Editing Structural violence (section)

== Cause and effects ==
In ''The Sources of Social Power'' (1986),<ref>Mann, Michael. 1986. ''The Sources of Social Power'', Vol. 1. Cambridge: Cambridge University Press. {{doi|10.1017/CBO9780511570896}}.</ref> [[Michael Mann (sociologist)|Michael Mann]] makes the argument that within [[state formation]], "increased organizational power is a trade-off, whereby the individual obtains more security and food in exchange for his or her freedom."<ref name=":1">{{Cite journal|title=How Old is Human Brutality?: On the Structural Origins of Violence|journal=Common Knowledge|volume=22|issue=1|last=Malešević|first=Siniša|publisher=Duke University Press|year=2016|pages=81–104|via=Academic Search Premier|doi=10.1215/0961754X-3322894|s2cid=147254014 }}</ref>

[[Sinisa Malesevic|Siniša Malešević]]&nbsp;elaborates on Mann's argument: "Mann's point needs extending to cover all [[social organization]]s, not just the [[State (polity)|state]]. The early [[chiefdom]]s were not states, obviously; still, they were established on a similar basis—an inversely proportional relationship between security and resources, on the one hand, and liberty, on the other."<ref name=":1" /> This means that, although those who live in organized, [[Centralized system|centralized]] social systems are not likely subject to hunger or to die in an animal attack, they are likely to engage in organized violence, which could include war. These structures make for opportunities and advances that humans could not create for themselves, including the development of agriculture, technology, philosophy, science, and art; however, these structures take tolls elsewhere, making them both productive and detrimental. In early human history, [[hunter-gatherer]] groups used organizational power to acquire more resources and produce more food; yet, at the same time, this power was also used to dominate, kill, and enslave other groups in order to expand territory and supplies.<ref name=":1" />

Although structural violence is said to be invisible, it has a number of influences that shape it. These include identifiable institutions, relationships, social phenomenon, and ideologies, including discriminatory laws, [[gender inequality]], and [[racism]]. Moreover, this does not solely exist for those of [[Social class|lower classes]], though the effects are much heavier on them, including higher rates of disease and death, [[unemployment]], [[homelessness]], [[Illiteracy|lack of education]], powerlessness, and shared fate of miseries. The whole [[social order]] is affected by [[social power]]; other, higher-class groups, however have much more indirect effects on them, with the acts generally being less violent.{{cn|date=October 2022}}

Due to [[Social structure|social]] and economic structures in place today—specifically divisions into [[rich and poor]], powerful and weak, and superior and inferior—the [[Excess death|excess]] premature [[Death Rate|death rate]] is between 10 and 20 million per year, which is over ten times the death rates from [[suicide]], [[homicide]], and [[warfare]] combined.<ref name=":0" />

The work of Yale-based German philosopher, [[Thomas Pogge]], is one major resource on the connection between structural violence and poverty, especially his book ''[[World Poverty and Human Rights]]'' (2002).

===Access to health care===
Structural violence affects the availability of [[health care]] insofar as paying attention to broad social forces ([[racism]], [[gender inequality]], [[class discrimination|classism]], etc.) can determine who falls ill and who will be given access to care. It is therefore considered more likely for structural violence to occur in areas where [[Biosocial theory|biosocial]] methods are neglected in a country's health care system. Since situations of structural violence are viewed primarily as biological consequences, it neglects problems stimulated by people's environment, such as negative [[Social behavior|social behaviours]] or the prominence of inequality, therefore ineffectively addressing the issue.<ref name="PLoS" />

[[Medical anthropologist]] [[Paul Farmer]] argues that the major flaw in the dominant model of medical care in the US is that medical services are sold as a [[commodity]], remaining only available to those who can afford them. As [[Medical Professionals|medical professionals]] are not trained to understand the social forces behind disease, nor are they trained to deal with or alter them, they consequently have to ignore the [[Social determinants of health|social determinants]] that alter access to care. As a result, medical interventions are significantly less effective in low-income areas. Similarly, many areas and even countries cannot afford to stop the harmful cycle of structural violence.<ref name="PLoS" />

The lack of training has, for example, had a significant impact on diagnosis and treatment of [[HIV/AIDS in the United States|AIDS]] in the United States. A 1994 study by Moore et al.<ref>{{cite journal|last=Moore|first=Richard D.|author2=David Stanton|author3=Ramana Gopalan|author4=Richard E. Chaisson|date=March 17, 1994|title=Racial Differences in the Use of Drug Therapy for HIV Disease in an Urban Community|journal=[[The New England Journal of Medicine]]|volume=330|issue=11|pages=763–768|doi=10.1056/NEJM199403173301107|pmid=8107743|doi-access=free}}</ref> found that [[African Americans|black Americans]] had a significantly lesser chance of receiving treatment than [[white Americans]].<ref name="PLoS" /> Findings from another study suggest that the increased rate of [[workplace injury]] among [[Undocumented immigrants (U.S.)|undocumented]] Latino immigrants in the United States can also be understood as an example of structural violence.<ref>{{Cite journal|last1=Flynn|first1=Michael A.|last2=Eggerth|first2=Donald E.|last3=Jacobson|first3=C. Jeffrey|date=2015-09-01|title=Undocumented status as a social determinant of occupational safety and health: The workers' perspective|journal=American Journal of Industrial Medicine|volume=58|issue=11|pages=1127–1137|doi=10.1002/ajim.22531|issn=1097-0274|pmc=4632487|pmid=26471878}}</ref>

If biosocial understandings are forsaken when considering [[communicable diseases]] such as [[Discrimination against people with HIV/AIDS|HIV]], for example, prevention methods and treatment practices become inadequate and unsustainable for populations. Farmer therefore also states that structural forces account for most if not all [[epidemic disease]]s.<ref name="PLoS" />

Structural violence also exists in the area of [[mental health]], where systems ignore the [[lived experience]]s of patients when making decisions about services and funding without consulting with the ill, including those who are illiterate, cannot access computers, do not speak the dominant language, are homeless, are too unwell to fill out long formal surveys, or are in locked [[Psychiatric hospital|psychiatric]] and forensic wards. Structural violence is also apparent when consumers in developed countries die from [[preventable disease]]s 15–25 years earlier than those without a lived experience of mental health.

==== Solutions ====
Farmer ultimately claims that "structural interventions" are one possible solution to such violence.<ref name="PLoS" /> However, for structural interventions to be successful, medical professionals need to be capable of executing such tasks; as stated above, though, many of professionals are not trained to do so.<ref name="PLoS" /> Medical professionals still continue to operate with a focus on individual lifestyle factors rather than general socio-economic, cultural, and environmental conditions. This paradigm is considered by Farmer to obscure the structural impediments to changes because it tends to avoid the root causes that should be focused on instead.<ref name="PLoS" />

Moreover, medical professionals can rightly note that structural interventions are not their job, and as result, continue to operate under conventional clinical intervention. Therefore, the onus falls more on political and other experts to implement such structural changes. One response is to incorporate medical professionals and to acknowledge that such active structural interventions are necessary to address real public health issues.<ref name="PLoS" />

Countries such as [[Healthcare in Haiti|Haiti]] and [[Healthcare in Rwanda|Rwanda]], however, have implemented (with positive outcomes) structural interventions, including prohibiting the [[commodification]] of the citizen needs (such as health care); ensuring equitable access to effective therapies; and developing [[social safety net]]s. Such initiatives increase the [[economic, social and cultural rights|social and economic rights]] of citizens, thus decreasing structural violence.<ref name="PLoS" />

The successful examples of structural interventions in these countries have shown to be fundamental.

Although the interventions have enormous influence on economical and political aspects of international bodies, more interventions are needed to improve access.<ref name="PLoS" />

Although [[health disparities]] resulting from social inequalities are possible to reduce, as long as health care is exchanged as a commodity, those without the power to purchase it will have less access to it. Biosocial research should therefore be the main focus, while [[sociology]] can better explain the origin and spread of infectious diseases, such as HIV or AIDS. For instance, research shows that the risk of HIV is highly affected by one's behavior and habits. As such, despite some structural interventions being able to decrease premature morbidity and mortality, the social and historical determinants of the structural violence cannot be omitted.<ref name="PLoS" />