•The cause of global neo-liberal capitalism is driven by dominant business groups within nations; by the most
powerful nation (USA); and by international organizations reflecting the interests of powerful nations and
•Increasing global inequality – main health problem in the world today lie in the underdeveloped nations and the
stark health discrepancies in the world.
oSome nations have a lot of wealth and food while other parts of the world die of starvation
•This international picture directly contradicts the claim of neo-liberals that free markets can best meet human
needs – “the wants of the wealthy trump the needs of the poor”
•The distribution of health in the world in the early 21st century – the healthiest nations have overall longevity
rates ranging around 80 and the unhealthiest nations show rate of 40-45years.
oThe World Health report indicates that of all the regions of the world, sub-Saharan Africa shows the
•Most of the unhealthiest nations are also the poorest (there is a correlation between GNP/capita and overall
oFor the less developed world, high GNP/capita is neither a sufficient nor a necessary condition for a
country to show good average levels of health.
•Government action to support welfare state like measures or to provide controlled economic growth and a
degree of independence of the state from business elites may be the source of better health in poor nations and
also the link between improved economic performance and human health and well-being in developed states
•More neo-liberal nations show greater social inequalities and also greater health inequalities and poorer overall
health status than do more social democratic nations
Neo-liberalism, Income Inequalities, and Health Inequalities within Nations
•In the developed nations the onset of neo-liberalism has bee associated with increasing within-nation
•Increases in inequality have been particularly pronounced in those nations adopting more neo-liberal or market-
oriented politics and policies.
oIn 1990s the USA, Australia, Canada and UK stood at the top of the income inequality ladder, while
Norway, Sweden and the Netherlands were the lowest
Clearly neo-liberal nations are the most unequal regarding income distributions – since many of
these market societies in which family incomes define access to resources, as opposed to social
democratic nations – provide many forms of access to resources.
•Two examples if increasing income and health inequalities associated with the politics of neo-liberalism are the
UK and USA.
oPrior to the neo-liberal era, income inequality in the USA & UK was low. From about 1968 in the USA
and 1977 in the UK, income inequality began to rise and continued into the 1990s
•Different welfare regimes and rising inequalities of various kinds have important implications for health
oIn general, within nations, the higher a group’s SES, the higher its health status.
oAmerican living in low SES areas have much worse mortality rates tat those living in high SES areas
In UK, Differences between longevity among Highest SES group and the lowest groups were 9.5
years for men and 6.4 years for women.
•Canada showed similar results, but less extreme.
oMales suffer a major ”mortality deficit” – longevity favors females. Hoever females were more likely to
suffer various forms of morbidity and disability
oIn US and Canada, infant mortality rates and longevity rates are highly related to geographical region
and to race and Aboriginal status
US – White/Black longevity rates in 2002 favored whites by 5.3 years
Canada – First Nations groups show much worse health than do other Canadians