The Political Economy of Disease: Marx, Social Medicine, and the Production of Health Inequality
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Authors
Department of Clinical Medicine, Second Clinical Medical College, Shaanxi University of Chinese Medicine, Xianyang 712046, Shaanxi, China
Department of Public Administration, School of Humanities Management and Foreign Languages, Shaanxi University of Chinese Medicine, Xianyang 712046, Shaanxi, China
Panorama Research Institute, Hong Kong, China
Abstract
Karl Marx did not formulate a clinical or pathological theory of medicine. His importance for medical thought lies elsewhere: his critique of capitalism repositioned disease and health as problems of labor, class, social reproduction, and public power. Through close conceptual reading, intellectual-historical reconstruction, and critical synthesis, this article develops its argument through three analytical movements. It first examines Marx's account of the laboring body, the working day, machinery, surplus value, and the reproduction of labor-power. It then situates Friedrich Engels's The Condition of the Working Class in England as a bridge between political economy and social medicine before tracing the reformulation of these concerns in the political economy of health and health-inequality research. The article proposes a four-domain distributional framework: capitalist institutions organize hazardous exposure, shape embodied susceptibility, stratify access to treatment, and differentiate recovery and cost-bearing. The framework's contribution lies in integrating processes that are often studied separately within a single account of institutional distribution. Marxian political economy therefore contributes to the social understanding of medicine and health by explaining how risks and protections are allocated, not by substituting for biomedical explanation. This perspective neither reduces every illness to class nor attributes later scholarship directly to Marx. Its continuing value is to connect biological mechanisms with the political and economic structures that distribute exposure, vulnerability, care, and the costs of recovery.
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