Autumn Unpolished Papers

Challenges and a Superpower: How Medical Students Understand and would Improve Health in Neoliberal Times

Eeva Sointu

Much research highlights the role of social disadvantage in ill health. The importance of inequity, however, remains marginal in medical school curricula, at least in the United Stated. This paper analyses how medical students would improve health of the US population. The material is drawn from a longitudinal, qualitative study of student experiences of clinical training. While some participants note the importance of social inequalities in ill health, many emphasise motivation and lifestyle as the prime means of improving health. Topics such as inequity and injustice, especially with regards to race, are almost completely absent from the accounts of the participants. The focus on health behaviour captures and reproduces values such as self-responsibility. The emphasis on self-responsibility, furthermore, points to the hold of neoliberal thinking on ideas of health and illness; a neoliberal ethos emphasising self-responsibility and self-management feeds individualistic understandings of health disparities. In the face of a vast amount of research highlighting the centrality of social disadvantage in ill health, neoliberal thinking lends approaches that stress health behaviour cultural clout. The silence around social inequity in health and illness is especially significant in the context of vast racial disparities and racism in the United States.