Stephen Nkansah-Amankra, PhD Samuel Kwami Agbanu, PhD Reuben Miller, PhD (c)

1. Health, Poverty, Incarceration and Social Justice in the United States: A critical review of evidence of close links with neoliberalism Stephen Nkansah-Amankra, PhD Samuel Kwami Agbanu, PhD Reuben Miller, PhD (c)

2. Presenter Disclosures The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: No relationships to disclose

3. Faces of poverty in the United States

4. Purpose and Objectives • To demonstrate linkage between neoliberalization, health disparities in and Incarceration in the United States • Discuss ways neoliberalism create routes for mass incarceration, poor health among disadvantaged populations. • To apply social justice perspective towards minimization of health disparities, incarceration and poverty.

5. Unique characteristics of poverty, incarceration, poor health among populations in the United States • Occur predominantly among minority populations • Populations impacted by existing political and social disparities • Higher proportion of African Americans, Hispanics, and non-whites • Gender

6. Neoliberalism and welfare in the United States • U.S. style neoliberalization—a political and economic policy regime designed in accord with prevailing market principles, and an ideology, discourse, and governance strategy privileging notions of individual freedom, choice, competition, and limited state intervention—and the rise of the mass incarceration.

7. Neoliberalism and Mass Incarceration • The unprecedented growth in the prison population during this era is unparalleled in the history of the country’s criminal justice system, and is the largest prison expansion project the world has known.

8. Neoliberalism, Health, Poverty and Incarceration • Limited empirical assessments of the relationships among neoliberal policies, public health, poverty, and incarceration. • Relied on indirect evidence from correlational studies, expert commentaries and critical reflections.

9. Evidence 1: Public goods provide critical safety nets for the poor and population wellbeing • Health related information and services that have led to reductions in disease prevalence and mortality over the years are public goods that benefits larger population, • Access to these public goods is the direct result of policy decision making e.g. the provision of immunizations and health information to prevent major infant and childhood diseases • Private markets in some cases lack the capacity and in others are unwilling to provide access to the goods and service these comprehensive health reforms provided to all U.S. citizens.

10. Evidence 2:Funding for public service institutions enhance social participation and economic development • Neoliberal social policies have been shown to adversely affect health and education directly through the denial of institutional supports for programs and activities that reduce poverty and improve public health (McGregor, 2001; Feo, 2008).

11. Evidence 3: Soaring poverty, poor health and incarceration • One of the most critical indictments of neoliberalism is that it has increased poverty and caused considerable social dislocation including the development of what some academics and activists have termed the “prison industrial complex” in the United States.

12. Toward a Social Justice Paradigm in Public Health • We contend applying social justice perspectives to public health and assessing the mechanisms through which these are related to population health or incarceration have important implications for understanding the upstream influences on population wellbeing in the era of neoliberalization in the United States

13. Toward a Social Justice Paradigm in Public Health-Continued • We contend that applying social justice perspectives to public health and assessing the mechanisms through which these are related to poverty and incarceration may have important implications for understanding the upstream influences on population wellbeing in the era of neoliberalization in the United States.

14. Discussion, conclusion and future directions • Although the particularities of neoliberalism are different, the ideology driving the neoliberal agenda is the belief in the superiority of the market economy. • A fair system of co-operation embedded in social justice is thus inconsistent with the market principles that consider humans as loose associations of individuals.

15. Conclusion and future directions • Neoliberalism has considerably contributed to widening public health disparities, disproportionate incarceration rates among disadvantaged populations, and increased poverty in the United States over the last 30 years. • Public health scholars focus on individual risk factors vs. impact of social policy (individualism, less regulation, funding cuts, privatization)