Commercial determinants of health: future directions.

This paper is about the future role of the commercial sector in global health and health equity. The discussion is not about the overthrow of capitalism nor a full-throated embrace of corporate partnerships. No single solution can eradicate the harms from the commercial determinants of health-the business models, practices, and products of market actors that damage health equity and human and planetary health and wellbeing. But evidence shows that progressive economic models, international frameworks, government regulation, compliance mechanisms for commercial entities, regenerative business types and models that incorporate health, social, and environmental goals, and strategic civil society mobilisation together offer possibilities of systemic, transformative change, reduce those harms arising from commercial forces, and foster human and planetary wellbeing. In our view, the most basic public health question is not whether the world has the resources or will to take such actions, but whether humanity can survive if society fails to make this effort.

Understanding systemic racism: Anti-Blackness, white supremacy, racial capitalism, and the re/creation of white space and time.

In this article, the authors explain systemic racism through a racial-spatial framework wherein anti-Blackness, white supremacy, and racial capitalism interlock to create and recreate white space and time. Through the creation of private property, institutional inequities become embedded and structured for the benefit of white people. The framework provides a way to conceptualize how our geographies are racialized and how time is often used against Black and non-Black people of Color. In contrast to white experiences of feeling "in-place" almost everywhere, Black and non-Black people of Color continually experience displacement and dispossession of both their place and their time. This racial-spatial onto-epistemology is derived from the knowledge and experiences of Black, Indigenous, Latinx, Asian, and other non-Black people of Color, and how they have learned through acculturation, racial trauma, and micro-aggressions to thrive in white spaces and contend with racism such as time-theft. The authors posit that through reclaiming space and time, Black and non-Black people of Color can imagine and practice possibilities that center their lived experiences and knowledge as well as elevate their communities. Recognizing the importance of reclaiming space and time, the authors encourage counseling psychology researchers, educators, and practitioners to consider their positionalities with respect to systemic racism and the advantages it confers to white people. Through the process of creating counterspaces and using counterstorytelling, practitioners may help clients develop healing and nurturing ecologies that challenge the perniciousness of systemic racism. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Racial Capitalism Within Public Health-How Occupational Settings Drive COVID-19 Disparities.

Epidemiology of the US coronavirus disease 2019 (COVID-19) outbreak focuses on individuals' biology and behaviors, despite centrality of occupational environments in the viral spread. This demonstrates collusion between epidemiology and racial capitalism because it obscures structural influences, absolving industries of responsibility for worker safety. In an empirical example, we analyzed economic implications of race-based metrics widely used in occupational epidemiology. In the United States, White adults have better average lung function and worse hearing than Black adults. Impaired lung function and impaired hearing are both criteria for workers' compensation claims, which are ultimately paid by industry. Compensation for respiratory injury is determined using a race-specific algorithm. For hearing, there is no race adjustment. Selective use of race-specific algorithms for workers' compensation reduces industries' liability for worker health, illustrating racial capitalism operating within public health. Widespread and unexamined belief in inherent physiological inferiority of Black Americans perpetuates systems that limit industry payouts for workplace injuries. We see a parallel in the epidemiology of COVID-19 disparities. We tell stories of industries implicated in the outbreak and review how they exemplify racial capitalism. We call on public health professionals to critically evaluate who is served and neglected by data analysis and to center structural determinants of health in etiological evaluation.

The Cholera Epidemics in Hamburg and What to Learn for COVID-19 (SARS-CoV-2).

© 2020 International Society for Advancement of Cytometry.

Cooperate! A paradigm shift for health equity.

The role of competition and cooperation in relation to the goal of health equity is examined in this paper. The authors explain why the win-lose mentality associated with avoidable competition is ethically questionable and less effective than cooperation in achieving positive outcomes, particularly as it relates to health and health equity. Competition, which differentiates winners from losers, often with the winner-takes-all reward system, inevitably leads to a few winners and many losers, resulting in social inequality, which, in turn, engenders and perpetuates health inequity.Competitive market-driven approaches to healthcare-brought about by capitalism, neo-liberalization, and globalization, based primarily on a competitive framework-are shown to have contributed to growing inequities with respect to the social determinants of health, and have undermined equal opportunity to access health care and achieve health equity. It is possible to redistribute income and wealth to reduce social inequality, but globalization poses increasing challenges to policy makers. John Stuart Mill provided a passionate, philosophical defense of cooperatives, followed by Karl Polanyi who offered an insightful critique of both state socialism and especially the self-regulating market, thereby opening up the cooperative way of shaping the future. We cite Hannah Arendt's "the banality of evil" to characterize the tragic concept of "ethical fading" witnessed in business and everyday life all over the world, often committed (without thinking and reflecting) by ordinary people under competitive pressures.To promote equity in health for all, we recommend the adoption of a radically new cooperation paradigm, applied whenever possible, to everything in our daily lives.

Disordered eating and the contradictions of neoliberal governance.

The last decade has seen the development of an important literature on the contradictions between neoliberal norms of corporal citizenship and the forms of consumption that market-based food systems promote. This paper seeks to contribute to the literature by exploring the relationship between these contradictions and the increased prevalence of particular eating disorders (binge eating disorder (BED) and bulimia nervosa). Within contemporary neoliberal food systems bingeing is increasingly normalised and consumption temporally disorganised. At the same time, neoliberal public health policy, and the wider 'health' entertainment media it legitimates, focuses on the promotion of 'correct' forms of consumer agency. Individuals who fail to manage consumption 'appropriately' are stigmatised. The growth of bulimia and BED can be related to the contradictory pressures that the food system and regime of corporal governance place on individuals. The paper also seeks to explore how the increased medicalisation and biomedicalisation of eating since the 1980s fits within a broader neoliberal governance strategy. By medicalising key social problems the neoliberal state depoliticises these issues. Medicalisation and biomedicalisation obscure the role of capitalism in generating these problems and encourage a focus on individual dysfunction.

The Willie Lomans of a Market Society: Addressing Political-Economic Sources of Suffering in Pastoral Counseling.

This article focuses on the culture of state-corporate capitalism as a source of psychological suffering for some people who seek the aid of pastoral counselors. An underlying premise of this article and, more particularly, the work of pastoral counseling comes from Frantz Fanon's view that the aims of psychotherapy are (a) 'to 'consciousnessize' [the patient's] unconscious, to no longer be tempted by a hallucinatory lactification', and (b) 'to enable [the patient] to choose an action with respect to the real source of the conflict, i.e., the social structure'. An aim of pastoral counseling, then, is to facilitate recognition of a person's sources of suffering so that s/he can decide how to respond. By contrast, it is argued that a pastoral counselor, in leaving a client unaware that his/her suffering is partially the result of a capitalistic culture, fosters hermeneutical mystification, and the patient is not able to choose an action directed toward a major source of his/her depression.

[Everyday practice in psychiatry and the politics of civilisation]. / Clinique du quotidien en psychiatrie et politique de civilisation.

Daily clinical practice confronts us not only with the clinical aspect but also with the political. Political orientation has a direct impact on the way in which we carry out this clinical practice, as well as on the place of those who are outside the system. The politics of civilisation are therefore an option in the face of neoliberalism.

Adopting and implementing nutrition guidelines in recreational facilities: tensions between public health and corporate profitability.

OBJECTIVE: Little is known about how public entities can partner with industry to achieve public health goals. We investigated industry's perspective of factors that influenced their adoption and implementation of voluntary, government-issued nutrition guidelines (Alberta Nutrition Guidelines for Children and Youth, ANGCY) in recreational facilities. DESIGN: In-depth semi-structured interviews were conducted. Data were analysed using directed content analysis. SETTING: Food services in recreational facilities. SUBJECTS: Seven managers from industry participated; five from companies that had adopted and implemented the ANGCY (adopters) in recreational facilities and two from companies that had not (non-adopters). RESULTS: Industry views nutrition guidelines through the lens of profitability. Non-adopters were unwilling to implement the ANGCY for fear of sacrificing short-term profitability, whereas adopters adhered to them in an attempt to position themselves for long-term profitability. Adopters faced barriers including few resources, no training, complex guidelines, low availability of and demand for ANGCY-compliant products, competitive pressures and substantial declines in revenue. Managers believed widespread voluntary adoption of the ANGCY was unlikely without government incentives and/or a mandate, as the environmental context for voluntary action was poor. All managers supported government-mandated implementation of the ANGCY to level the playing field upon which companies compete. CONCLUSIONS: Public-private partnerships in recreational facilities can embrace public health goals in the short term, provided industry perceives potential for long-term financial gain. Widespread uptake of voluntary nutrition guidelines in this setting is unlikely, however, as market mechanisms do not encourage industry to sell and promote healthier options. Government legislation may therefore be warranted.

Capitalism, the state and health care in the age of austerity: a Marxist analysis.

The capacity to provide satisfactory nursing care is being increasingly compromised by current trajectories of healthcare funding and governance. The purpose of this paper is to examine how well Marxist theories of the state and its relationship with capital can explain these trajectories in this period of ever-increasing austerity. Following a brief history of the current crisis, it examines empirically the effects of the crisis, and of the current trajectory of capitalism in general, upon the funding and organization of the UK and US healthcare systems. The deleterious effect of growing income inequalities to the health of the population is also addressed. Marx's writings on the state and its relation to the capitalist class were fragmentary and historically and geographically specific. From them, we can extract three theoretical variants: the instrumentalist theory of the state, where the state has no autonomy from capital; the abdication theory, whereby capital abstains from direct political power and relies on the state to serve its interests; and the class-balance theory, whereby the struggle between two opposed classes allows the state to assert itself. Discussion of modern Marxist interpretations includes Poulantzas's abdication theory and Miliband's instrumentalist theory. It is concluded that, despite the pluralism of electoral democracies, the bourgeoisie do have an overweening influence upon the state. The bourgeoisie's ownership of the means of production provides the foundation for its influence because the state is obliged to rely on it to manage the supply of goods and services and the creation of wealth. That power is further reinforced by the infiltration of the bourgeoisie into the organs of state. The level of influence has accelerated rapidly over recent decades. One of the consequences of this has been that healthcare systems have become rich pickings for the evermore confident bourgeoisie.

The Future of Public Health Must be Radical: Incorporating Racial Capitalism.

Racism impedes the health of communities of color and, more recently, has been declared a public health crisis. Social uprisings in response to the police brutalities in the summer of 2020 have further pushed public health as a discipline to recognize racism as a public health issue. We argue that, as a discipline, we must challenge ourselves to move toward radical public health to achieve health equity. Radical public health requires future and current public health practitioners to discuss the root of health inequities, which we identify as racial capitalism. We (a) discuss racial capitalism and its intersection with public health and (b) critique current anti-racist pedagogy with recommendations on how to move forward. Future public health practitioners must acquaint themselves with racial capitalism and use it as a lens to see all public health problems if they are to dismantle structural racism that perpetuates health inequities.

Looking Beyond the Lamp Post: Health Inequality in the Times of COVID-19.

In times of a pandemic, the world lives in the throes of colossal economic and public health crises. The world seems unprepared and ill-equipped to cater to the catastrophic pandemic of COVID-19. The apocalyptic infectious diseases keep revisiting to expose the global widening economic and health inequalities. This review in its different sections argues that with the "financialization of everything," a new consciousness comprising a more general heightened sense of awareness and interest in personal health and well-being pervades whereby citizens become customers. This effectively forefends the dynamics of interaction between the individual and her/his environment with its consequent impact on health and promotes an individuated risk and responsibility. Even in times of a pandemic, draconian state surveillance, lockdown, behavior modification, self-help, and self-care have emerged as guiding principles of public health. There is an urgent need for a radical reordering of the world order beyond the hegemonic, neoliberal, capitalistic ethos of rabid consumerism and unconstrained private profit.

The Key Role of Social Movements in Protecting the Health of People and the Planet Comment on "Ensuring Global Health Equity in a Post-pandemic Economy".

In his recent article, titled "Ensuring Global Health Equity in a Post-pandemic Economy," Ronald Labonté addresses a key challenge the world is facing, trying to 'build back' after the global crisis related to the COVID-19 pandemic. He explores and critically examines different policy options, from a more inclusive 'stakeholder model' of capitalism, to a greater role of states in shaping markets and investing in the protection of health and the environment, to more radical options that propose to reframe the capitalist mantra of growth and look at different ways to value and center our societies around what really matters most to protect life. Social movements are key players in such transformation, however the political space they move in is progressively shrinking.

Addressing Racial Capitalism's Impact on Black Essential Workers During the COVID-19 Pandemic: Policy Recommendations.

Black Americans are more likely to be essential workers due to racial capitalism. Because of the COVID-19 pandemic, essential workers are less able to adhere to social distancing and stay-at-home guidelines due to the nature of their work, because they are more likely to occupy crowded households, and are more likely to possess pre-existing health conditions. To assist Black essential workers in preventing infection or reducing the intensity of symptoms if contracted, vaccination against the virus is essential. Unfortunately, Black essential workers face considerable barriers to accessing vaccinations and are hesitant to receive the vaccine due to widespread misinformation and justified historical mistrust of the American medical system. The purpose of this work is to (1) describe the disproportionate impact of COVID-19 on Black essential workers due to racial capitalism, (2) outline the socioeconomic and racial barriers related to vaccination within this population, and (3) to suggest policy-related approaches to facilitate vaccination such as access to on-site vaccination opportunities, the funding of community outreach efforts, and the mandating of increased employee benefits.

Austerity: a failed experiment on the people of Europe.

Many governments in Europe, either of their own volition or at the behest of the international financial institutions, have adopted stringent austerity policies in response to the financial crisis. By contrast, the USA launched a financial stimulus. The results of these experiments are now clear: the American economy is growing and those European countries adopting austerity, including the UK, Ireland, Greece, Portugal and Spain, are stagnating and struggling to repay rising debts. An initial recovery in the UK was halted once austerity measures hit. However, austerity has been not only an economic failure, but also a health failure, with increasing numbers of suicides and, where cuts in health budgets are being imposed, increasing numbers of people being unable to access care. Yet their stories remain largely untold. Here, we argue that there is an alternative to austerity, but that ideology is triumphing over evidence. Our paper was written to contribute to discussions among health policy leaders in Europe that will take place at the 15th European Health Forum at Gastein in October 2012, as its theme 'Crisis and Opportunity - Health in an Age of Austerity'.

Ensuring Global Health Equity in a Post-pandemic Economy.

With coronavirus disease 2019 (COVID-19) receding, many countries are pondering what a post-pandemic economy should look like. Some advocate a more inclusive stakeholder model of capitalism. Others caution that this would be insufficient to deal with our pre-pandemic crises of income inequality and climate change. Many countries emphasize a 'green recovery' with improved funding for health and social protection. Progressive tax reform and fiscal policy innovations are needed, but there is concern that the world is already tilting towards a new round of austerity. Fundamentally, the capitalist growth economy rests on levels of material consumption that are unsustainable and inequitable. More radical proposals thus urge 'degrowth' policies to reduce consumption levels while redistributing wealth and income to allow the poorer half of humanity to achieve an ethical life expectancy. We have the policy tools to do so. We need an activist public health movement to ensure there is sufficient political will to adopt them.

Toward a post-Charter health promotion.

The past 25 years have seen enormous shifts in the environmental, political, economic and social landscapes that condition people's abilities to be healthy. Climate change is now a reality. China, India, Brazil and other 'developing' countries are emerging as new axes of political and economic power. Global capitalism has become increasingly predatory and crisis ridden, a result of unregulated and irresponsible greed of unimaginable scale. The elite response has been the increased erosion of the health and other social protection policies of redistribution that characterized the first-world run-up to the Ottawa Charter. These new realities challenge health promoters in ways unforeseen a quarter century ago. It is imperative that local determinants of health, to which health promoters give their attention, be traced to broader, even global levels of determinants. Support for groups acting at these levels should become a fundamental practice tenet. So, too, should advocacy for the social state, in which progressive taxation and hefty social investment blunt the health inequalities created by unfettered markets. As environmental and economic insecurities and inequalities increase in many of the world's countries, so does the risk of xenophobia and conflict. The roots of racism are complex; but weeding them out becomes another health promotion practice of the new millennium. There are some hopeful signs of health promoting political change, much of it emanating now from countries in the global South; but the threat of a return to health behaviourism in the face of the new global pandemic of chronic disease is real and must be confronted.

Material Insecurity, Racial Capitalism, and Public Health.

In the influential 1995 article "Social Conditions as Fundamental Causes of Disease," Bruce Link and Jo Phelan described social and political factors as "fundamental causes" of death and disease. Whitney Pirtle has recently declared racial capitalism another such fundamental cause. Using the case of the water crisis in Flint, Michigan, she has argued that racial capitalism's role in that situation meets each of the criteria Link and Phelan's article outlines: racial capitalism influenced multiple disease outcomes, affected disease outcomes through multiple risk factors, involved access to flexible resources that can be used to minimize both risks and the consequences of disease, and was reproduced over time through the continual replacement of intervening mechanisms. We argue for Pirtle's conclusion using the extensive literature on racial capitalism and case studies concerning housing in the United States and Brazil and what Naomi Klein has termed "corona capitalism" in India. If races correspond to hierarchies of material security, as suggested by Ruth Wilson Gilmore, then these hierarchies and their causal effects are fundamental determinants of public health.

We Must Take Advantage of This Pandemic to Make a Radical Social Change: The Coronavirus as a Global Health, Inequality, and Eco-Social Problem.

COVID-19 not only constitutes a serious public health problem and a global major threat to the poorest and most vulnerable social groups and neighborhoods of the world, creating a potential pandemic of inequality, but also poses an enormous challenge from the perspective of public health, ethics, economy, environment, and politics. However, many of the deep and complex systemic interrelationships created and developed by this pandemic are largely hidden, unknown, or neglected, both by the hegemonic media and by a highly specialized and fragmented academic world. However, when all the available knowledge is critically integrated, the origins and effects underlying this pandemic are likely to be found in the development of neoliberal capitalism and its inherent logic of ceaseless accumulation, economic growth, large inequalities, and ecological devastation. This commentary reflects on these issues, drawing out some of the most important lessons to be learned and challenges to be faced in the COVID-19 pandemic and its aftermath, advocating for a radical social change to deal with these challenges.