Ted Schrecker

• Professor (Full) at Newcastle University

Recognition that globalization has an important role in explaining health inequalities has now moved into the mainstream. Much of that role relates to what has been called ‘[t]he inequality machine [that] is reshaping the planet.’ At the same time, more attention must be paid to how the state can tame the inequality machine or compensate for its ef...

Can health promotion in Canada effectively respond to the challenge of reducing health inequities presented by the WHO Commission on Social Determinants of Health? Against a background of failure to take seriously issues of social structure, I focus in particular on treat-ments of stress and its effects on health, and on the destructive congruence...

This article examine how epidemiological evidence is and should be used in the context of increasing concern for health equity and for social determinants of health. A research literature on use of scientific evidence of "environmental risks" is outlined, and key issues compared with those that arise with respect to social determinants of health. T...

The idea of resource scarcity permeates health ethics and health policy analysis in various contexts. However, health ethics inquiry seldom asks—as it should—why some settings are ‘resource-scarce’ and others not. In this article I describe interrogating scarcity as a strategy for inquiry into questions of resource allocation within a single politi...

“Building back better” post-pandemic, as advocated by the Organisation for Economic Co-operation and Development, could advance the realization of health as a human right. However, the COVID-19 pandemic is more likely to represent a tipping point into a new and even more unequal normal, nationally and internationally, that represents a hostile envi...

A dramatic increase in the volume of research literature referencing social determinants of health (SDH) since the report of the World Health Organization Commission on the topic in 2008 has not been matched by expansion of policies and interventions to reduce health inequalities by way of SDH. This article argues that familiar hierarchies of evide...

The concept of health equity—in a simplified view, socially patterned inequalities in health outcomes that are unfair or unjust and avoidable—originated in the work for the World Health Organization’s European regional office, and was foregrounded by the work of WHO’s Commission on Social Determinants of Health (2005–2008). Yet as political scienti...

For many years I have discussed with colleagues, and more recently with students, the definition of critical perspectives (plural, for there are many) on public health. Based on those discussions, and with a focus on health inequalities, this article identifies five elements of such perspectives. First, they involve some degree of commitment to hea...

Addressing global health is one of the largest challenges facing humanity in the 21st century, however, this task is becoming even more formidable with the accelerated destruction of the planet. Building on the success of the previous edition, the book outlines how progress towards improving global health relies on understanding its core social, ec...

Addressing global health is one of the largest challenges facing humanity in the 21st century, however, this task is becoming even more formidable with the accelerated destruction of the planet. Building on the success of the previous edition, the book outlines how progress towards improving global health relies on understanding its core social, ec...

The central task of any critical social science is speaking truth about power. After a brief review of ‘glass half full’ and ‘glass half empty’ perspectives on recent developments in global health, I argue that such a critical perspective need not answer the question about the glass, but rather ask what more could have been achieved under different...

Ten years after the August 2008 release of the report of the WHO Commission on Social Determinants of Health, it is important to reflect on the fate of its recommendations for reducing ‘health inequity’. The article describes some key developments in the decade, notably in understanding the etiology of health inequalities, and then juxtaposes a hop...

This commentary argues that Canada’s public and global health communities have a special ethical and political responsibility to act to reverse the harms associated with Canadian mining activities in Latin America and beyond through advocacy, research, and using their public voice. We begin with an overview of the direct and indirect health effects...

A systematic and theoretically informed analysis of how extractive industries affect health outcomes and health inequities is overdue. Informed by the work of Saskia Sassen on "logics of extraction," we adopt an expansive definition of extractive industries to include (for example) large-scale foreign acquisitions of agricultural land for export pr...

In 2010, Mackenbach reflected on England's lack of success in reducing health inequalities between 1997 and 2010, asserting that “it is difficult to imagine a longer window of opportunity for tackling health inequalities”; asking “[i]f this did not work, what will?”; and concluding that reducing health inequalities was not politically feasible at l...

In their recent editorial, Baltussen and colleagues provide a concise summary of the prevailing discourse on priority-setting in health policy. Their perspective is entirely consistent with current practice, yet they unintentionally demonstrate the narrowness and moral precariousness of that discourse and practice. I respond with demonstrations of...

Ewen Speed and Russell Mannion correctly identify several contours of the challenges for health policy in what it is useful to think of as a post-democratic era. I argue that the problem for public health is not populism per se, but rather the distinctive populism of the right coupled with the failure of the left to develop compelling counternarrat...

Trade and Investment Agreements (TIAs) have been widely criticized for their potentially negative effects on health. Many governments, particularly from low- and middle-income countries, have voiced concerns that mega-regional agreements such as the Trans-Pacific Partnership agreement, and the Transatlantic Trade and Investment Partnership, will er...

In the global governance of climate change, the impact on food security remains a contested policy arena with multiple obstacles to resolution. The article begins by considering how conventional indicators understate the extent off food insecurity and diet-related inequalities. While there may be scientific consensus that climate change will affect...

A recent book addresses the health effects of neoliberalism using the provocative rubric of ‘neoliberal epidemics’. This article reviews literature on the health effects of neoliberalism starting with the structural adjustment conditionalities mandated by the World Bank and the International Monetary Fund. It continues with an analysis of how neoli...

New contours of global inequality present new challenges for global health, and require that we consider new kinds of health issues as global. I provide a number of illustrations, arguing the need for a political science of health that goes beyond conventional preoccupations with formal institutional and inter-state interactions and takes into acco...

A recent CPH editorial addressed ‘the perils of invoking neoliberalism in public health critique’. While in sympathy with many of the authors’ concerns, I argue that the analytical literature on neoliberalism, the historical record of neoliberalism’s promotion and diffusion, and the empirical evidence of its health consequences support the view tha...

The growing prevalence of NCDs in low- and middle-income countries (LMICs) is now recognized as one of the major global health policy issues of the early 21st century. Current official approaches reflect ambivalence about how health policy should approach the social determinants of health identified by the WHO Commission on the topic that released...

The Lancet-University of Oslo Commission on Global Governance for health correctly concluded that: 'with globalization, health inequity increasingly results from transnational activities that involve actors with different interests and degrees of power'. At the same time, taking up that Commission's focus on political determinants of health and 'po...

The growing prevalence of NCDs in low- and middle-income countries (LMICs) is now recognized as one of the major global health policy issues of the early 21st century. Current official approaches reflect ambivalence about how health policy should approach the social determinants of health identified by the WHO Commission on the topic that released...

Globalization describes processes of greater integration of the world economy through increased flows goods, services, capital and people. Globalization has undergone significant transformation since the 1970s, entrenching neoliberal economics as the dominant model of global market integration. Although this transformation has generated some health...

Since the early 1980s, neoliberalism or 'market fundamentalism' has dominated politics and economics across the globe. In this important book, Ted Schrecker and Clare Bambra consider the effects of over three decades of these policies with particular reference to the US and the UK. They focus on obesity, insecurity, austerity, and inequality, argui...

Anthropologists have described, often in eloquent detail, local destruction of opportunities to lead a healthy life (the social determinants of health) attendant on the macroscale economic processes conveniently described as ‘globalization’. Recent reorganizations of production and finance redraw maps both literal and metaphorical of the inequaliti...

Five years after the release of the report of the WHO Commission on Social Determinants of Health, limited progress has been made in advancing its agenda of reducing health inequity by way of action on the social determinants of health, despite the added urgency introduced by the post‐2008 financial crisis. With a focus on Canada but drawing on dev...

Flexicurity, or the integration of labor market flexibility with social security and active labor market policies, has figured prominently in economic and social policy discussions in Europe since the mid-1990s. Such policies are designed to transcend traditional labor-capital conflicts and to form a mutually supportive nexus of flexibility and sec...

Forced evictions heighten vulnerability among slum dwellers who already face multiple risks of ill health. They constitute a well-documented violation of economic and social rights and are reaching epidemic proportions in sub-Saharan Africa as economic globalization creates and strengthens incentives for forced evictions. We describe evictions in t...

"Global Reach" was the title of one of the first popular books on the power of transnational corporations, published in 1974. Since then globalization has transformed the world to an extent that would then have been difficult to imagine. In this article I explore the effects of globalization with respect to two dimensions, global reach and local de...

The world economy is entering an era of multiple crises, involving finance, food security and global environmental change. This article assesses the implications for global public health, describes the contours of post-2007 crises in food security and finance, and then briefly indicates the probable health impacts. There follows a discussion of the...

The governments and citizens of the developed nations are increasingly called upon to contribute financially to health initiatives outside their borders. Although international development assistance for health has grown rapidly over the last two decades, austerity measures related to the 2008 and 2011 global financial crises may impact negatively...

Study Selection Description of data: describes process of study selection.

(Expanded Table 3): Provides examples of policies that cohere with each of the four accounts of justice.

Socioeconomic gradients in health status are ubiquitous and often marked, within and across national borders. Much of the explanation involves social determinants of health - the conditions of life and work that affect opportunities to be healthy. Historically, wealthier has meant healthier, although the processes by which increased income is trans...

Piroska Östlin and colleagues argue that a paradigm shift is needed to keep the focus on health equity within the social determinants of health research agenda.

Summary of process and results. This table outlines the process which a child must go through before they can be said to have effective coverage. In addition, the results of our study are summarized in the last column of this figure. A table including the process of moving through the health system and descriptive results of the data analysis.

Serbia has proclaimed access to healthcare as a human right. In a context wherein the Roma population are disadvantaged, the aim of this study was to assess whether the Roma population are able to effectively access primary care services, and if not, what barriers prevent them from doing so. The history of the Roma in Serbia is described in detail...

Analyses of how health system priorities should be set in resource-poor settings are routine in the health ethics and policy analysis literature. Less attention is devoted to asking why some settings are resource-poor and others not. Asking this question must be considered a central task of global health research. Comparison of the relatively meage...

“All observations of life are harsh, because life is. I lament that fact, but I cannot change it.” —Margaret Atwood, The Tent (McClelland and Stewart 2006) Over the past few decades, most of the world's economies and societies have been integrated into the global marketplace, revealing and deepening various socioeconomic divisions. In this article,...

In May 2010, Grand Challenges Canada (GCC) was launched with the mandate to identify global challenges in health that could be supported through the Government of Canada's Development Innovations Fund (DIF: $225 million over five years). The GCC offers a potentially excellent mechanism for taking Canada's participation in global health challenges "...

Introduction Sir Michael Marmot, who chaired the World Health Organization (WHO) Commission on Social Determinants of Health, has identified the need to seek “public policy based on a vision of the world where people matter and social justice is paramount” (Marmot, 2005, p. 1099). In this chapter, we ground this imperative in evidence of dramatic d...

Since the nineteen seventies, high- and low-income countries have undergone a pattern of transnational economic and cultural integration known as globalization. The weight of the available evidence suggests that the effects of globalization on labor markets have increased economic inequality and various forms of economic insecurity that negatively...

The WHO Commission on Social Determinants of Health (CSDH) ascribed health disparities within and between countries to "a toxic combination of poor social policies and programmes, unfair economic arrangements, and bad politics." This article analyzes the relevance of the international human rights framework (IHRF) to the Commission's goal of reduci...

One of the most important challenges in addressing global health is for institutions to monitor and use research in policy-making. In low- and middle-income countries (LMICs), civil society organizations such as health professional associations can be key contributors to effective national health systems. However, there is little empirical data on...

The first 25 years of universal public health insurance in Canada saw major reductions in income-related health inequalities related to conditions most amenable to medical treatment. While equity issues related to health care coverage and access remain important, the social determinants of health (SDH) represent the next frontier for reducing healt...

In recent decades, public health policy and practice have been increasingly challenged by globalization, even as global financing for health has increased dramatically. This article discusses globalization and its health challenges from a vantage of political science, emphasizing increased global flows (of pathogens, information, trade, finance, an...

Despite major advances in knowledge and unprecedented gains in global wealth, health inequities between the rich aqnd thepoor are increasing, both within and among countries. Poverty, poor living and working conditions and the inability to influence theses conditions are directly relation to poor health. The 2008 report of the World Health Organiza...

Increased availability of antiretroviral therapy (ART) for HIV infection is a global health success story. According to UNAIDS, in just the three years from 2003 to 2006, the estimated number of people receiving ART in low- and middle-income countries quintupled (from 400,000 to just over two million); in sub-Saharan Africa, where the need is great...

In the second half of 2008, two events occurred that are, individually and together, highly significant for the future of global health. First, in August 2008 the World Health Organization (WHO)’s Commission on Social Determinants of Health (CSDH) released its final report (Commission on Social Determinants of Health, 2008; for a brief summary, see...

In 2001, colleagues and I1 began the first ‘report card’ on how the actions and policies of the G7/G82 affected population health, in particular the health of populations outside the high-income countries (Labonté and Schrecker, 2004; Labonté et al., 2004). The focus on the G7/G8 was and is justified for at least two reasons.

The reduction of health inequities is an ethical imperative, according to the WHO Commission on Social Determinants of Health (CSDH). Drawing on detailed multidisciplinary evidence assembled by the Globalization Knowledge Network that supported the CSDH, we define globalisation in mainly economic terms. We consider and reject the presumption that g...

In this Health Policy article, we selected and reviewed evidence synthesised by nine knowledge networks established by WHO to support the Commission on the Social Determinants of Health. We have indicated the part that national governments and civil society can play in reducing health inequity. Government action can take three forms: (1) as provide...

Most scarcities that underpin health disparities within and among countries are not natural; rather, they result from policy choices and the operation of social institutions. Using examples from the United States of America: the Chicago heat wave and hurricane Katrina, this paper develops "denaturalizing scarcity" as a strategy for enquiry to infor...

Most scarcities that underpin health disparities within and among countries are not natural; rather, they result from policy choices and the operation of social institutions. Using examples from the United States of America: the Chicago heat wave and hurricane Katrina, this paper develops "denaturalizing scarcity" as a strategy for enquiry to infor...

Vertical, Horizontal, and Diagonal approach. This illustration illustrates the effect of vertical, horizontal and diagonal financing approaches in countries where present government health expenditure is about US$10 per person per year.