Unemployment and Health in the Neoliberal Era: Towards a Political Economy of Widening Health Inequalities

There is an extensive literature on the topic of health inequalities. A key insight to emerge from this body of research is the finding that, despite more than a decade of professed effort on the part of governments, health inequalities are widening in most, if not all, advanced capitalist countries. Though scholars have posited several competing explanations for this problematic trend, these have not been subject to rigorous empirical testing. As a result, we know little about why health inequalities are widening over time.

In response to this gap in the literature, we investigate the case of changing unemployment-related health inequalities in Canada. Using data from the Canadian Community Health Survey, we complete three sets of analyses. First, we describe recent trends in the health status of employed and unemployed Canadians and show that the gap between these populations has grown over time. Next, we examine whether these adverse trends can be explained by commensurate changes in the demographic, socioeconomic, and behavioural characteristics of the unemployed. Finally, we use a quasi-experimental study design to test the hypothesis that neoliberal welfare state reforms have contributed to growing unemployment-related health inequalities.

The results of our analyses suggest that compositional factors provide little in the way of an explanation for widening health inequalities between employed and unemployed Canadians. Instead, our findings suggest that this gap has widened due to the neoliberal restructuring of Canada’s social and economic landscape, including its welfare state policies. Advancing recent calls for a political economy of health inequalities, we conclude that scholars interested in explaining why advanced capitalist countries are failing at health equity should turn their theoretical and empirical attention to the neoliberal transformation that is underway in these societies.