Glorifying Virchow: Current Debate on Neoliberal Policies and Health Inequalities in India

Srinivas Goli, International Institute for Population Sciences (IIPS)

The pathways in which inequality generates particular population health outcomes remain a major source of dispute within social epidemiology and health economics. Virchow’s philosophy undoubtedly galvanised thinking across the disciplines, with its emphasis on how political-economic ideologies and income inequality shape the distribution of health and social problems. In this paper, we argue that the focus on health inequality, whilst important, understates the role of neoliberal discourses and practises in making sense of contemporary debates on health inequality. Many quantitative studies have demonstrated that more neoliberal countries have poorer health compared to less neoliberal countries, but we hardly found a comprehensive documentation of evidence in Indian context. In light of the fast-changing political and social environment and policy priorities post 1990s in general and post 2014 in particular, this paper examines the impact of the rising share of private healthcare delivery on health inequalities. Using inequality in Under Five Mortality Rate (U5MR) as a health outcome and per capita NSDP, per capita public health expenditure, share of private health care spending and poverty ratio as an indicator of neoliberal policies, through robust econometric assessment, we found that economic growth without poverty reduction and public health care spending raises health inequalities.

Keywords: Economic Demography, Econometrics , Population and Development, Population Policies

See paper.