Socialism as the way forward: updating a discourse analysis of the social determinants of health

Abstract

In 2011 Raphael identified seven discourses on the social determinants of health (SDH). These discourses ranged from ‘SDH as identifying those in need of health and social services’ to ‘SDH and their distribution result from the power and influence of those who create and benefit from health and social inequalities’. Developments since then have led us to identify an eighth: ‘SDH and their distribution result from the processes inherent to capitalism–capital accumulation, competition, and exploitation’. We identify scholarship espousing the view that quality and equitable distribution of SDH will require the creation of a post-capitalist socialist state. While the form this state will take remains uncertain, means of moving towards it are available. Specific steps the public health community can undertake are identified.