Galtung contrasts structural violence with "classical violence:" violence that is "direct," characterized by rudimentary, impermanent "bodily destruction" committed by some actor. Galtung places this as the first category of violence. In this sense, the purest form of structural violence can be understood as violence that endures with no particular beginning, and that lacks an 'actor' to have committed it.[7]:5,11
Following this, by excluding the requirement of an identifiable actor from the classical definition of violence, Galtung lists poverty (i.e., the "deprival of basic human needs") as the second category of violence and "structurally conditioned poverty" as the first category of structural violence.[7]:11
Asking why violence necessarily needs to be done to the human body for it to be considered violence—"why not also include violence done to the human mind, psyche or how one wants to express it"—Galtung proceeds to repression (i.e., the "deprival of human rights") as the third category of violence, and "structurally conditioned repression" (or, "repressive intolerance") as the second type of structural violence.[7]:11
Lastly, Galtung notes that repression need not be violence associated with repressive regimes or declared on particular documents to be human-rights infractions, as "there are other types of damage done to the human mind not included in that particular tradition." From this sense, he categorizes alienation (i.e., "deprival of higher needs") as the fourth type of violence, leading to the third kind of structural violence, "structurally conditioned alienation"—or, "repressive tolerance," in that it is repressive but also compatible with repression, a lower level of structural violence.[7]:11
Since structural violence is avoidable, he argues, structural violence is a high cause of premature death and unnecessary disability.[5]
In his book Violence: Reflections on a National Epidemic, James Gilligan defines structural violence as "the increased rates of death and disability suffered by those who occupy the bottom rungs of society, as contrasted with the relatively lower death rates experienced by those who are above them." Gilligan largely describes these "excess deaths" as "non-natural" and attributes them to the stress, shame, discrimination, and denigration that results from lower status. He draws on Richard Sennett and Jonathan Cobb (i.e., The Hidden Injuries of Class, 1973), who examine the "contest for dignity" in a context of dramatic inequality.[8]
In her interdisciplinary textbook on violence, Bandy X. Lee wrote "Structural violence refers to the avoidable limitations that society places on groups of people that constrain them from meeting their basic needs and achieving the quality of life that would otherwise be possible. These limitations, which can be political, economic, religious, cultural, or legal in nature, usually originate in institutions that exercise power over particular subjects."[9] She goes on to say that "[it] is therefore an illustration of a power system wherein social structures or institutions cause harm to people in a way that results in maldevelopment and other deprivations."[9]
Rather than the term being called social injustice or oppression, there is an advocacy for it to be called violence because this phenomenon comes from, and can be corrected by, human decisions, rather than just natural causes.[9]
Cause and effects
In The Sources of Social Power (1986),[10]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."[11]
Siniša Maleševićelaborates on Mann's argument: "Mann's point needs extending to cover all social organizations, not just the state. The early chiefdoms 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."[11] This means that, although those who live in organized, 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.[11]
Although structural violence is said to be invisible, it has a number of influences that shape it. These include identifiable institutions, relationships, force fields, and ideologies, including discriminatory laws, gender inequality, and racism.[citation needed] Moreover, this does not solely exist for those of lower classes, though the effects are much heavier on them, including higher rates of disease and death, unemployment, homelessness, 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.[citation needed]
Due to social and economic structures in place today—specifically divisions into rich and poor, powerful and weak, and superior and inferior—the excess premature death rate is between 10 and 20 million per year, which is over ten times the death rates from suicide, homicide, and warfare combined.[9]
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, 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 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 behaviours or the prominence of inequality, therefore ineffectively addressing the issue.[5]
Medical anthropologistPaul 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 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 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.[5]
The lack of training has, for example, had a significant impact on diagnosis and treatment of AIDS in the United States. A 1994 study by Moore et al.[12] found that black Americans had a significantly lesser chance of receiving treatment than white Americans.[5] Findings from another study suggest that the increased rate of workplace injury among undocumented Latino immigrants in the United States can also be understood as an example of structural violence.[13]
If biosocial understandings are forsaken when considering communicable diseases such as 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 diseases.[5]
Structural violence also exists in the area of mental health, where systems ignore the lived experiences 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 and forensic wards. Structural violence is also apparent when consumers in developed countries die from preventable diseases 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.[5] 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.[5] 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.[5]
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.[5]
Countries such as Haiti and 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 nets. Such initiatives increase the social and economic rights of citizens, thus decreasing structural violence.[5]
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.[5]
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.[5]
Cultural violence refers to aspects of a culture that can be used to justify or legitimize direct or structural violence, and may be exemplified by religion & ideology, language & art, and empirical science & formal science.[14]
Cultural violence makes both direct and structural violence look or feel 'right', or at least not wrong, according to Galtung.[14]:291 The study of cultural violence highlights the ways the act of direct violence and the fact of structural violence are legitimized and thus made acceptable in society. Galtung explains that one mechanism of cultural violence is to change the "moral color" of an act from "red/wrong" to "green/right," or at least to "yellow/acceptable."[14]:292
Petra Kelly wrote in her first book, Fighting for Hope (1984):
A third of the 2 Billion people in the developing countries are starving or suffering from malnutrition. Twenty-five percent of their children die before their fifth birthday […] Less than 10 per cent of the 15 million children who died this year had been vaccinated against the six most common and dangerous children's diseases. Vaccination costs £3 per child. But not doing so costs us five million lives a year. These are classic examples of structural violence.
The violence in structural violence is attributed to the specific organizations of society that injure or harm individuals or masses of individuals. In explaining his point of view on how structural violence affects the health of subaltern or marginalized people, medical anthropologistPaul Farmer writes:[15][5]
Their sickness is a result of structural violence: neither culture nor pure individual will is at fault; rather, historically given (and often economically driven) processes and forces conspire to constrain individual agency. Structural violence is visited upon all those whose social status denies them access to the fruits of scientific and social progress.
This perspective has been continually discussed by Farmer, as well as by Philippe Bourgois and Nancy Scheper-Hughes. Farmer ultimately claims that "structural interventions" are one possible solution to such violence; structural violence is the result of policy and social structures, and change can only be a product of altering the processes that encourage structural violence in the first place.[5]
Theorists argue that structural violence is embedded in the current world system; this form of violence, which is centered on apparently inequitable social arrangements, is not inevitable. Ending the global problem of structural violence will require actions that may seem unfeasible in the short term. To some,[who?] this indicates that it may be easier to devote resources to minimizing the harmful impacts of structural violence. Others, such as futurist Wendell Bell, see a need for long-term vision to guide projects for social justice. Many structural violences, such as racism and sexism, have become such a common occurrence in society that they appear almost invisible. Despite this fact, sexism and racism have been the focus of intense cultural and political resistance for many decades. Significant reform has been accomplished, though the project remains incomplete.[citation needed]
Farmer notes that there are three reasons why structural violence is hard to see:
Suffering is exoticized—that is, when something/someone is distant or far away, individuals tend to not be affected by it. When suffering lacks proximity, it's easy to exoticise.
The weight of suffering is also impossible to comprehend. There is simply no way that many individuals are able to comprehend what suffering is like.
Lastly, the dynamics and distribution of suffering are still poorly understood.[15]
AnthropologistSeth Holmes studied suffering through the lens of structural violence in his 2013 ethnographyFresh Fruit Broken Bodies: Migrant Farmworkers in the United States. He analyzed the naturalization of physical and mental suffering, violence continuum, and structural vulnerability experienced by Mexican migrants in the U.S. in their everyday lives.[16] Holmes used examples like governmental influences of structural violence—such as how American subsidization of corn industries force Mexican farmers out of business, thereby forcing them to make the very dangerous trip across the border, where the U.S. Border Patrol hinder these migrants' chances of finding work in America, and the impact this all has on the migrants’ bodies.[16]
Criticism
The concept of structural violence has come under criticism, on the one hand for being "increasingly outdated and poorly theorized," and on the other hand for naming non-violent situations, such as poverty, as "violence," has been interpreted as offensive to those who have been victims of physical violence, like assault or rape.[17]
1 2 Gilligan, James (1997). Violence: Reflections on a National Epidemic. Vintage Books. p.196. ISBN978-0679779124. Structural violence is ... the main cause of behavioral violence on a socially and epidemiologically significant scale (from homicide and suicide to war and genocide). The question as to which of the two forms of violence—structural or behavioral—is more important, dangerous, or lethal is moot, for they are inextricably related to each other, as cause to effect.
↑ Galtung, Johan. 1993. "Kulturelle Gewalt." Der Burger im Staat vol. 43. p. 106, as cited in Ho, Kathleen. 2007. "Structural Violence as a Human Rights Violation." Essex Human Rights Review 4(2).
↑ Gilligan, James (1996). Violence: Reflections on a National Epidemic (seconded.). New York: First Vintage Books. ISBN0-679-77912-4.
1 2 3 4 Lee, Bandy X. (2019). Violence: An Interdisciplinary Approach to Causes, Consequences, and Cures. New York, NY: Wiley-Blackwell. pp.123–42. ISBN978-1-119-24068-6.
↑ Mann, Michael. 1986. The Sources of Social Power, Vol. 1. Cambridge: Cambridge University Press. doi:10.1017/CBO9780511570896.
1 2 3 Malešević, Siniša (2016). "How Old is Human Brutality?: On the Structural Origins of Violence". Common Knowledge. 22 (1). Duke University Press: 81–104. doi:10.1215/0961754X-3322894. S2CID147254014– via Academic Search Premier.
1 2 Farmer, Paul, and Margaret Connors. 1996. Women, Poverty & AIDS: Sex, Drugs and Structural Violence (reprint ed.), Series in Health and Social Justice. Common Courage Press. ISBN978-1-56751-074-4
1 2 Holmes, Seth (April 15, 2013). Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United States. Berkeley, University of California Press, 2013. pp.80, 90, 183.
Henderson, Sophie. 2019. "State-Sanctioned Structural Violence: Women Migrant Domestic Workers in the Philippines and Sri Lanka." Violence Against Women 26(12-13):1598–615. doi:10.1177/1077801219880969.
Violence is the use of physical force to cause harm to people, animals, or property, such as pain, injury, death, damage, or destruction. Some definitions are somewhat broader, such as the World Health Organization's definition of violence as "the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, which either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation."
Johan Vincent Galtung was a Norwegian sociologist and the principal founder of the discipline of peace and conflict studies. He was the main founder of the Peace Research Institute Oslo (PRIO) in 1959 and served as its first director until 1970. He also established the Journal of Peace Research in 1964.
Human security is a paradigm for understanding global vulnerabilities whose proponents challenge the traditional notion of national security through military security by arguing that the proper referent for security should be at the human rather than the national level. Human security reveals a people-centred and multi-disciplinary understanding of security which involves a number of research fields, including development studies, international relations, strategic studies, and human rights. The United Nations Development Programme's 1994 Human Development Report is considered a milestone publication in the field of human security, with its argument that ensuring "freedom from want" and "freedom from fear" for all persons is the best path to tackle the problem of global insecurity.
Peace and conflict studies or conflict analysis and resolution is a social science field that identifies and analyzes violent and nonviolent behaviors as well as the structural mechanisms attending conflicts, with a view towards understanding those processes which lead to a more desirable human condition. A variation on this, peace studies (irenology), is an interdisciplinary effort aiming at the prevention, de-escalation, and solution of conflicts by peaceful means, thereby seeking "victory" for all parties involved in the conflict.
Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequities, and face worse health outcomes than those who are able to access certain resources. It is not equity to simply provide every individual with the same resources; that would be equality. In order to achieve health equity, resources must be allocated based on an individual need-based principle.
Critical medical anthropology (CMA) is a branch of medical anthropology that blends critical theory and ground-level ethnographic approaches in the consideration of the political economy of health, and the effect of social inequality on people's health. It puts emphasis on the structure of social relationships, rather than purely biomedical factors in analyzing health and accounting for its determinants.
In 2022, Freedom House rated Nepal’s human rights at 57 out 100.
Peace journalism is a style and theory of reporting that aims to treat stories about war and conflict with balance, in contrast to war journalism, which peace journalism advocates say display a bias toward violence. The theory proposes practical methods for correcting biases in stories appearing in the mainstream and alternative media, and suggests ways for journalists to work with other media professionals, audiences, and organizations in conflict.
Peacebuilding is an activity that aims to resolve injustice in nonviolent ways and to transform the cultural and structural conditions that generate deadly or destructive conflict. It revolves around developing constructive personal, group, and political relationships across ethnic, religious, class, national, and racial boundaries. The process includes violence prevention; conflict management, resolution, or transformation; and post-conflict reconciliation or trauma healing before, during, and after any given case of violence.
Social medicine is an interdisciplinary field that focuses on the profound interplay between socio-economic factors and individual health outcomes. Rooted in the challenges of the Industrial Revolution, it seeks to:
Understand how specific social, economic, and environmental conditions directly impact health, disease, and the delivery of medical care.
Promote conditions and interventions that address these determinants, aiming for a healthier and more equitable society.
Nancy Scheper-Hughes is an anthropologist, educator, and author. She is the Chancellor's Professor Emerita of Anthropology and the director and co-founder of the PhD program in Critical Medical Anthropology at the University of California, Berkeley. She is known for her writing on the anthropology of the body, hunger, illness, medicine, motherhood, psychiatry, psychosis, social suffering, violence and genocide, death squads, and human trafficking.
Deficient sanitation systems, poor nutrition, and inadequate health services have pushed Haiti to the bottom of the World Bank’s rankings of health indicators. According to the United Nations World Food Programme, 80 percent of Haiti’s population lives below the poverty line. In fact, 75% of the Haitian population lives off of $2.50 per day. Consequently, malnutrition is a significant problem. Half the population can be categorized as "food insecure," and half of all Haitian children are undersized as a result of malnutrition. Less than half the population has access to clean drinking water, a rate that compares poorly even with other less-developed nations. Haiti's healthy life expectancy at birth is 63 years. The World Health Organization (WHO) estimates that only 43 percent of the target population receives the recommended immunizations.
Structural abuse is the process by which an individual or group is dealt with unfairly by a social or cultural system or authority. This unfairness manifests itself as abuse in a psychological, financial, physical or spiritual form, and victims often are unable to protect themselves from harm. An individual's inability to protect themselves may lead to their entrapment in the system, preventing them from seeking justice or recompense for crimes endured and damages incurred, creating a feeling of isolation or helplessness.
The social determinants of health in poverty describe the factors that affect impoverished populations' health and health inequality. Inequalities in health stem from the conditions of people's lives, including living conditions, work environment, age, and other social factors, and how these affect people's ability to respond to illness. These conditions are also shaped by political, social, and economic structures. The majority of people around the globe do not meet their potential best health because of a "toxic combination of bad policies, economics, and politics". Daily living conditions work together with these structural drivers to result in the social determinants of health.
The World Health Organization (WHO) has defined health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." Identified by the 2012 World Development Report as one of two key human capital endowments, health can influence an individual's ability to reach his or her full potential in society. Yet while gender equality has made the most progress in areas such as education and labor force participation, health inequality between men and women continues to harm many societies to this day.
Societal racism is a type of racism based on a set of institutional, historical, cultural and interpersonal practices within a society that places one or more social or ethnic groups in a better position to succeed and disadvantages other groups so that disparities develop between the groups. Societal racism has also been called structural racism, because, according to Carl E. James, society is structured in a way that excludes substantial numbers of people from minority backgrounds from taking part in social institutions. Societal racism is sometimes referred to as systemic racism as well.
Peace psychology is a subfield of psychology and peace research that deals with the psychological aspects of peace, conflict, violence, and war. Peace psychology can be characterized by four interconnected pillars: (1) research, (2) education, (3) practice, and (4) advocacy. The first pillar, research, is documented most extensively in this article.
Haiti is impacted by structural violence, a form of dysfunction where social structures prevent certain groups of people from having access to basic human rights, like education and healthcare. This has resulted from its colonial history, and from decades of political instability and social unrest. Additionally, Haitians are financially impoverished and within Haiti, there exist social inequalities. In 2012, 58.5% of its population was below its poverty line. Educational standards within the nation are low, where its literacy rate is about 60.7%, below the 84.1% global average. Haiti is also globally ranked lower than most other nations in various measurements of health outcomes. Such health outcomes include life expectancy, mortality rates, and disease levels. While there has been some international assistance, there are insufficient supportive infrastructures in place within the country to provide resources and opportunities for Haitians who are trying to attain a higher quality of life. Causes that have resulted in higher levels of structural violence within Haiti include political instability and corruption, as well as the impact of post-colonialism, which has established a caste-based class system within Haiti.
Rachel Renee Hardeman is an American public health academic who is associate professor of Division of Health Policy and Management at the University of Minnesota School of Public Health. She holds the inaugural Blue Cross Endowed Professorship in Health and Racial Equity. Her research considers how racism impacts health outcomes, particularly for the maternal health of African-Americans.
The COVID-19 pandemic has revealed race-based health care disparities in many countries, including the United States, United Kingdom, Norway, Sweden, Canada, and Singapore. These disparities are believed to originate from structural racism in these countries which pre-dates the pandemic; a commentary in The BMJ noted that "ethnoracialised differences in health outcomes have become the new normal across the world" as a result of ethnic and racial disparities in COVID-19 healthcare, determined by social factors. Data from the United States and elsewhere shows that minorities, especially black people, have been infected and killed at a disproportionate rate to white people.
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