↳ Wages

April 21st, 2020

↳ Wages

Group Formation


Comparative development and social policy

Among the diverse local and national policy responses undertaken to combat the pandemic in recent months, Kerala's has been notable. Within the broader context of Indian economic development, Kerala's government has a tradition of successful redistributive development policies, sometimes referred to as the Kerala model.

In a 2005 article, MANALI DESAI traces Kerala's unique post-independence record of welfare provision to its experience under indirect British rule. By comparing the trajectory of its policy successes to those of West Bengal, a state with a similar electoral history, Desai strikes a distinctive balance between path dependency and contingency, arguing that "the form and content of welfare policies are shaped by the exigencies of state formation, but political struggles are the decisive determining factors of the former."

From the article:

"In the somewhat meager annals of comparable state action in third world societies, Kerala appears as a clear exception. Despite fierce party competition, a church-landlord coalition, and the imposition of presidents’ rule on two different occasions (in 1959 and 1965), the state has seen an array of policies aimed at redistributing land, and providing education, pension plans, minimum wage legislation, and housing for the poor. There have been few serious attempts at understanding these state actions as a form of historical agency. In particular, an issue that is consistently overlooked is the fact that Kerala’s post-independence policy regime was preceded by significant welfare expansion in the nineteenth century in its two southern princely states of Travancore and Cochin. In part under pressure from the British administration, both monarchies undertook significant land reforms and expanded education and health care. While reforms by princely states were not that unusual in the colonial era, the scale and scope of Kerala’s surpassed its peers.

The extreme nature of the caste hierarchy in Kerala, perhaps the most oppressive across India, meant that Christian missionaries not only found a home in Kerala but fed and even stimulated caste insurgency. In particular, one crucial effect of British rule and Protestant missionary activity was the increased porosity of the state to social (lower caste) demands. Both dimensions of colonial power (colonial power as well as social resistance to this power) destroyed status privileges, primarily those based on caste, to a larger degree than found elsewhere in British India. Early welfare policies in Kerala were implemented in a dependent colonial context and aimed at warding off annexation by the British, but their unintended consequences were to stimulate what they were precisely designed to avoid—radical caste and class movements."

Link to the piece.

  • An edited volume from 2000 looks at the history of Kerala's social policies. Link. (A 1991 exchange in the NYRB between Barbara H. Chasin and Richard W. Franke, and Amartya Sen discusses the nature of Kerala's "exceptionalism." Link.)
  • "This article addresses the welfare state in a global historical context. In the new societies of industrial capitalism, two powerful and opposite interests converged in generating public social policies. It uses the five-part model to ask what lessons, if any, it has for the likely emergence of welfare states in the developing world. It also recognizes the immense variety within the 'global South' and distinguishes the distinctive patterns of risk management within it." A 2010 paper by Ian Gough and Göran Therborn. Link. (Ungated version here.)
  • A 2007 paper by Nita Rudra looks at the applicability of Gøsta Esping-Andersen's welfare state typology in the developing context. Link. And Stephen Haggard and Robert Kaufman's 2009 book provides a comparative account of welfare state development across Latin America, East Asia, and Eastern Europe. Link.
⤷ Full Article

April 7th, 2020

Big Horse


Histories of public health

Comparisons of responses to the Covid-19 crisis across national lines yield as many questions as answers. Divergent histories of public health programs, differences in cultural norms, population density, age distributions, and internal migration patterns create a muddy picture for causal understandings of the national variations in impact.

PETER BALDWIN's Contagion and the State in Europe 1830-1930 provides a fundamental historical study on these questions. The book explores the "reasons for the divergence in public health policies in Britain, France, Germany and Sweden" and the "spectrum of responses to the threat of contagious diseases such as cholera, smallpox and syphilis."

From the book's conclusion:

"Since at least the era of absolutism, preventing and dealing with contagious and epidemic disease have together been one of the major tasks of states. Given that, from the first European cholera epidemics to the cusp of the antibiotical era, the problem faced by each country has been much the same in biological terms, why have they responded in markedly different ways? Especially before the bacteriological revolution, etiological knowledge was inextricably bound up with political, administrative, economic, and geographic factors.

The fundamental implication of a political interpretation of public health is that prophylactic strategy and ideology are correlated. Approaches to prevention may be expected to reflect common assumptions held in a society as to where group and individual interests diverge, how much autonomy citizens can rightfully claim, the power of the community over its members. The right to be spared prophylactic imposition was not the only measure of liberty; there was also the freedom from disease. Traditional conservative quarantinists argued this line. Conversely, liberals objected to such interventions when they impinged on personal liberties too drastically or for insufficiently redeeming purpose. There was, also an understanding of public health that transcended such sterile oppositions between community and individual, holding that society’s concern with public health was a positive freedom that, while limiting absolute individual autonomy, returned to each a higher measure of liberation from affliction.

Such political interpretations of preventive strategies appear, however, to have inverted matters. It was not British liberalism or German interventionism (to take again the outliers) that, by themselves, determined prophylactic strategies, but the imperatives of geoepidemiology, and the associated factors identified here, that helped shape not only the preventive precautions they encouraged, but indeed the very political traditions of these nations."

Link to the book.

  • A new podcast from the Cambridge history department discusses Baldwin's book as a guide for thinking through the present crisis. Link.
  • For the classic international history of public health, see George Rosen's 1958 A History of Public Health. Link. And see his 1947 paper "What Is Social Medicine?" Link.
  • "After yellow fever was firmly ensconsed, it underpinned a military and political status quo, keeping South America under Spanish rule. After 1780, and particularly in the Hatian Revolution, yellow fever undermined the status quo by assisting independence movements in the America tropics." A 1999 article by J.R. McNeill on "Ecology, Epidemics, and Empires." Link.
⤷ Full Article

March 9th, 2020

Flanked by Two Dolphins


An ecosocial theory of disease

The correlation between health, income, and wealth is widely recognized in contemporary research and policy circles. This broadly social understanding of public health outcomes has its origins in a theoretical tradition dating back to the 1970s and 80s, in which scholars began to embed medical research within a political and economic framework.

In a 2001 paper, epidemiologist NANCY KRIEGER seeks to strengthen the theoretical foundations of epidemiological research by linking them back to biological study.

From the paper:

"If social epidemiologists are to gain clarity on causes of and barriers to reducing social inequalities in health, adequate theory is a necessity. Grappling with notions of causation raises issues of accountability and agency: simply invoking abstract notions like 'society' and disembodied 'genes' will not suffice. Instead, the central question becomes who and what is responsible for population patterns of health, disease, and well-being, as manifested in present, past and changing social inequalities in health?

Arising in part as a critique of proliferating theories that emphasize individuals' responsibility to choose healthy lifestyles, the political economy of health school explicitly addresses economic and political determinants of health and disease, including structural barriers to people living healthy lives. Yet, despite its invaluable contributions to identifying social determinants of population health, a political economy of health perspective affords few principles for investigating what these determinants are determining. I propose a theory that conceptualizes changing population patterns of health, disease and well-being in relation to each level of biological, ecological and social organization (e.g. cell, organ, organism/ individual, family, community, population, society, ecosystem). Unlike prior causal frameworks—whether of a triangle connecting 'host', 'agent' and 'environment', or a 'chain of causes' arrayed along a scale of biological organization, from 'society' to 'molecular and submolecular particles'—this framework is multidimensional and dynamic and allows us to elucidate population patterns of health, disease and well-being as biological expressions of social relations—potentially generating new knowledge and new grounds for action."

Link to the piece.

  • Krieger's 1994 article takes a closer look at epidemiological causal frameworks, questioning the adequacy of multiple causation. And her 2012 paper asks: "Who or what is a population?" and articulates the analytical significance of this definition for epidemiological research. Link and link.
  • "Disease epidemics are as much markers of modern civilization as they are threats to it." In NLR, Rob and Rodrick Wallace consider how the development of the global economy has altered the spread of epidemics, taking the 2014 Ebola outbreak as a case study. Link.
  • Samuel S. Myers and Jonathan A. Patz argue that climate change constitutes the "greatest public health challenge humanity has faced." Link.
  • A history of epidemics in the Roman Empire, from 27 BC – 476 AD, by Francois Relief and Louise Cilliers. Link. And a 1987 book by Ann Bowman Jannetta analyzes the impact of disease on institutional development in early modern Japan. Link.
⤷ Full Article