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In Chile, rapid social and economic change combined with relatively high-quality health data provides an important opportunity to study the relationship between socioeconomic status and mortality in a middle-income country. This chapter shows that despite overall economic growth and improvement in aggregate health status, health inequalities are large and widening in Chile. The increase is temporally related to broadening income inequalities associated with the structural economic reforms and marketization begun in 1981. Not only was Chile the first country in the American region to embark on a structural economic reform process, but its reform program has also been the most radical. This intensity persisted until the demise of Pinochet's military government and the arrival of democracy in 1990. In the light of the changing macroeconomic context, the chapter examines recent evidence on the factors underlying health inequalities in Chile through both individual-level and ecological-level analyses.

The literature addressing market dynamics within neoliberalism typically assumes that reforming labor legislation has a direct impact on economic performance, the configuration of labor markets, and the strength of labor organizations. Within this literature one prevalent school of thought advocates increased flexibility of labor laws as the key to creating economic prosperity, enhancing labor productivity, increasing formal sector employment, and successfully fighting poverty and socioeconomic inequality. This chapter tests these assumptions by analyzing the case of Brazil between 1995 and 2010. The chapter’s findings suggest that legislation reforms seeking to flexibilize the Brazilian labor code do not significantly change the country’s labor market or economy. The author therefore proposes that transformations in international economic contexts as well as differing policy orientations of successive Brazilian federal governments may hold more explanatory power in accounting for labor market changes during this time period.

The election of President Ronald Reagan in 1980 established a new form of right-of-center liberalism as a powerful force in the nation's political life. Although the fortunes of the conservative movement would wax and wane over the next twenty-five years, overall it experienced remarkable consolidation and growth during this time. The Civil Rights movement represented the most powerful political force dedicated to a simultaneous attack on both racial discrimination and socioeconomic inequality in the nation's history. This combination of neoconservatism and New Right organizing revitalized the larger conservative movement, which had been fighting an uphill battle for most of the preceding decades. The future of equalitarian politics in the United States is at best uncertain. Reviving it will require the development of a larger motivating vision, a set of practical policy reforms capable of attracting broad political support, and an organizational structure with the muscle to get out both the message and the vote.

Chapter 4 examines violence against women in the context of the political economy of globalization. The first part of the chapter examines the global and local environments that accentuate gendered inequalities, migration for precarious employment, and the attendant risks of violence. The second part considers women's survival strategies, especially the choice to migrate, given the need for their labor in developed countries and for their income in often impoverished families and countries. The third part of the chapter investigates state responses to labor exploitation, highlighting the criminal justice approach adopted to stem trafficking in particular. The chapter argues that governments in sending and receiving countries have failed to protect migrant women workers and to attend to the socioeconomic inequalities at the root of labor exploitation and trafficking. The fourth part of the chapter analyzes a similar failure at the international level, noting how countertrafficking strategies tend to perpetuate violence against women with their focus almost solely on prosecution rather than prevention. The chapter concludes by considering alternative strategies for preventing violence suggested by a political economy perspective.

This chapter explores how responsibility should be distributed for democratically sponsored injustice by focusing on two leading views of complicity, which produce either false positives or false negatives and overexculpate or overimplicate the democratic citizen. The first is participatory accounts, which condition complicity on citizens acting together with the intention of producing a collective outcome. The second is associative accounts, which hold that individual citizens, embedded in political systems, engage in a kind of mediated wrongdoing. The chapter views the two accounts as two implausible poles and proposes a democratic conception of complicity designed to avoid these two poles. It also considers how socioeconomic inequalities affect the distribution of responsibility and concludes by explaining how the ineliminable regret caused by participation in unjust structures can warrant the active taking of responsibility.

The bioethical principle of respect for patient autonomy represents an advance over the paternalism that earlier pervaded medical practice. Yet the normative set of assumptions that accompany the autonomy principle has its own difficulties. The notion of autonomy makes assumptions about capability and capacity that are often belied when patients are in need of medical care. Patients who can compensate for their diminished autonomy tend to have more material and social resources at their disposal. The author argues that the assumption that the recipient of health care is an autonomous subject effectively skews the distribution of health resources in favor of those who are most likely to fit that norm and who, when they have diminished capacities, have their autonomy “supported” through periods of medical need. The assumption of patient autonomy thus illuminates one way in which socioeconomic inequalities result in health disparities. Analyzing a study of three heart attack victims belonging to three different socioeconomic classes, the author concludes that a better model of medical care should anticipate the needs of a patient or the patient’s home caregiver, identify what this patient needs to meet her medical needs, and promote ways for patients to make life choices most conducive to health.

This concluding chapter discusses how the increasing socioeconomic inequality in the last twenty years has resulted in a negative redistribution of wealth from the bottom to the top. Along with the erosion of socioeconomic equality, political equality and reciprocal respect has also eroded. The fragmentation resulting from the rise of the new social media as well as the spread of some of the more insular forms of identity politics have done serious damage to the cultivation of enlarged mentality among the citizens and to their capacity and willingness to take the standpoint of the others. However, the chapter shows that such fragmentation is not wholly negative, in that it has also given rise to “counter-publics” by oppositional groups that had not enjoyed their own public voices and media.

This chapter examines what the author calls “the final inequality”—the variance in the age at death. While it is well known that life expectancy at birth and life expectancy conditional on age ten or age twenty has increased in almost every country of the world, what is less well known is what has happened to the inequality of the age of death. This chapter studies what happened in Sweden between 1950 and 2000. Over this fifty-year period, life expectancy at birth grew by 12 percent and remaining life expectancy, conditional on reaching age sixty-five, grew by 33 percent. This chapter then examines death inequality in a variety of large developed countries (Canada, Denmark, France, United Kingdom, Japan, Sweden, and the United States) and finds that, once again, the United States stands out as exceptional. The United States has the highest level of inequality of the age of death of all of these countries. The chapter also includes a brief analysis of life expectancy and inequality for Americans with different levels of education and income.

This chapter investigates the relationship between socioeconomic inequalities among women and disparities in the time they spend on housework. It analyzes the gap related to income differences of women in Germany, Sweden and the United States. The chapter compares this economic disparity in the time spent by women on housework with respect to the gender gap in domestic labor within each country.

This chapter takes a look at DJ Shadow, a member of one of the wealthiest local clans in SMX. The discussion introduces the One Love ideology, which is the assertion of a universal human identity and a privileging of individuality above ethnic and national differences. It discusses Rastafari and the Rastafari message of egalitarianism, and even identifies the secrets of DJ Shadow's success. The chapter also introduces DJ Shadow's notion of Rastafari individuality, which is a way to promote an inclusive politics of belonging without explicitly addressing socioeconomic inequalities.

This chapter focuses on policies as continuous processes, characterised by conflicts of interest and the unequal exercise of power. It is argued that the presentation of demographic trends as a problem to be grappled with by policy-makers coincides with neo-liberal economic agendas to the detriment of older people. The impact of global-level liberalisation of markets and production on health and care policies is considered and a critical analysis is developed of the actions of global actors, including the World Bank, in shaping policies of direct relevance to the health and care of older people. The outputs of the UN and the World Health Organisation are also critically examined for their roles in the policy process and the impact these have on health and age-related inequalities. In this chapter the influence of the capabilities approach on policy-making for health is discussed and the relevance of age to equity in resource distribution is considered.

This chapter discusses health gaps by giving an example of a campaign for flu vaccination. To improve the town’s flu vaccination rate, the mayor tasks the health commissioner to develop a strategy that communicates, primarily through doctors’ offices, the importance of flu vaccinations. The strategy works; the flu vaccination rate increased from 45% to 65%. This success is not as complete as it looks, however. At the level of what the mayor intended—that more residents would be vaccinated—the campaign worked. However, the health gaps in town between the rich and the poor residents also increased—substantially. Health inequities like these are the result of systematic injustice—in this case, the injustice of unequal access to health care settings where vaccine marketing and delivery take place, and the broader socioeconomic inequality this reflects. These inequities matter. After all, if a pocket of the town’s population remains unvaccinated, it puts the whole area at risk, even if vaccination rates go up among the rich. Public health must recognize that a healthy society is one where health is accessible to all—not some, or even most, but all.

This chapter studies DJ Cimarron, a disc jockey who sought to address socioeconomic inequality and the responsibility of the “have-mores” toward the “have-lesses.” DJ Cimarron's case shows that discursive regimes that are constitutive of dominant societal identifications always “fail” to a certain extent, because people are social subjects and are never carbon copies. This chapter also discusses the modification of the performance of social roles.

This chapter discusses the crisis that arose in the relationship between the local population and the commune administration in Son-Duong in the late 1990s, marked by open confrontation and challenge by the local population to the Party and state apparatuses. Spontaneous local associations based on kinship, religious, and communal ties and constitutive of “alternative civilities” in rural northern Vietnam can serve as a strong foundation for the mobilization for collective action in the face of growing local socioeconomic inequality. These associations have been at least as effective in strengthening the voice of local populations as bourgeois-dominated voluntary associations are in communities with a greater market penetration. Such dialogues have led to a restructuring of governance in rural Vietnam.

This chapter looks at Canadian multiculturalism. Canada as a nation-state provides a different context for a critical discussion of multiraciality between racialized immigrant groups because of the way that mixture is acknowledged through the category of “Métis” identity. However, the country's image as a tolerant and welcoming place for immigrants—a view many Canadians uphold, and a reputation Canada holds internationally—must be understood as superficial. This image downplays significant socioeconomic inequalities faced by racialized groups in Canada, as evident in measures aimed at protecting a White settler nation, as well as the imposition of a “head tax” on Chinese.

Chapter Four, Delhi, introduces Meena, a Hindu woman residing in a government housing settlement in north Delhi. She faces complexities of diabetes, distress, and social pressures linked with social mobility and financial insecurity. For instance, intergenerational stress associated with joint-family living arrangements cultivates both memories of suffering at the hands of her mother-in-law and survival strategies through the support of her daughter-in-law for Meena's diabetes and mental health. While articulating swift-changing cultural norms, this chapter also reveals the social impact on conditions like diabetes on low-income populations who are largely overlooked in epidemiological transitions in low-income countries. Meena's narrative critiques how scholars conceive of diabetes in India, and argues that the experience of diabetes as an illness is fundamentally different when people face economic scarcity. The narrative reveals how the confluence of poverty, culture change, social demands, psychological distress, and care-seeking delays create a unique syndemic within a context focused on social mobility and material success.