The Political Economy of Health Inequality

How are health inequalities shaped by a country's political economy? In answering this question this article takes as its point of analytical departure health inequalities in England that are persistent, entrenched, and, by some metrics, increasing. Political economy in the English context is understood as broad commitment to neoliberalism as a governing paradigm. Partial answers to this question have already been provided through analyses of neoliberalism broadly conceived, as well as the impact of its key policy tenets (privatization, liberalization, and deregulation) on access to health and health care. The key contribution of this article, however, is to take a step back to consider the contributory role of the broader philosophical underpinnings of neoliberalism, thereby providing fresh insights into the manner in which the appropriate role of government, individualism, and inequality shape government understandings of, and responses to, health inequalities. In doing, so the article contributes to a greater understanding of the frequently neglected structural, or "upstream," determinants of health inequalities.