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The political economy of responsibility in health and illness

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  • Donahue, John M.
  • McGuire, Meredith B.

Abstract

This article addresses the question: to what extent do health care strategies in a given political economy increase people's perceptions of responsibility to take charge of their health, but do not structurally empower them to satisfy their health needs. In shaping health care policies, societies typically adopt one of three broad strategies, linking their larger political economy and modes of exercising power: a marketplace strategy, a state-managerial strategy or a national participatory strategy. Because of their different arrangements of structural power, these strategies result in three very different approaches to responsibility for health and illness. Changes in the political economy of health in Nicaragua during the Somoza, Sandinista and Chamorro periods illustrate the changing fields of choice within which care-seekers must make their health care decisions.

Suggested Citation

  • Donahue, John M. & McGuire, Meredith B., 1995. "The political economy of responsibility in health and illness," Social Science & Medicine, Elsevier, vol. 40(1), pages 47-53, January.
    • Handle: RePEc:eee:socmed:v:40:y:1995:i:1:p:47-53
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    Cited by:

    1. Abel, Thomas & Frohlich, Katherine L., 2012. "Capitals and capabilities: Linking structure and agency to reduce health inequalities," Social Science & Medicine, Elsevier, vol. 74(2), pages 236-244.
    2. Novo, Paula & Garrido, Alberto, 2010. "The new Nicaraguan water law in context: Institutions and challenges for water management and governance," IFPRI discussion papers 1005, International Food Policy Research Institute (IFPRI).

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