Location
HSB 208
Series/Type
Dates
  • March 21, 2016 from 1:00pm to 2:00pm

“Was Mackenbach right? Neoliberal epidemics, the new Gilded Age, and the politics of health inequality”

Presented by: Ted Schrecker, Professor of Global Health Policy, Durham University

Click here for event poster.

Abstract: Although the New Labour government of the UK (1997‐2010) identified reducing health inequalities as a priority, on most measures they actually increased. Writing about this experience, Johan Mackenbach correctly observed that ‘health inequalities are the result of the cumulative impact of decades of exposure to health risks, some of them intergenerational, of those who live in socioeconomically less advantaged circumstances.’ Because reducing them ‘requires a massive re‐allocation of societal resources’, he argued that ‘it is unlikely that a majority of the English electorate would have supported the substantial redistribution of income and wealth that would have been necessary’. (Scottish and Welsh electorates are quite different, but they are too small to alter the overall distribution of Parliamentary power at Westminster.) Mackenbach’s article appeared in the same year that a Conservative‐led government came to power and embarked on a systematic upward redistribution of income, wealth and economic opportunity.

Against a background of rising economic inequality in most high‐income countries, what can be learnt from the UK experience by other jurisdictions like Canada and its provinces? The public health community must begin by understanding and framing public finance as a public health issue. This means not only becoming familiar with the evidence of the health damage associated with neoliberal economic and social policies – ‘neoliberal epidemics’ – but also supporting strong counter‐narratives to the equation of economic competence with deficit reduction through selective, regressive spending cuts. If such counter‐narratives can be advanced, then forceful advocacy around the principle of ‘first, do no harm’ in economic and social policy might prove effective. On the other hand, the authors of the best book on the politics of responses to the post‐crisis recession in the United States and the UK identify a constituency of the ‘squeezed but basically safe’, arguing that ‘in hard times the exposed are more desperate for help than ever, but the majority … have come to calculate that it is better to throw their lot in with the haves, than to risk being saddled with tax rises to provide assistance to the have‐nots’. If they are correct, then prospects for avoiding further increases in health inequalities in jurisdictions where such constituencies are substantial must be reckoned as bleak.