Recognizing the Adverse Health Effects of Neoliberal Global Capitalism

It is rather striking how the last few years have seen an increase in literature linking features of capitalism to problematic quality and distributions of the social determinants of health79,80,83,85,142 and health care.82,84 McNamara and Bambra for example, map out the polycrisis and its relation to health inequalities. 16 While they mention the failure of free market capitalism to deliver its promised effects, they do not explicitly call for radically reforming or replacing capitalism itself, a common failure, as we noted earlier, to most working in the political economy of health area. Instead, Bambra, Lynch, and Smith, as example, show how progressive policy implementation promoted health during “The Great Society” in the USA, England’s “Health Inequalities Strategy”, and “German Reunification.” 57 Whether such innovations are possible in our current period of neoliberal global capitalism is uncertain. 107

The earliest and perhaps still the best exposition of the adverse effects of unrestrained capitalism is Friedrich Engels’s Condition of the Working Class in England. 144 Medvedyuk, Govender and Raphael document how Engels’s description of the adverse effects of capitalism as social murder was virtually absent for 150 years from any academic discourse but has seen a striking revival in the public health literature. 145 This has been driven by events such as the Grenfell Fire in London UK, the imposition of austerity in many nations, and the differential health effects of the COVID-19 epidemic.

Additionally, Govender, Medvedyuk, and Raphael document the increasing framing of these adverse health effects as social murder by the mainstream media. 146 In the UK the health effects of imposition of austerity have been termed social murder 21 and in the USA, the term has been used to describe the effects of corporate authoritarianism overtaking the democratic rule of law. 147 Another thread of literature describes these adverse effects on those occupying specific social locations. Gender, race, and Indigeneity interact with class-related capitalist structures to cause adverse health outcomes for women, racialized, and Indigenous populations.148,149 The role capitalism played, and still plays, in colonialism falls within this thread.150–152

It is important to note that even when the term social murder is applied to contemporary issues such as the Grenfell Fire, austerity in the UK, and the effects of the COVID-19 epidemic, these works do not necessarily implicate capitalist exploitation as being behind it.145,153 In many cases, the cause is simply considered to be bad public policy, illustrating the resistance to tackling capitalism head on, and calling for its radical transformation or replacement.