How to Address Inequities in the Era Woke Capitalism

Social justice as a concept arose in the early 19th century during the Industrial Revolution and subsequent civil revolutions throughout Europe, which aimed to create more egalitarian societies and remedy capitalistic exploitation of human labor. Social justice refers to a political and philosophical theory that focuses on the concept of fairness in relations between individuals in society and equal access to wealth, opportunities, and social privileges. The five main principles of social justice include access to resources, equity, participation, diversity, and human rights. From access to healthcare to safe spaces to live, social justice aims to level the playing field and eliminate discrimination. This is about introducing equality, justice and fairness so that it not just a perception, but a reality, that the system is no longer gamed for those at the top. Social justice is the assertion of the ideal that all humans should have the same rights and opportunities.

The public health reformer Sir Edwin Chadwick is best known for highlighting the link between poor sanitation and outbreaks of disease in urban environments. Chadwick became involved in social reform in 1832, when he joined the newly formed Royal Commission into the Operation of the Poor Laws as an assistant. Appointed a commissioner the following year, Chadwick played a key part in the passing of the Poor Law Amendment Bill in 1834. It led to the first Public Health Act of 1848 and the creation of a General Board of Health, with Chadwick being made a commissioner. When cholera struck London in the board’s first year of operation, they responded with the emergency measures of waste removal and street cleaning. Chadwick took the handle off of the Broad Street pump to no longer allow the use of the water for cooking. drinking or washing. His theory was proved true because the rate of cholera did decrease in that area closest to the pump.

According to a recent study by the prestigious Brookings Institution, published in 2019, 44% of workers in the United States (more than 53 million workers) have low salaries, with the average salary being less than $18,000 (all figures in U.S. dollars) per year. As such, the report concludes that “almost half of U.S. workers earn salaries which are insufficient for providing economic security.” This percentage significantly increased during the Trump era. One indicator of scarce social protection is that the large majority of workers do not have sick leave, meaning that if they cannot work as a result of being ill, they do not receive any income or financial help – whether that be private (provided by their employer) or public (from social security). As a consequence, workers were resistant to stopping working or taking days off, as doing so would halt their income. This is why many individuals who became ill with the Coronavirus kept working and, therefore, infecting others.

The strategy of President Trump’s government was centered around denying that there is a problem and accusing the Democratic Party of creating a nonexistent epidemic, through – according to President Trump – dissemination of “fake news.” The administration even ordered the top federal authority on public health, the Centers for Disease Control and Prevention (whose budget was been cut by 18% annually by the Trump government), to prohibit the distribution of tests that show whether a person is infected with COVID-19 by any institution other than the CDC. This limited the number of tests to a minimum: Only 26 tests for COVID-19 per 1 million inhabitants were carried out between January 3 and March 11 of 2020 (according to data from the BBC), while in the same period, South Korea had carried out 4,000 tests per 1 million inhabitants. The United States has more than 300 million inhabitants.

Schrecker and Bambra focus on four ‘neoliberal epidemics’ – obesity, insecurity, austerity and inequality – which they portray as the latter-day equivalents of cholera and tuberculosis (in early 19th century TB accounted for one-third of all deaths). Strikingly, none of these ‘epidemics’ are diseases in a medical sense. Obesity and stress are risk factors for disease; inequality is a contributing factor of health inequities; and ‘austerity’ is a hyperbolic term for balancing the budget through fiscal restraint. Schrecker and Bambra concede that these diseases are not confined to market economies, but they claim that ‘the changes associated with neoliberalism increase our susceptibility’ to them. Poverty is inversely related to life expectancy. Individuals living in poverty in the US had 10.5 years lower life expectancy at age 18 than those with incomes ≥400% of the poverty threshold. COVID-19, drug overdoses, and accidental injury accounted for about two-thirds of the decline in life expectancy, according to the 2022 report.

The ideology behind America’s economy has failed the most vulnerable, although lay people believe that lifestyle and environmental factors such as smoking and air pollution are the most important determinants of mortality. Recent research suggests that social factors have the same or even a greater impact on health. Indeed, while their importance tends to be underestimated (Haslam, McMahon, et al., 2018), meta-analytic evidence suggests that social isolation, loneliness, and living alone are among the most potent determinants of mortality. Loneliness is also related to stress hormones, immune, and cardiovascular function. In this way, the link between social disconnection and poorer health outcomes has been validated across multiple studies. Neoliberal reforms lead to deep changes in healthcare systems around the world, on account of their emphasis on free market rather than the right to health. People with disabilities can be particularly disadvantaged by such reforms, due to their increased healthcare needs and lower socioeconomic status.

It has been argued that inequality is not an unintended result but itself an important feature of neoliberal politics because it is supposed to serve as a mechanism to increase competition and productivity (Foucault, 2008; Mirowski, 2014). Rising inequality, in turn, is related to lower levels of social cohesion and trust and a decline of community life. In line with this, researchers have shown that happiness declines as social inequality rises. This relationship between inequality and happiness is explained statistically by lower perceived fairness and lower generalized trust rather than by lower household income (Oishi et al., 2011). Accordingly, there is already evidence that by fostering social inequality neoliberal politics can have a negative impact on well-being at a societal level. Neoliberalism also encourages consumerism and when people adopt materialistic values, they are more likely to have symptoms of anxiety and depression with poorer relationships and lower self-esteem.1

The more wealth and power are concentrated in a society, the more racial and other exclusivist discourses will be deployed and the more criminal its government system, and ultimately the society, will become. As German philosopher Max Horkheimer first diagnosed it, the inherently criminal dynamics of modern governance in a capitalist system rest on a relationship of dependency between ruler and ruled, in which those in power both “[protect] and at the same time [exploit] their clients.” Precarity is that condition of uncertainty and insecurity that threatens violence, exclusion, and/or poverty. And precarity is politically induced. This means that conditions of life that make it more difficult are the result of political decisions, despite the fact that we are made to believe that such struggle is a natural and inevitable part of life. This trope of personal responsibility has the effect of concealing the political motivations for allowing and inducing precarity.

Under neoliberal logic, wellbeing and security are linked to how hard one works to earn the supports that make a good life possible. So that means that people struggling in precarity often feel responsible for their condition and believe they are not living up to the American Dream, a feeling of perceived “failure” that can induce a lot of shame. Have you ever had to make a difficult decision like choosing between paying for child care for your kids or going back to school to get a degree? These are just some of the everyday struggles that a social existence defined by precarity brings. Precarious work is the new norm as more and more people in the United States enter work in the gig economy, taking temporary or one-off jobs that pay little and offer no job security. Precarious work is also becoming normalized in salaried jobs like teaching, where teachers are left in positions of uncertainty and insecurity year after year as conservative governments gut the power of labor unions to collectively bargain and organize.

As the World Health Organization concludes, mental disorders are shaped by social and economic factors, with inequality being chief among them. Over the past 15 years, antidepressant use has increased in the United States by nearly 65%. From 2017 to 2018, 19% of adults in the United States experienced a mental illness – an increase of 1.5 million people when compared to the previous year (State & of Mental Health in America, 2021). These do not include the increases in distress after COVID-19, which has resulted in heightened rates of moderate to severe depression, anxiety, and suicidal ideation. Additionally, life expectancy, which has increased yearly since 1918, has decreased over the past several years in the United States due to dramatic rises in deaths from suicide, alcoholism, and drug overdoses (Case & Deaton, 2020). Over the past decade, sociologists, and mental health practitioners have posited that the increases in mental illness and distress are due to neoliberal economic policies and ideologies.2

Today, social justice has shifted towards a stronger emphasis on human rights and improving the lives of disadvantaged and marginalized groups that have historically faced discrimination in society. Many of these groups have been discriminated against on the basis of factors such as sex, age, wealth, ethnicity, heritage, social status, religion, and others. Woke nowadays refers to being aware or well informed in a political or cultural sense, especially regarding issues surrounding marginalised communities – it describes someone who has “woken up” to issues of social injustice. Woke capitalism, also referred to as woke capital or stakeholder capitalism, is a term referring to forms of marketing, advertising and corporate structures that pertain to sociopolitical standpoints held by millennials and Generation Z, including social justice and activist causes. We need to shift the cancel culture of censorship, ostracism, anathemas, threats, destruction or vandalism of works of art, attempts at linguistic and historical revision, and media lynching campaigns on social networks response to woke capitalism.

Woke, or stakeholder capitalism is the idea that businesses have a responsibility that extends beyond their shareholders. Employees, the media, and investors are urging businesses to take a stand on issues that affect their wider communities and create greater equality. The real issue is the trade-offs between short-termism and long-termism. Stakeholder and shareholder interests do align in the long term. If you have happy employees, collaborative suppliers, satisfied regulators, and devoted consumers, then they will help you deliver higher benefits over a longer-term period. ESG metrics are used to screen investments based on corporate policies and to encourage companies to act responsibly. This only includes the risks to its business and shareholders, not the risks the business creates for the outside world, to people and planet. All people, regardless of their backgrounds, have rights and responsibilities to fulfill their potential in life, and lead decent, dignified and rewarding lives in a healthy environment. With no good definition there is no way to determine whether goals or targets of present system are being met.

The problem is, without goals or targets we are unable to measure progress, there can be no way to engage in serious debate. We need a new system to counter the attack from the right wing on “Woke” capitalism. Social justice is the view that everyone deserves equal rights and opportunities. The inequities of health are measured by the spread in life expectancies between poor and rich neighborhoods. Let’s replace ESG with the social determinants of health. The social and economic factors that influence people’s health are apparent in the living and working conditions that people experience every day. Inequalities in the distribution of the social determinants of health are now a widely recognized problem. We need to take the handle off the pump, and introduce significant upstream public policy interventions. This requires us to filter social and economic policies through the lens of the social determinants of health before they are implemented to ensure they support actions that reduce inequities in the system.

1 https://bpspsychub.onlinelibrary.wiley.com/doi/full/10.1111/bjso.12438

2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145185/

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