Promoting Health Equity in an Era of Growing Contradictions Between Capital Accumulation and Social Reproduction in Capitalist Economies
Bibliographic record
Abstract
Background: Despite a robust literature on the importance of promoting health equity, actual progress in doing so is flagging and this is especially the case in Anglo-Saxon liberal welfare states such as Canada, the USA, and the United Kingdom. Purpose: In this paper we place these developments within the context of the political economy concepts of capital accumulation -- or profit making -- and social reproduction -- or the ongoing functioning of society. Research Design: We carefully reviewed the current state of theorization and research into the political economy of health to identify the main themes and findings in this literature in relation to the polycrisis of living and working conditions in Canada, the USA, and United Kingdom. Analysis: We drew upon critical materialist political economy thought to show how the growing contradictions between profit making and societal functioning in capitalist economies – and this especially so in liberal welfare states -- threaten both the quality and equitable distribution of the living and working conditions that shape health – the social determinants of health – and the organization and delivery of health care. Results: While there is increasing application of political economy approaches to understanding the adverse effects of capitalism, almost all of these are limited to critiquing capitalism without envisioning a post-capitalist society. Various ways of addressing these contradictions are provided that include 1) redistribution, social spending by governments, and managing the market economy within existing economic and political structures; 2) movement towards social democratic or conservative models of governance common to the Nordic and Continental nations respectively; or 3) building a post-capitalist socialist future. Conclusion: While we offer three paths forward towards achieving health equity, we conclude that the last path, building a post-capitalist socialist future, offers the most useful means of promoting health equity in both the short and long-term.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.006 | 0.070 |
| Scholarly communication | 0.012 | 0.008 |
| Open science | 0.001 | 0.008 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".