Friedrich Engels in his 1845 Condition of the Working Class in England documented how capitalist practices prematurely sickened and then killed workers, a process he termed social murder.
Outside of a few writers from the later decades of the 20th century, an explicitly anti-capitalist and pro-socialist public health analysis has until recently been limited to the Latin American social medicine literature.
Specific analysis of how capitalism shapes the quality of living and working conditions – now termed the social determinants of health — is now accumulating in the English-language public health literature.
This is coming about because of the polycrises in employment security and wages, food insecurity and hunger, health and health care, housing, income and wealth inequality and environmental protection as a result of the acceptance of neo-liberal governance in many capitalist nations.
The inability of even social democratic political parties to respond to these crises had led to increasing numbers of public health researchers endorsing Marx and Engels’s call for a rupture from capitalism towards a post-capitalist socialist society.
We documented these developments and compiled a selection of recent public health literature that explicitly indicts capitalism as a threat to health (see Table 1). This increasing concern parallels the reemergence of Engels’s concept of social murder in the public health and public policy literature.
TABLE 1: Public Health Literature Providing a Critique of Capitalist Practices
| Author | Title | Description |
|---|---|---|
| Panitch, L. and Leys, C., 2009 | Morbid Symptoms: Health Under Capitalism | Sees health as a field of struggle between commercial forces wanting health as a field of profit and popular forces fighting to make it a public good. |
| Waitzkin, H., 2018 | Health Care Under the Knife: Moving Beyond Capitalism for Our Health | Essays address the “medical industrial complex,” impact of privatization and cutbacks under neoliberalism, the nature of health-care work, and the intersections between health care and imperialism. |
| Benach, J., et al., 2019 | Public Health and Inequities Under Capitalism: Systemic Effects and Human Rights | Claims that capitalism impregnates the social organization of all human domains, permeating humanity and the many facets of the health-disease production process. |
| Rosenthal, S., 2019 | Rebel Minds: Class War, Mass Suffering, and the Urgent Need for Socialism | Outlines means of creating a healthful, cooperative, and sustainable world. Argues that the capitalist class forces us to live in a health threatening and unsustainable world. |
| Wolff, 2020 | The Sickness is the System: When Capitalism Fails to Save us from Pandemics or Itself | “Returning to normal” no longer responds adequately to the problems of capitalism. What is necessary is a transition to a new economic system that works for all of us. |
| Freudenberg, N., 2021 | At What Cost: Modern Capitalism and the Future of Health | Argues that 21st-century capitalism cannot solve our most serious public health problems, from climate change to opioid addiction. |
| Das, R., 2022 | Capital, Capitalism and Health | Analyses Marx’s thoughts about health in relation to the value of labour power relative to wages; employment precarity; capitalists’ control over workers; and the capitalist transformation of nature. |
| Govender, P., Medvedyuk, S. and Raphael, D., 2023 | 1845 or 2023? Friedrich Engels’s Insights into the Health Effects of Victorian-Era and Contemporary Canadian Capitalism | Similarities between the political economy of Victoria-era England and 2022 Canada make explicit the means by which capitalism first sickens and kills so many. |
We also brought together recent works on how to move towards a post-capitalist socialist society. These writings identify the specific public policy actions that would help erode capitalist institutions and move us towards a post-capitalist socialist society (Table 2).
In practice, many would first move us towards the institutions common to the social democratic Nordic nations such as greater redistribution of income and wealth, social spending, and management of the labour market. But at the same time, they would provide space for the emergence of non-capitalist structures and processes.
As examples, Stephen McBride calls for a “radical transformation” whereby popular sovereignty comes to control capital; there is a rebuilding of the public domain and state; and socialization of capital investment.
Erik Olin Wright advocates civil society control of the economy by strengthening competing institutions such as credit unions, workers cooperatives, and governmental structures of participatory budgeting.
Marx and Engels would find little in McBride’s and Wright’s suggestions to disagree with.
TABLE 2: Literature Suggesting Means of Moving Towards a Post-Capitalist Socialist Society
| Author | Title | Description |
|---|---|---|
| Fisher, M., 2009 | Capitalist Realism: Is There No Alternative? | By examples from politics, films, fiction, work and education, Fisher shows the many barriers to moving beyond capitalism. |
| Klein, N., 2015 | This Changes Everything: Capitalism vs. the Climate | Provides an analysis of the economic drivers warming our planet and how the climate crisis can yet spur economic, cultural and political transformation. |
| DuRand, C., 2016 | Moving Beyond Capitalism | Examines institutions and practices now being built that can move beyond capitalism toward a more equal, participatory, and democratic society. |
| Wright, E., 2019 | How to Be an Anti-capitalist in the Twenty-First Century | Provides an urgent and powerful argument for socialism, and a guide on how to get there by building alternatives structures. |
| Jackson, A., 2021 | The Fire and the Ashes: Rekindling Democratic Socialism | Outlines a path towards democracy with equalities of wealth and political power, social ownership and public investment. |
| Meiville, C., 2022 | A Spectre, Haunting: On the Communist Manifesto | The author offers a spirited defense of the enduring relevance of Marx and Engels’s ideas and means of moving towards a post-capitalist society. |
| Albo, G., et al., 2022 | Socialist Register 2022: New Polarizations, Old Contradictions. The Crisis of Centrism | Original essays examine issues of growing economic inequality, democratic decline, and the shifting parameters of great power rivalry. How can the left move forward? |
| Chibber, V., 2022 | Confronting Capitalism: How the World Works and How to Change It | Provides a clear map of how capitalism works, limits the power of working and oppressed people, and how to overcome those limits and build a socialist future. |
| McBride, S., 2022 | Escaping dystopia: Rebuilding a Public Domain | Calls for a radical transformation whereby popular sovereignty comes to control capital; rebuilds the public domain and state and socializes capital investment. |
| Sunkara, B., 2022 | The Socialist Manifesto: The Case for Radical Politics in an Era of Extreme Inequality | Explores socialism’s history since the mid-1800s and presents a realistic vision for its future. |
| Winlow, S., & Hall, S., 2022 | The Death Of The Left: Why We Must Begin from the Beginning Again | Argues the way to resurrect what was valuable in leftist politics is to mobilize citizens around core unifying principles and build a post-capitalist society. |
We cannot be sure of what the ultimate post-capitalist socialist society will look like, yet the well-documented adverse health effects of capitalism require we nevertheless strive towards that goal.
For David Harvey, we have no option as the inherent contradictions of capitalism will lead to its demise.
China Meiville, in a discussion of the impending climate catastrophe states: “Socialism, wherein the astonishing scientific and technical powers of humanity are harnessed to need, for all the uncertainties and errors that would occur, would give an infinitely greater likelihood of sustaining a habitable world than more of the same system that got us here.”
We see these times of crises as an opportunity to move towards a post-capitalist society. Yet, these crises also present threats of which the primary one is the rise of anti-democratic reactionary movements. Indeed, some have compared the present political scene to developments of the rise of the left and right during the Weimar Republic.
What is required is the bringing together – within an anti-capitalist framework — of the various social movements which represent dissatisfaction with the current state of affairs. This requires linking working class labour movements with those especially disadvantaged by capitalist practices: people of colour, Indigenous peoples, women, and persons with disabilities, among others.
As noted by Susan Rosenthal: “Socialism is back on the agenda.”
Dennis Raphael is a professor of health policy and management at York University in Toronto, Canada.
Toba Bryant is an associate professor of health sciences at Ontario Tech University in Oshawa, Canada.
To learn more, see Dennis Raphael and Toba Bryant. Socialism as the way forward: updating a discourse analysis of the social determinants of health. Critical Public Health 2023.
Image: Karl Marx and Friedrich Engels statue in The Marx-Engels Forum, Berlin. Taken by Dennis Raphael, July 26, 2019.