Book: ii 'Health and Health Care Inequities'

In the introduction to Health and Health Care Inequities - A Critical Political Economy Perspective, Borras concludes:

'This book aims to spark thoughutful conversation and collaboration by moving away from capitalism to improve society and health. Health is not just about nursing and medicine; it is integrally connected to economic, political, cultural, and institutional systems. Moreover, it encompasses philosophy and ethics. Capitalism's focus on individualism and competition harms people and the environment,making it all but impossible to achieve health equity. We must work together to envision and create a new world that ensures fairer and better health for all.' p.3.

This sets the tone for a short 163 page book, with a page of acknowledgements, (said) introduction pp.1-3, reference listing pp.136-153; 10 page index, and eight chapters:

Chapter 1: Social Determinants of Health Inequities
Chapter 2: Neoliberalism and Canada’s Housing Policies
Chapter 3: Neoliberalism and Canada’s Health Care System
Chapter 4: Political Power and Policy Advocacy
Chapter 5: The Role of Evidence and Ideas
Chapter 6: A Critical Political Economy Approach
Chapter 7: Searching for Socialism
Chapter 8: Mobilizing for Health Equity

Chapter 1 on 'Social Determinants' provides the first of many political points to underscore the effort with Hodges' model here. If income and poverty come second the preceding paragraphs on wages reveal the socialist stance stand of the author, and the acknowledged networks. Throughout the book the relational nature of determinants, inequality, inequity, protected characteristics, socio-economics and political struggle is raised. In the discussion on wages the importance of education is described in cross-cultural and gender-based terms. The book possibly turns on the sentence:

'To effectively address poverty, we need to unite those who are in poverty with individuals who have more economic stability but are still ulnerable within our capitalist system. These individuals are at risk of falling into poverty if they lose their jobs due to workplace closures or privatization. It is essential to acknowledge that certain groups experience higher poverty rates, but we should see them not as victims but as protagonists and capable workers facing unique but connected challenges.' p.7.

For the people who follow the news, the majority of 'us' are (even if only roughly) aware of the distribution of wealth across national and the global population: the injustice. The erosion and lack of union representation within many workforces, especially 'Big-tech'. The way utility enterprises have provided dividends for shareholders at the expense of ongoing investment in infrastructure, the quality of service provided to the public and even public safety. COVID (p.7), crystalised 'difference' for us all. I came to now substitute collective for 'group' in Hodges' model. Suddenly all those individuals, many working in health, were collectively vulnerable:

Individual

|

      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

Group

PSYCHOLOGICALLY EXISTENTIALLY BELIEFS	SCIENCE PHYSICALLY data, information, knowledge
SOCIALLY CULTURALLY SOCIAL MEDIA	wisdom, leadership, truth LAW - POLICY FREEDOM - CHOICE

Throughout the text, I like the concise coherence Borras demonstrates in the steps from wages, income and poverty to investigate the state of health inequities. Once again (from i) the context is Canada, but the lessons are for all - as globalisation should/must demand?  There is public health history too. As expected Canada's First Nation, Indigenous, and Nunavut populations are frequently referenced regards exclusion and disparity in health services access and provision. Under health inequities, after infant mortality and life expectancy there is a convention(?) adopted of several axes being identified. The first (p.9) is the class-health axis, then class-gender-health and others. No surprise I found the relational and organisational aspects of these 'constructs' very helpful. As I try to think of Hodges' model as a mathematical object I realise (through oft impromtu conversations^) that we don't have two 'axes' in Hodges' model. Still musing on this; and more to follow ...

Arnel M. Borras. (2025) Health and Health Care Inequities - A Critical Political Economy Perspective. Fernwood Publishing.

^A pure maths lecturer, Gower St Waterstones, London.

See also: Post i : Post iii : Post iv : Post v (to follow)