Structural violence refers to systematic or institutionalized violence which can indirectly harm marginalized people. It is a systematic way social structures harm otherwise disadvantaged individuals. “Structure in this sense is not a material thing, but rather an observable regularity in human social activity, that has become so firmly entrenched (though habits, social relations, economic arrangements, institutional practices, law, policy, etc) as to have taken on thing-like qualities” (Farmer). The concept of violence does not specifically identified as physical violence as we would consider in its more traditional definition. Violence in this context involves multifaceted forms of oppression “in which sexism, racism, homophobia, and other forms of social pathology frequently come together with economic exploitation and deprivation” (Sparke). “Structural violence is the natural expression of political and economic order that seems as old as slavery, with social inequality at the heart of the matter” (Farmer). In essence, Farmer’s idea of structural violence argues that people in positions of power “stack the deck” in their favor. The divide of power between the elites and marginalized is predominantly controlled by members of the elite groups and identities with their needs compromising the needs of the marginalized. Consider the idea that structural violence “encourages us to look for differences within large scale structures including differences of power, wealth, privilege and health that are unjust and unacceptable” (Farmer). One particular identified structure that is of particular interest is that of structural violence in the U.S. Healthcare system. I’m sure most in this class can remember the public outcry behind the proposed heath reform act more commonly known as “Obamacare”. I’m not here to debate politics, but I would like to address a primary example of structural violence within our own country. Consider the notion that research supports the human development process stating that roughly half of our health as adults is programmed from the time of conception to around the first 2 years of age” (Bezrucha). The United States is one of only 3 major countries that has not recognized the significance of “the first thousand days” of child development by identifying more accommodating maternity/paternity healthcare reform. The U.S. has significant infant death rates in comparison to other world leaders. Significant rates of death by violent crime are astronomically high within the United States. Consider the expense of healthcare for individuals within the United States. Often private health insurance companies require high deductible on tops of additional copays for rendered services. While there are government programs such as Medicaid that have recently become back up for individuals who may not otherwise be able to afford healthcare services, consider the barriers many Americans face in obtaining this government service. Consider citizens who struggle to read and write english, trying to navigate the often complicated and time consuming government healthcare forms. Another barrier for low income individuals may be accessibility to agencies providing services. How can services be rendered if the individual can not physical get to the services? Think about the amount of immigrants who have not been declared citizens or are considered illegal, should these individuals be subject to structural violence? These unjust inequalities should not be considered acceptable simply because those in power influenced by the major money making insurance companies and pharmaceutical companies. Healthcare reform needs to continue to be a hot button issue to combat the unacceptable structural violence vessel that is healthcare in the United States.
Bezruchka, Stephen. 2014. “Inequality Kills”
Farmer, Paul. “An Anthropology of Structured Violence”