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HLTC05H3 Chapter Notes -United States House Committee On Oversight And Government Reform, Neoliberalism, Health Promotion

Health Studies
Course Code
Rhan- Ju Song

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HLTC05 - Summer 2013 - Week 5 - Vincent Navarro
What We Mean By Social Determinants of Health
o article analyzes the changes in health conditions and quality of life in developed and devloping
countries over the past 30 years
o challenges "globalization" and the assumption that states are disappearing, Navarro shows that
what has been happening is not a reduction of state interventions but a change in the nature
and character of those interventions, resulting from major changes in class (and race and
gender) power relations in each country
o it is not inequalities that kill people, it is those who are responsible for these inequalities that kill
o the mortality differentials among countries are enormous, but they also exist within developed
o race mortality differentials are large in the US, but class mortality differentials are even larger
Changes in Political, Economic, and Social Context Over the Past 30 Years
o past 30 years have seen this policy implementations (US, EU, WHO)
1) need to reduce public responsibility for the health of populations
2) need to increase choice and markets
3) need to transform health services into insurance-based HC systems
4) need to privatize medical care
5) patients are referred to as clients and planning is replaced by markets
6) individuals' personal responsibility for health improvements
7) an understanding of health promotion as behavioral change
8) need for individuals to increase their personal responsibility by adding social capital to
o US, the leader of the neoliberal movement, in contrast to neoliberalism -- public expenditure
has INCREASED and an INCREASE in taxes
o it is FALSE -- states are NOT disappearing, we are seeing not a reduction of state interventions
but a change in the nature of these interventions, with LESS targeted to programs for persons,
military expenditures INCREASED, and private enterprise expenses INCREASING
o we see MORE privatization of health services with expansion of the role of insurance companies,
an increase of tax subsidies - not tax exemptions
o there is more investment in public and private biomedical and genetics research
Changing Nature of Public Interventions: the Importance of Class
o public intervention changes are occurring in response to changes in distribution of power in our
o as "class" has disappeared from scientific literature, it has been replaced by "status"
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