Health inequalities, capitalism and the social economy

Reducing health inequities is … an ethical imperative. Social injustice is killing people on a grand scale.1 November 21, 2016, marks the 30th anniversary of the signing of the World Health Organization (WHO)’s Ottawa Charter on Health Promotion. The Ottawa Charter was notable for reaffirming the important idea that political, economic, social, cultural, environmental, behavioural, and biological factors can all favour or harm “health,” defined by the WHO as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”2 Various prominent studies, both before and since that time, have revealed that health is inseparably connected to underlying political, social, and economic conditions. A range of “social determinants of health” have been identified,3 including income and income distribution; education, unemployment and job security; employment and working conditions; early childhood development; food insecurity; housing; social exclusion; social safety networks; and access to, and quality of, health services. We know, too, that Indigenous people are particularly at risk for poor health, and factors such as gender, race, and disability are also relevant in in shaping how long, and how healthy, our lives are likely to be.