Politics as a determinant of health: a Foucauldian perspective on governance, norms, and health equity

This paper applies a Foucauldian discourse analysis to examine how political determinants, particularly governance, shape health outcomes in society, with a focus on the COVID-19 pandemic. Politics, as a form of power/knowledge, regulates health-related norms, policies, and institutional practices, thereby influencing the distribution of key social determinants such as environment, housing, education, and healthcare access. Empirical evidence indicates that democratic stability and good governance—characterized by transparency, accountability, participation, and organizational integrity—are critical for effective health system stewardship and equity. The COVID-19 pandemic vividly demonstrated these dynamics: countries with robust governance structures managed the crisis more successfully, while political instability, misinformation, and lack of accountability exacerbated health inequities and mortality. Foucault’s concepts of regime of truth and bio politics are used to analyse how governments exercised power over populations through public health measures, normalization of behaviours, and surveillance. This analysis underscores the need for health researchers and policymakers to critically engage with political determinants and governance structures to address health inequities and promote social justice in health.