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The Policies-Inequality Feedback and Health: the Case of Globalization
  1. Roberto De Vogli1,
  2. David Gimeno1,
  3. Ritesh Mistry2
  1. 1 University College London, United Kingdom;
  2. 2 University of California Los Angeles, United Kingdom
  1. E-mail: r.devogli{at}


Background: Major research contributions aiming at explaining the association between economic inequality and health concentrated on the plausibility of the material deprivation and psychosocial factors pathways. However, little work has analyzed the reciprocal associations between public policies and inequality and their effect on health.

Methods: We first proposed a conceptual framework explaining how the public policies-inequality feedback can influence health outcomes via material deprivation and psychosocial factors. Then, we conducted a critical review of the literature and analysed the health effects of the globalization-inequality feedback as a case study.

Results: Different bodies of evidence seem to give support to the hypothesis of a public policies-inequality feedback influencing health-related outcomes. This seems to be particularly true when considering globalization policies. Since the widespread adoption of the so-called “Washington Consensus,” economic inequalities have sharply increased worldwide. The rise of inequality has, in turn, further consolidated the adoption of these policies through an increasing “democratic deficit.” The reciprocal effects of globalization and inequality produced adverse health outcomes between and within societies through both material deprivation and psychosocial stress.

Conclusions: Public policies and economic inequality are inextricably interrelated and can affect health through multiple, indirect, reciprocal pathways. Future studies should avoid investigating the health effects of policies and inequality separatedly.

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