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Social Determinants of Health

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From:
Dennis Raphael <[log in to unmask]>
Reply To:
Social Determinants of Health <[log in to unmask]>
Date:
Fri, 24 Sep 2004 06:33:53 -0400
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Meeting Sept 29, Health Sciences Complex H 670 1 pm

Our next pophealth meeting will be next Wednesday.  The following one will
be at Seattle U October 12 at 5 pm.  For a map of the UW health sciences
complex, go to
http://depts.washington.edu/hsnews/images/health_sci_map.gif

The next meeting will be about planning this academic year's efforts and
hearing Linn Gould present her analysis of inequaltiy and health within
Washington State.

So come with ideas, and strategies.

For newcomers, the Population Health Forum, an organization of health
activists originally launched at the University of Washington, raises
awareness of, promotes dialogue about, and explores how political,
economic and social inequalities interact to reduce the overall health
status of our society.  We host forums, sponsor discussions, develop
curriculum, teach courses,  sponsor workshops, and provide speakers to
promote knowledge and to advocate for action in service of a healthier
society.

Stephen Bezruchka

PS:  Many of us talk about income distribution which is an important
measure of hierarchy in the US.  This concept doesn't sit well in this
nation, which seems to delight in creating a bigger gap.  May this article
below on a social wage might fly better?

PPS:  We men suffer from the X chromosome deficiency disorder and pay
dearly with severely shortened lives.  The discrepancy, the health price
we pay for not having the X is increasing.  Go to this online paper and
look at the fine colored graphs of this phenomenon.

http://human-nature.com/ep/downloads/ep026685.pdf

  ****
ZNet Commentary The Social Wage September 24, 2004 By Yves Engler

If you work for a living, you're better off when welfare payments are
high.

Sound strange? Only because truth is often ignored in a society where the
narrow interests of wealth holders dominate over all else.

At the start of this year the right-wing British Columbia liberal
government slashed welfare payments. By 2006 the "Hartz IV" reforms of
Germany's Social Democratic government will have reduced unemployment
benefits from 32 months down to 12 (eighteen months for those over 55) and
cut other long-term unemployment benefits. Huge protests against these
reforms have swept across Germany the past few Mondays. In the U.S., both
state and federal governments have enacted drastic cuts to welfare over
the past decade.

These attacks against the poor and unemployed should be opposed by anyone
who cares about their fellow human beings. But, in addition to compassion,
working people have another important reason to oppose these cuts to
social benefits; our self-interest in maintaining the social wage.

Right-wing pundits often claim that welfare payments or unemployment
benefits cost us all. In rare displays of concern for "society" they say
that those unwilling (or unable) to work are a burden on us all. Often,
these pundits develop elaborate, and sometimes racist, discourse about
Black (or Aboriginal, or Hispanic or immigrant) communities to strengthen
opposition to (non-corporate) welfare benefits.

On one level it is true that welfare benefits cost us all, though rarely
are these costs a significant chunk of public expenditure. (Unlike
military spending or road building, which are essentially forms of
corporate welfare.)

However, examined from another perspective, social entitlements such as
welfare and unemployment insurance are an important means to protect the
wages and conditions of working people. Decent welfare and unemployment
benefits provide a security guarantor for working people who may fear
losing their job. When decent social entitlements exist, invariably
workers' bargaining power is improved. In short, the strength of welfare
and unemployment benefits helps determine a country's social wage; its
generally accepted minimum pay and benefits.

On August 23rd the Financial Times ran a revealing article on the "Hartz
IV" reforms. " To date," the Financial Times reports, "it has often been
more attractive for people to remain on generous unemployment and social
benefits" than to take poorly paid jobs. "This may change", according to
the FT, since Hartz IV will put "increasing pressure on the jobless to
find work." Already Hartz IV has led to a dramatic rise in so-called
'mini-jobs', which are poorly paid jobs in shops, cafes and private homes.

410 000 'mini-jobs' were added between April and the end of June to a
total of 1.2 million in the past year. The current total of 7.6 million
'mini-jobs' will rise as people become more desperate. The employers love
it. Caf owner Gerald Uhlig told the FT: 'mini-jobs are sensitive because
Germans, who are often a bit inflexible, have had very comfortable lives
for many years. Now things are getting harder and things like mini-jobs
are part of that.

Capitalists understand that larger social entitlements drive up the social
wage, which displeases them immensely. Why? Because, the higher the social
wage, the higher will be the wages business owners must pay their
employees. Capitalism causes immense pressure to cut costs, one of the
most significant of which is wages.

So, if business owners can reduce salaries they will. But, they recognize
that to reduce their salary costs a multi-pronged attack against wages is
needed. Simply cutting their own workers' salaries is only effective to a
point. If workers feel they deserve better wages, and social entitlements
are available, they will refuse to accept less than the prevailing social
wage.

Lobbyists for wealth holders certainly understand the relationship between
social entitlements and the social wage. Business organizations over the
past 20 years have ferociously attacked social entitlements around the
world. These assaults on social entitlements are central to neo-liberal
ideology. If successful, they drive down the social wage and increase the
proportion of income that goes to the relatively small number of wealth
holders.

In some U.S. states (non-corporate) welfare has been cut to the point
where benefits can only be claimed by working an inordinate number of
hours in highly exploitative industry, as Michael Moore's film Bowling for
Columbine highlights. But, the corporate sector's drive to reduce the
social wage does not end with its assault against welfare and unemployment
benefits.

In fact, that is just the beginning and just one more way to divide the
working class. The government sector is also attacked to help reduce the
social wage. That is because unionization rates are substantially higher
in the public sector, only 8.5% of U.S. private sector employees are
unionized whereas the rate is 37.5% in the public sector.
(www.laborreasearch.org)

Governments that, on some level, must be responsive to the democratic will
are usually less fierce in their attacks against unionization. As a result
of higher unionization rates government-run services typically pay workers
somewhat better average wages, which drives up the social wage. According
to the Economist, average public sector pay is 27% higher in Spain, 10%
higher in France and 45% higher in Portugal than private sector pay (July
5 2003).

In Canada a recent report that examined the salaries of 257 occupations in
both the public and private sector found that many federal employees are
paid better than their private sector colleagues. The Ottawa Citizen
reports, "clerks typically made 27 percent more" in the public sector
(higher paid jobs are usually the ones that pay better in the private
sector.)

The wages and benefits of public sector workers, especially clerical and
other 'service' workers provide some point of comparison for similar
private sector workers. That is why the Canadian Federation of Independent
Business, one of Canada's largest business groups, recently sent a letter
to Canadian prime minister, Paul Martin, calling on him to freeze public
sector pay.

The privatization or contracting-out of government-run operations is also
often a roundabout way of lowering the social wage. The B.C. Liberals'
recent privatization of provincial liquor stores, which were a highly
profitable source of revenue for the government, is an example of such an
attack. The workers in the stores are unionized and make decent wages,
which are substantially higher than the usual hyper-exploitative retail
wage.

The government claims they want to introduce 'competition' but what they
really mean is they want to undermine wages. (At the end of the same
process in neighboring Alberta there were no unionized, decent-paying jobs
in liquor stores and the price of booze was the same.) The beneficiaries
will be the new private owners of liquor stores and more generally the
entire retail sector, which will no longer be reminded of those
better-paid liquor store workers.

Capitalists understand that the stronger the social entitlements the
higher their wage costs. But they do not come right out and say (except
occasionally in the business press), let's lower social entitlements so we
will be better off. Instead, they divide and conquer. They play off
workers against welfare recipients. They blame immigrants or exploit
lingering racism.

What to do? How do we protect and boost the social wage? The answer is
obvious. Ordinary working people must stand together with welfare mothers.

Unions must fight for wider interests than narrowly defined members' wages
and benefits. Coalitions must be built. There's a good reason why the
union and other progressive movements like to say 'an injury to one is an
 injury to all.'

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