Capitalism and the 'commercial determinants of health': A more-than-human micropolitics.

This paper argues that studies of the 'commercial determinants of health' (CDoH) need to acknowledge fully the part the capitalist mode of commodity production and exchange plays in producing negative health outcomes. This proposition is supported by recourse to a recent development in political economy that has established a more-than-human, relational and monist (or 'flat') ontology of capitalism, in place of the more conventional neo-Marxist perspective. This ontology reveals a dynamic to capitalism that operates beyond human intentionality, driven by the supply of, and demand for the capacities of commodities. This dynamic determines the production and consumption of all commodities, some among which (such as tobacco, alcohol and processed foods) contribute to ill-health. A case study of food consumption reveals how these supply and demand affects drive 'unhealthy' food choices by consumers. Ways to undermine this more-than-human dynamic are offered as an innovative approach to addressing the effects of commerce and capitalism upon health.

Privatization and oligopolies of the renal replacement therapy sector on contemporary capitalism: a systematic review and the brazilian scenario

ABSTRACT: Worldwide the assistance on renal replacement therapy (RRT) is carried out mainly by private for-profit services and in a market with increase in mergers and acquisitions. The aim of this study was to conduct an integrative systematic review on privatization and oligopolies in the RRT sector in the context of contemporary capitalism. The inclusion criteria were scientific articles without language restrictions and that addressed the themes of oligopoly or privatization of RRT market. Studies published before 1990 were excluded. The exploratory search for publications was carried out on February 13, 2024 on the Virtual Health Library Regional Portal (VHL). Using the step-by-step of PRISMA flowchart, 34 articles were retrieved, of which 31 addressed the RRT sector in the United States and 26 compared for-profit dialysis units or those belonging to large organizations with non-profit or public ones. The main effects of privatization and oligopolies, evaluated by the studies, were: mortality, hospitalization, use of peritoneal dialysis and registration for kidney transplantation. When considering these outcomes, 19 (73%) articles showed worse results in private units or those belonging to large organizations, six (23%) studies were in favor of privatization or oligopolies and one study was neutral (4%). In summary, most of the articles included in this systematic review showed deleterious effects of oligopolization and privatization of the RRT sector on the patients served. Possible explanations for this result could be the presence of conflicts of interest in the RRT sector and the lack of incentive to implement the chronic kidney disease care line. The predominance of articles from a single nation may suggest that few countries have transparent mechanisms to monitor the quality of care and outcomes of patients on chronic dialysis.

Profits over care? An analysis of the relationship between corporate capitalism in the healthcare industry and cancer mortality in the United States.

The characteristic features of 21st-century corporate capitalism - monopoly and financialization - are increasingly being recognized by public health scholars as undermining the foundations of human health. While the "vectors" through which this is occurring are well known - poverty, inequality, climate change among others - locating the root cause of this process in the nature and institutions of contemporary capitalism is relatively new. Researchers have been somewhat slow to study the relationship between contemporary capitalism and human health. In this paper, we focus on one of the leading causes of death in the United States; cancer, and empirically estimate the relationship between various measures of financialization and monopoly in the US healthcare system and cancer mortality. The measures we focus on are for the hospital industry, the health insurance industry, and the pharmaceutical industry. Using a fixed effects model with different specifications and control variables, our analysis is at the state level for the years 2012-2019. These variables include data on population demographic controls, social and economic factors, and health behavior and clinical care. We compare Medicaid expansion states with non-Medicaid expansion states to investigate variations in state-level funded health insurance coverage. The results show a statistically significant positive correlation between the HHI index in the individual healthcare market and cancer mortality and the opioid dispensing rate and cancer mortality.

Every loaf of bread is political - Reflections on collective care responses to Covid-19 in Cape Town.

Feminist perspectives on care have demonstrated how capitalism undervalues care work. The Covid-19 pandemic highlighted this further, as systems of production and social reproduction became destabilized globally. In many countries, the formal pandemic response fell short of attending to the daily, fundamental care needs of people living through the crisis, especially those compromised by the socio-economic effects of the pandemic. These needs were often attended to at the community level. This article explores a community-led network of care, known as CANs, that emerged in response to the pandemic in Cape Town. It makes three overarching observations. The first is that community-led responses were characterised by a push towards the collectivisation of care work. The second is that this enabled emergent strategies and relational practices of care, centring notions of solidarity, inter-dependence and horizontal exchange of resources and knowledge. Finally, we observed that, although the devaluation of care work limited the recognition and material support extended to CANs, opportunities to re-politicise care work as resistance work emerged. These represent a prefigurative moment in which alternative logics and strategies can transform the vision of our health and care systems, and the notion of community participation in and ownership of those systems.

Research on the impact of equity incentive model on enterprise performance: A mediating effect analysis based on executive entrepreneurship.

In implementing the equity incentive system, this paper delves into the listed enterprises' selection of equity incentive models. While previous research has extensively covered the effects, models, and influencing factors of equity incentives, there needs to be more in-depth literature focusing on the diverse incentive models and their impact on corporate performance. Notably, there needs to be more literature on considering entrepreneurial spirit as a mechanism. It aims to explore the relationship between executives' choices under different incentive models, the entrepreneurial spirit fostered by these models, and their combined impact on corporate performance. The findings reveal that adopting the restricted stock incentive model by listed enterprises implementing the equity incentive system significantly positively affects enterprise performance. Mechanistic tests show that when a company implements the restricted stock incentive model, executives prioritize maximizing their interests, leading them to embrace more risk in their investment decisions. This behavior, in turn, stimulates the adventurous spirit of executives, positively impacting enterprise performance, particularly pronounced in companies with more concentrated executive power. Moreover, executives may be more inclined to invest in high-risk, high-reward innovative projects, a behavior indicative of innovation and more prevalent in firms with higher research and development (R&D) investment. However, the limitation of this paper is that the study evaluates the operation of the equity incentive system in China by taking listed companies in China as an example, which is not necessarily suitable for foreign developed capitalist countries. This study contributes to the study of principal-agent problems by exploring the relationship between executives, entrepreneurship and firm performance.

Feminism and Capitalism under the Nuclear Cloud & Barbie.

The Warner Brothers/Mattel movie Barbie is meant to be about feminism and capitalism in complicated, comical, and nuanced ways. It mostly succeeds in its dual purpose of comedy and inspiration. The doll's origin in 1959 places her and her consort, Ken, squarely in the context of the Cold War, although neither the movie nor the doll's long and successful marketing history acknowledges anything outside the sunny world of Barbie Land. The nuclear shadow does affect the movie's reception, however, in the form of international protests over the dashed lines scrawled on a supposed "World Map" in one scene. For nations in and around the South China Sea, the dashed lines evoke the specter of war in a nuclear age over claims to territorial sovereignty. Yet director Greta Gerwig's film is a runaway success, the first film solo directed by a woman to gross more than a billion dollars and counting.

A Critical Understanding of Inclusion in Oral Microbiome Research through the Lens of Racial Capitalism.

There are important calls for greater inclusion of Indigenous and racialised communities in oral microbiome research. This paper uses the concept of racial capitalism (the extractive continuity of colonialism) to critically examine this inclusion agenda. Racial capitalism explicitly links capitalist exploitations with wider social oppressions e.g., racisms, sexism, ableism. It is not confined to the commercial sector but pervades white institutions, including universities. By using the lens of racial capitalism, we find inclusion agendas allow white institutions to extract social and economic value from relations of race. Racially inclusive research is perceived as a social good, therefore, it attracts funding. Knowledge and treatments developed from research create immense value for universities and pharmaceutical companies with limited benefits for the communities themselves. Moreover, microbiome research tends to drift from conceptualisations that recognise it as something that is shaped by the social, including racisms, to one that is determined genetically and biologically. This location of problems within racialised bodies reinforces racial oppressions and allows companies to further profit from raciality. Inclusion in oral microbiome research must consider ways to mitigate racial capitalism. Researchers can be less extractive by using an anti-racism praxis framework. This includes working with communities to co-design studies, create safer spaces, giving marginalised communities the power to set and frame agendas, sharing research knowledges and treatments through accessible knowledge distributions, open publications, and open health technologies. Most importantly, inclusion agendas must not displace ambitions of the deeper anti-oppression social reforms needed to tackle health inequalities and create meaningful inclusion.

Organized abandonment under racial capitalism: Measuring accountable actors of structural racism for public health research and action.

Understanding the shifting nature of structural racism historically and across institutions is vital for effective action towards racial health equity. While public health research on structural racism is rapidly increasing, most studies are missing the interdependence of policies and institutional practices over time that shape power imbalances and lead to entrenched health inequities. Here, we discuss Ruth Wilson Gilmore's concept of organized abandonment - the intentional disinvestment in communities which, in turn, creates opportunities for extraction, revenue generation, and carceral enforcement to fill the cracks of a compromised social infrastructure - to encourage action-oriented public health research that is grounded in history and an understanding of racial capitalism. We present a case example using publicly-available data on redlining, gentrification and policing in Seattle, Washington. We mapped the intersections of redlining and gentrification and estimated their neighborhood-level association with police activity using Bayesian spatial Poisson regression models. We found that histories of racist housing policies like redlining and processes of gentrification are interdependent and shape contemporary neighborhood racial and economic segregation and police activity. Compared to structurally advantaged neighborhoods, police stops were higher in neighborhoods that were 1) historically disinvested (i.e. redlined) and remain low-income and structurally disadvantaged and 2) formerly industrial and business districts that were not redlined and are now gentrified. Notably, we found that policing practices were significantly more intensive in neighborhoods that were both high redlined and gentrified. Together, these findings illustrate how the place-based racialized processes of dispossession, displacement and policing are deeply intertwined to maintain racial capitalism. Our findings also highlight the importance of examining multiple racialized processes simultaneously to fill critical gaps in the existing literature that are necessary for sustainable solutions to address structural racism.

Nursing as total institution.

Healthcare under the auspices of late-stage capitalism is a total institution that mortifies nurses and patients alike, demanding conformity, obedience, perfection. This capture, which resembles Deleuze's enclosure, entangles nurses in carceral systems and gives way to a postenclosure society, an institution without walls. These societies of control constitute another sort of total institution, more covert and insidious for their invisibility (Deleuze, 1992). While Delezue (1992) named physical technologies like electronic identification badges as key to understanding these societies of control, the political economy of late-stage capitalism functions as a total institution with no cohesive, centralized, connected material apparatus required. In this manuscript, we outline the ways in which the healthcare industrial complex demands nurse conformity and how that, in turn, operationalizes nurses in service to the institution. This foundation leads to the assertion that nursing must foster a radical imagination for itself, unbound by reality as it presently exists, in order that we might conjure more just, equitable futures for caregivers and care receivers alike. To tease out what a radical imagination might look like, we dwell in paradox: getting folks the care they need in capitalist healthcare systems; engaging nursing's deep history to inspire alternative understandings for the future of the discipline; and how nursing might divest from extractive institutional structures. This paper is a jumping-off place to interrogate the ways institutions telescope and where nursing fits into the arrangement.

Open AI meets open notes: surveillance capitalism, patient privacy and online record access.

Patient online record access (ORA) is spreading worldwide, and in some countries, including Sweden, and the USA, access is advanced with patients obtaining rapid access to their full records. In the UK context, from 31 October 2023 as part of the new NHS England general practitioner (GP) contract it will be mandatory for GPs to offer ORA to patients aged 16 and older. Patients report many benefits from reading their clinical records including feeling more empowered, better understanding and remembering their treatment plan, and greater awareness about medications including possible adverse effects. However, a variety of indirect evidence suggests these benefits are unlikely to accrue without supplementation from internet-based resources. Using such routes to augment interpretation of the data and notes housed in electronic health records, however, comes with trade-offs in terms of exposing sensitive patient information to internet corporations. Furthermore, increased work burdens on clinicians, including the unique demands of ORA, combined with the easy availability and capability of a new generation of large language model (LLM)-powered chatbots, create a perfect collision course for exposing sensitive patient information to private tech companies. This paper surveys how ORA intersects with internet associated privacy risks and offers a variety of multilevel suggestions for how these risks might be better mitigated.

Nation-builders and market architects: How social origins mold the careers of law graduates over 200 years in Norway.

This paper examines the types of work that jurists have historically undertaken and maps how opportunities for legal practice have been shaped by social origins across three centuries: after constitutional independence in the mid-1800s, during industrial capitalism in the mid-1900s, and at present-day advanced capitalism. I analyze historical archive data on law graduates from the 19th and 20th centuries in combination with administrative registry data from the 1990s onwards and employ correspondence analysis to explore how social backgrounds shape careers, considering transformations in class structures and the changing significance of juridical expertise over time. Within each period, jurists have served in very different roles including those that craft and cater to the institutional make-up of the state and the markets. My analysis shows that the impact of social origin on occupational outcomes has undergone significant changes, mirroring shifts in the broader social structure; from the importance of legal and political capital (within regional jurisdictions) in the 19th century to the significance of economic capital as the main structuring principle, but also a greater significance of cultural capital, in contemporary times. The ability to reach the most powerful positions among law graduates-within the polity in the 19th century, and the economy in the 21st century-has been differently structured by origins. I argue that expansion of the student body, the declining standing of the university, and heightened differentiation of the social structure and the juridical field have made intimate familiarity with the business world pivotal for forging mutually beneficial alliances between jurists and the increasingly dominant capitalist class. Today, a select group of jurists have managed to connect with and contribute to the rising power of private capital. Thus, the historical tale of jurists cannot be accurately captured by notions of uniform descent from national power structures.

The biological standard of living of Korean men under Confucianism, colonialism, capitalism, and communism.

This study focuses on analysing the heights of 10,953 Korean men aged 20 to 40 years who were measured during the Joseon dynasty, the Japanese colonialisation period, and the contemporary period, the latter including both North and South Korea. This study thus provides rare long-term statistical evidence on how biological living standards have developed over several centuries, encompassing Confucianism, colonialism, capitalism, and communism. Using error bar analysis of heights for each historical sample period, this study confirms that heights rose as economic performance improved. For instance, economically poorer North Koreans were expectedly shorter, by about 6 cm, than their peers living in the developed South. Similarly, premodern inhabitants of present-day South Korea, who produced a gross domestic product (GDP) per capita below the world average, were about 4 cm shorter than contemporary South Koreans, who have a mean income above the world average. Along similar lines, North Koreans, who have a GDP per capita akin to that of the premodern Joseon dynasty, have not improved much in height. On the contrary, mean heights of North Koreans were even slightly below (by about 2.4 cm) heights of Joseon dynasty Koreans. All in all, the heights follow a U-shaped pattern across time, wherein heights were lowest during the colonial era. Heights bounced back to Joseon dynasty levels during the interwar period, a time period where South Korea benefitted from international aid, only to rise again and surpass even premodern levels under South Korea's flourishing market economy.

Financiamento dos sistemas de saúde na América Latina no capitalismo contemporâneo em crise: uma contribuição a partir do pensamento crítico de Vicente Navarro López / Financing of health systems in Latin America in contemporary capitalism in crisis: a contribution from the critical thinking of Vicente Navarro López

Introdução: No capitalismo contemporâneo em crise, os sistemas de saúde de todo o mundo estão sendo sistematicamente enfraquecidos devido à aplicação de contrarreformas sociais por meio de políticas neoliberais/ultraneoliberais promovidas pelo Estado capitalista. Por um lado, observa-se um permanente subfinanciamento público, e por outro lado, há uma inserção, reprodução e ampliação da lógica de mercado neoliberal no setor saúde. Esse processo tem transformado a saúde em um setor voltado para a acumulação de capital e a busca incessante por sua maior valorização. Objetivo: Analisar a produção cientifica latino-americana sobre o financiamento dos sistemas de saúde na América Latina no capitalismo contemporâneo em crise, com a finalidade de compreender como os autores latino-americanos discutem o financiamento da saúde à luz do pensamento crítico de Navarro, a partir de sua obra "La Medicina bajo el Capitalismo", de 1978. Método: Inicialmente, realizou-se uma revisão da literatura sobre a saúde no capitalismo contemporâneo em crise. Em seguida, realizou-se uma revisão integrativa, a partir da pergunta: Como a literatura cientifica, especialmente latino-americana, vem discutindo o financiamento dos sistemas de saúde na América Latina no capitalismo contemporâneo em crise? A busca bibliográfica foi realizada na Biblioteca Virtual de Saúde, em 3 de fevereiro de 2023, encontrando-se 265 publicações, e incluindo-se, após o processo de seleção, 23 artigos na revisão integrativa. Por fim, realizou-se uma análise comparativa, identificando convergências e divergências entre os resultados da revisão à luz do pensamento crítico de Vicente Navarro López. Resultados: Os artigos incluídos na revisão foram classificados em eixos temáticos: 65,2% discutiram o financiamento e a privatização da saúde e cobertura universal de seguro de saúde; 47,8%, o financiamento em meio a processos de reforma do setor saúde; 43,5%, o subfinanciamento público da saúde; 39,1%, o financiamento em meio a processos de reforma fiscal ou tributária ou busca de novas fontes de financiamento para a saúde; 26,1%, o financiamento em meio a processos de descentralização da saúde; e 17,4%, o financiamento em meio a processos constituintes ou de implementação de novas constituições políticas. Enquanto as convergências e divergências entre os resultados desses artigos e as contribuições do pensamento crítico de Navarro, identificou-se que 39,1% tiveram alguma aproximação ao método de estudo marxista, em oposição ao funcionalismo; 30.4% foram críticos com os supostos da teoria das etapas do desenvolvimento na abordagem da saúde; 47,8% e 21,7% abordaram os determinantes econômicos e políticos do subdesenvolvimento da saúde e do direito à saúde, respectivamente; e 26,1% discutiram a influência das agências internacionais nas decisões de política de saúde. Conclusões: Os pesquisadores latino-americanos no campo do financiamento da saúde enfrentam os desafios de estudá-lo dialeticamente com o cenário econômico, político e social das próprias sociedades capitalistas em que a saúde está inserida, e de incorporar em sua análise a determinação social da saúde no capitalismo contemporâneo em crise. A transição da economia da saúde para a econômica política crítica da saúde exige que esses pesquisadores superem esses desafios para integrar esses elementos em suas futuras investigações no campo do financiamento da saúde.

Introduction: In contemporary capitalism in crisis, health systems around the world are being systematically weakened due to the application of social counter-reforms through neoliberal/ultraneoliberal policies promoted by the capitalist state. On the one hand, there is permanent public underfunding, and on the other hand, there is an insertion, reproduction and expansion of the neoliberal market logic in the health sector. This process has transformed health into a sector focused on the accumulation of capital and the incessant search for its greater appreciation. Objective: To analyze the Latin American scientific production on the financing of health systems in Latin America in contemporary capitalism in crisis, in order to understand how the Latin-American authorsAmericans discuss health financing in light of Navarros critical thinking, from his 1978 work "La Medicina bajo el Capitalismo". Method: Initially, a review of the literature on health in contemporary capitalism in crisis was carried out. Then, an integrative review was carried out, based on the question: How has the scientific literature, especially Latin American, been discussing the financing of health systems in Latin America in contemporary capitalism in crisis? The bibliographic search was performed in the Virtual Health Library, on February 3, 2023, with 265 publications, and including, after the selection process, 23 articles in the integrative review. Finally, a comparative analysis was carried out, identifying convergences and divergences between the results of the review in the light of the critical thinking of Vicente Navarro López. Results: The articles included in the review were classified in thematic bundles: 65.2% discussed the financing and privatization of health and universal health insurance coverage; 47.8%, financing in the midst of health sector reform processes; 43.5%, public health underfunding; 39.1%, financing in the midst of fiscal or tax reform processes or seeking new sources of health funding; 26.1%, financing in the midst of health decentralization processes; and 17.4%, funding in the midst of constituent processes or the implementation of new political constitutions. While the convergences and divergences between the results of these articles and the contributions of Navarros critical thinking, it was identified that 39.1% had some approximation to the Marxist method of study, as opposed to functionalism; 30.4% were critical of the supposed theory of stages of development in the approach to health; 47.8% and 21.7% addressed the economic and political determinants of underdevelopment of health and the right to health, respectively; and1% discussed the influence of international agencies on health policy decisions. Conclusions: Latin American researchers in the field of health financing face the challenges of studying it dialectically with the economic, political and social scenario of capitalist societies themselves in which health is inserted, and to incorporate in its analysis the social determination of health in contemporary capitalism in crisis. The transition from health economics to critical health policy economics requires these researchers to overcome these challenges to integrate these elements into their future research in the field of health finance.