Globalization, austerity and health equity politics : taming the inequality machine, and why it matters.

The recognition that globalization has an important role in explaining health inequalities has now moved into the mainstream. Much of that role relates to what has been called ‘[t]he inequality machine [that] is reshaping the planet’. At the same time, more attention must be paid to how the state can tame the inequality machine or compensate for its effects. I argue that governments have more flexibility in this respect than is often acknowledged. With an emphasis on current and recent social policy in Britain, I illustrate the need for researchers and practitioners to focus not only on external constraints associated with globalization but also on domestic political mechanisms and dynamics that may limit the extent to which governments can reduce health inequalities by addressing underlying social determinants

Money Matters: A Reality Check, with Help from Virginia Woolf

This article provides a qualified defence of economic indicators of human well being. Purchasing power obviously matters as a prerequisite for obtaining basic needs; abundant examples of human behaviour even in the richest countries in the world suggest that it matters for many other reasons, as well. Despite the shortcomings of indicators like GDP and GNP, richer nations (like richer individuals) have options that are simply not available to poorer ones. A particularly serious limitation of such indicators arises from their failure to take into account the distribution of income and wealth, both within and among nations. Higher income does not automatically lead to increased well being, but extreme caution is in order about attempts to dismiss its contribution, or to pathologize certain forms of consumption. While arguing the merits of a lifestyle less organized around consumption, proponents of sustainable development must acknowledge the strength of the evidence that money matters

Ecology as if People (and Power) Mattered

The idea of ecological risk assessment arguably represents the latest chapter in a long story: the attempt to make environmental policy more "rational". We can start to evaluate the strengths and limitations of ecological risk assessment, and its uneasy coexistence with democratic political institutions, by evaluating the strengths and limitations of that enterprise taken as a whole

A New Gilded Age, and What It Means for Global Health Comment on "Global Health Governance Challenges 2016 – Are We Ready?"

New contours of global inequality present new challenges for global health, and require that we consider new kinds of health issues as global. I provide a number of illustrations, arguing the need for a political science of health that goes beyond conventional preoccupations with formal institutional and interstate interactions and takes into account how globalization has affected the health policy landscape and restructured the distribution of economic and political power not only among countries, but also within them

Was Mackenbach right? Towards a practical political science of redistribution and health inequalities

In 2010, Mackenbach reflected on England's lack of success in reducing health inequalities between 1997 and 2010, asserting that “it is difficult to imagine a longer window of opportunity for tackling health inequalities”; asking “[i]f this did not work, what will?”; and concluding that reducing health inequalities was not politically feasible at least in that jurisdiction. Exploring the empirics of that observation offers a window into the politics of reducing health inequalities. For purposes of future comparative research, I outline three (not mutually exclusive) perspectives on political feasibility, identify their implications for a political science of health inequalities, and explore what they mean for advocacy in support of reducing those inequalities

Global reach, local depth, and the future of health equity

"Global Reach" was the title of one of the first popular books on the power of transnational corporations, published in 1974. Since then globalization has transformed the world to an extent that would then have been difficult to imagine. In this article I explore the effects of globalization with respect to two dimensions, global reach and local depth, and draw some rather pessimistic conclusions about prospects for the ambitious agenda advanced by the Commission on Social Determinants of Health in 2008

‘Neoliberal epidemics' and public health: sometimes the world is less complicated than it appears

A recent CPH editorial addressed ‘the perils of invoking neoliberalism in public health critique’. While in sympathy with many of the authors’ concerns, I argue that the analytical literature on neoliberalism, the historical record of neoliberalism’s promotion and diffusion, and the empirical evidence of its health consequences support the view that ‘neoliberal epidemics’ represent a substantial and clearly definable threat to public health and health equity

Globalization and social determinants of health: Introduction and methodological background (part 1 of 3)

Globalization is a key context for the study of social determinants of health (SDH). Broadly stated, SDH are the conditions in which people live and work, and that affect their opportunities to lead healthy lives