcare and social services system. This number is almost certainly an undercount. Much of what caregivers do cannot be commodified even in principle. The reassurance of a familiar voice, the context a family member holds about someone's history and preferences, the judgment calls made at three in the morning. These things do not appear on any balance sheet.
What is less often discussed is the dependency chain embedded in this system. When a primary caregiver becomes chronically ill and can no longer hold everything together, the people who depended on them face a cascading vulnerability. The elderly parent loses their main support. The child with complex needs loses their most informed advocate. The household loses the person who was quietly managing everything. The formal system, already under strain, is asked to absorb what informal care was providing.
Caregiver burnout is a recognised and serious public health issue in its own right. Research consistently shows that family caregivers experience elevated rates of depression, anxiety, and physical ill health. This is partly a direct consequence of the demands of caregiving, and partly because caregivers routinely deprioritise their own health in service of someone else's. The result, not infrequently, is that the caregiver eventually becomes a patient themselves. Two people now need the system, where before there was one.
The argument here is not complicated. The people who most need care, including children, the elderly, and those with serious illness, are often dependent on the health of someone else. That someone else is rarely counted in the statistics. But their capacity matters enormously. When you protect your own health, you are also protecting the people who need you to be well. That is not a small thing.
What This Means, Practically
Neither of these arguments is a reason to be anxious about your health or to feel that your wellbeing is somehow a civic obligation imposed on you from outside. They are simply two ways of seeing something that is already true: your health does not stop at your skin. It radiates outward into your household, your workplace, your community, and the systems everyone shares.
The good news, which is also the premise of everything we build, is that the behaviours most associated with long-term health are not heroic. They are not expensive. They are not reserved for people with unlimited time, money, or willpower. Moving more, sleeping better, managing stress where you can. These compound quietly over time. They are not a perfect solution, but they are a real one, and they are available to almost everyone.
Some economists have argued that prevention programs cost health systems more than they save, and the evidence gathered over decades for this is real. It rests on one assumption: that reaching people costs money. A free app on the phone already in your pocket changes that arithmetic entirely. When the cost of reaching one more person approaches zero, that case against prevention does not apply.
Taking care of yourself is not selfishness. For most people, it is one of the most practical forms of contribution available. Start small. Stay consistent. It tends to be enough.