This project is designed as a resource for people who worry about population health, health care and / or public health and are keen to explore a political economy approach to health policy. The worriers in focus include health science students (undergraduate and postgraduate), health policy analysts (however labelled or located), and health activists everywhere.

Political economy is a broad discipline that has an important contribution to make to understanding, policy development and activism around population health and health systems. However, political economy is rarely broached in health science education and is generally relegated to the underground in established health policy discourse.

Like any discipline political economy has its own jargon which can be a barrier to accessing the insights it has to offer. Accordingly, a resource focusing on key terms in political economy (for health) might facilitate wider access to the disciplines of political economy as they can be applied in relation to population health and health care.  (Terms currently included: Alienation / Class / Consciousness (Ideology, Praxis, and Solidarity) / Social determinants and social determination / Financialisation / Imperialism  / Intersectionality / Neoliberalism / New International Economic Order / Overproduction.)

Dive straight into the current draft of Key Terms (15 March 2023).

Political economy

‘Political economy’ is a discipline where the stocks and flows of ‘the economy’ are explicitly mapped against the institutions and power relations which shape where those stocks are held and how those flows are mediated.

However, the term also carries assumptions about the kinds of economy and polity which would support a good society. These assumptions have their roots in the history of political economy.

Prior to the emergence of ‘neoclassical economics’ the established discipline of economics was political. However, with the development of neoclassical economics (with Jevons and Walras as significant early figures) there was a growing emphasis on modelling (based on the supply and demand relationship) commonly at the cost of neglecting institutions and power relations. 

Contemporary usage of the term ‘political economy’ carries connotations of economic heterodoxy and critique, in particular critique of neoclassical economics. This heterodoxy includes various streams of Marxist political economy. However, Marx’s own writing on economics (whilst highly political) was commonly cast in polemic against the economic establishment, referred to as ‘political economy’, as in his Contribution to the Critique of Political Economy (1859).

Neoclassical economics relies heavily on the use of economic models and in recent decades has taken economic modelling to new levels of complexity and in doing so has transformed conventional economics from an inductive science to a deductive dogma. Induction develops generalisations from specific experience; deduction applies generalisations, derived from theory, to the interpretation of experience. In this case, complex models of ‘the economy’ are created, based on mathematical equations selected for their elegance rather than their real-world relevance. (This elegance depends in large degree upon assumptions about economic relations tending to equilibrium as opposed to the dynamic complexity which is observed in the real-world.)

The appropriation of the term ‘political economy’ by various schools of heterodox economics (defined by their critique of orthodox (neoclassical) economics) serves to reaffirm the importance of institutional structures and power relations in shaping the stocks and flows of the economy and in setting the context for market relations.

The purpose of this resource centres around the use of the language of political economy for making sense of population health and health systems (includes the institutions of health care and public health), where ‘making sense’ encompasses description, explanation and strategy. Thus, each entry/chapter includes a discussion of usage and a reflection on ways in which some of those usages may contribute to more useful descriptions, explanations and strategies in relation to population health and health systems.

The Key Terms Project

The Key Terms Project was initially conceived as an accessible, browsable resource which would support health practitioners in exploring the relevance of political economy to their work.  Critical aspects of the design would be extensive cross referencing (between the key terms) and a full index focused on the health implications of the various key terms. These two features would support browsability and repeated dipping into and skimming across the resource.

We have identified a number of key terms which could be covered in later versions of the project (see Annex). At this stage we have draft entries for ten of these. 

The final form that the resource might take (online, hard copy, or journal publication) is open for further consideration. 

Readers are begged to keep in mind that the entries included in this document are first drafts only. They will benefit greatly from your feedback.

Acknowledgements

This project started out as an activity for a meeting of the Political Economy of Health Special Interest Group of the Public Health Association of Australia. Advice and feedback from members of the SIG are greatly appreciated. 

The project has also benefitted greatly from conversations within the People's Health Movement over many years. 

DGL
15 March 2023