Conclusion: prospects for political and social transformation

The conclusion examines some of the themes across chapters and suggests a way forward. Contributors highlight the political and economic context and associated generative processes that produce and perpetuate health inequalities as significant barriers to progressive change. As noted in the Introduction in Part I, neoliberal globalization has led to a polycrisis, where an insatiable economic system has permeated and undermined democratic processes and public services - including healthcare, social services and education - to protect unrestricted capital accumulation. It is argued that shifting to post-capitalist economic structures and processes may be the only means to seriously address the polycrisis created by neoliberal capitalism and its unrestricted capital accumulation processes. Contributors show how neoliberalism led to radical economic restructuring through the implementation of austerity policies. While many would argue that shifting to the political left would alleviate insecurity, political parties of the left seem to have moved to the political centre and are reluctant to recommend bold public policies usually associated with left-wing parties. These have created increased insecurity for many households around the globe. Among the structural changes required is rearticulating a working-class identity to help drive progressive change towards redistributive public policies - higher social and health spending - and embracing post-capitalist structures. These changes will help improve the quality and distribution of the social determinants of health, and the health of populations.