The iconoclastic US epidemiologist Nancy Krieger has argued that ‘analysis of causes of disease distribution requires attention to the political and economic structures, processes and power relationships that produce societal patterns of health, disease, and wellbeing via shaping the conditions in which people live and work’ (emphasis in original). Responding to this challenge, Clare Bambra and I have deployed the concept of ‘neoliberal epidemics’ to explain how contemporary economic and social policies in many places have widened health inequalities and imperiled past gains in health indicators. In our analysis we conflate three distinct categories: a health outcome (overweight and obesity); key social determinants of health outcomes (inequality and insecurity); and one of the policy drivers of those social determinants (austerity). However, neoliberalism connects these categories in a way that advances understandings of how unequal distributions of power and resources affect health. I first argue that definitional disputes about neoliberalism must not distract attention from a set of core propositions that are remarkably consistent across jurisdictions and contexts. I then expand on evidence base implicating neoliberalism as an explanation for health outcomes with reference to case studies of the era of structural adjustment in (much of) the developing world, and its sequelae, and of contemporary UK social and labour market policy. I conclude with some pessimistic inferences from the larger political economy context about prospects for reducing health inequalities.
Ted's academic background is in political science, and he has taught that discipline as well as environmental studies and population health (at the doctoral level) from an interdisciplinary perspective. For the past decade his research has addressed the consequences of transnational economic integration (globalization) for health and health equity; he also has a long-standing interest in issues at the interface of science, ethics, law and public policy. Ted is co-editor of the Journal of Public Health, and co-leads the Wolfson Research Institute's Special Interest Group on Health Equity in a Global World.
The Faculty of Public Health and Policy Seminar Series provide a forum for presenting current research on health systems and policy in low-, middle- and high-income countries. The series cover empirical research, theoretical and methodological issues, and gives an opportunity for staff and students to participate in debate and learn about new developments in health systems and policy research.
Series organised by: Dina Balabanova and Alec Fraser