Institute of Health & Society

Staff Profile

Professor Ted Schrecker

Professor of Global Health Policy

Background

Introduction

I am a political scientist by background, and moved from Canada to take up a position at Durham University in June, 2013 before transferring to Newcastle University with colleagues from Durham's School of Medicine, Pharmacy and Health in 2017.  The video of my inaugural lecture at Durham (2014) is available here.  My research interests focus on the political economy of health inequalities,especially as they are affected by neoliberal globalisation, and on issues at the interface of science, ethics, law and public policy. (See Research tab for more detail.)  Earlier in my working life, I spent many years involved with environmental policy and law as a legislative researcher, academic and consultant.  A link to my blog 'Health as if Everybody Counted - second edition', so far in its early stages, is available here.

Roles and responsibilities

Member, advisory group, Independent Panel on Global Governance for Health

Member (2015-17), Independent Panel on Global Governance for Health

Co-editor, Journal of Public Health

Associate editor (globalisation), Journal of Bioethical Inquiry

Member, editorial board, Critical Public Health

External examiner, M.Sc. Medicine, Health and Public Policy, King’s College London

Taught programme external examiner, Institute of Global Health Board, University College London.

Areas of expertise

  • Globalisation
  • Global health
  • Neoliberalism
  • Political economy
  • Social determinants of health

Recent previous positions

  • 2013-2017: Professor of Global Health Policy, Durham University
  • 2012-2013: Clinical Scientist, Bruyere Research Institute, Ottawa, Ontario
  • 2011-2014: Adjunct Professor, Department of Epidemiology and Community Medicine, University of Ottawa
  • 2005-2011: Scientist (Associate Professor rank), Department of Epidemiology and Community Medicine and Principal Scientist, Institute of Population Health, University of Ottawa
  • 2003-2004:  Research Associate, Saskatchewan Population Health and Evaluation Research Unit, University of Saskatchewan
  • 2002-2003: Associate Scientist, Lawson Health Research Institute, London, Ontario
  • 2000-2002:  Full-time consultant and Associate Member, Centre for Medicine, Ethics and Law, McGill University

Google Scholar: Click here.

Research

Basic principles guiding teaching and research

Political economy of health

'[A]nalysis of causes of disease distribution requires attention to the political and economic structures, processes and power relationships that produce societal patterns of health, disease, and wellbeing via shaping the conditions in which people live and work' (Nancy Krieger, 2011; emphasis in original).

Speaking truth about power (a play on Wildavsky's familiar description of the task of the policy analyst)

A fine illustration:‘[U]nequal distribution of health-damaging experiences is not in any sense a “natural” phenomenon but is the result of a toxic combination of poor social policies and programmes, unfair economic arrangements, and bad politics’ (Commission on Social Determinants of Health, 2008).

Major current commitments

Global Health in a Neoliberal Era: Critical Perspectives (under contract to Polity Press)

Handbook of Global Health Politics (co-edited with K.S. Mohindra, under contract to Edward Elgar)


Major themes going forward

Neoliberal epidemics

Clare Bambra’s and my book How Politics Makes Us Sick: Neoliberal Epidemics (2015) was reviewed as [b]oth sophisticated and accessible to non-specialist audiences …. Schrecker and Bambra marshal solid, cross-national evidence and clear arguments to make a compelling and incriminatory case against neoliberalism and the epidemics it has engendered’ in The Lancet.  Key research directions:

  • Advancing understanding of public finance as a public health issue (perhaps the most important take-home message of all) by way of
  • Continued description of the destructive consequences of neoliberal policies for health.
  • Comparative multidisciplinary research on the politics of support for redistributive policies that can reduce health inequalities, and on
  • Why some settings are ‘resource-scarce’ and others not.
  • Relentlessly challenging ‘lifestyle drift’ in health policy, research and intervention design.
The politics of evidence

Four decades of scholarship on standards of proof in environmental policy and law have had surprisingly little influence in other areas of population health research. So we need first of all to ask

  • How much evidence is enough for acting on social determinants of health and health inequalities (the standard of proof issue)? What are relevant guiding principles? Who should decide?

Some specific topics:

Extractive industries and health

This is work I have been undertaking with Canadian colleague Anne-Emanuelle Birn and others, as part of the work of the Independent Panel on Global Governance for Health.  We have published one overview article in Health & Place as well as an extensive online bibliography; another article has been accepted and at least one more is in preparation.  We draw on Saskia Sassen's work on "logics of extraction" to develop a more expansive definition of extractive industries than is customary to include not only mining, oil and gas but also (for example) large scale land acquisitions by foreign investors and governments and some forms of tropical timber 'harvesting'.  Such activities are increasingly part of global commodity or value chains dominated by transnational corporations, and their direct and indirect health impacts remain seriously under-studied.

Population health in a new, darker (post-democratic?) future

The overarching theme here is captured in David Rieff's 1993 description of how globalisation had transformed Los Angeles that is now a quarter-century old: ‘After all, nobody got up one balmy afternoon on the Capitoline Hill sometime in the fifth century and said that the Roman empire was over and the Dark Ages had begun’.  In other words, population health must now come to grips with the potential existence of multiple tipping points. Key trends that require exploration in terms of their implications for population health:

  • The shift from public to private power associated with rising economic inequality and ultra-wealth; transnational corporations; financialisation, tax avoidance and global financial flows; philanthro-capitalism.
  • Global health in the Anthropocene age, with climate change being only one of multiple challenges.
  • How to understand and react to the drift towards what Fareed Zakaria has called ‘illiberal democracy’ and the spread of authoritarianism. 
  • What can be learned about the challenges of reducing health inequalities in other jurisdictions from the prospect of a poorer, meaner, more unequal and inward-looking post-Brexit United Kingdom.
  • Reconstructing lost political vocabularies: exploring the consequences of the near-disappearance from academic discourse of the concepts of state terror and corporate crime.

I am delighted to hear from colleagues and prospective students interested in these themes and challenges.


Teaching

A reflection on teaching

Catharine MacKinnon, whose work has been an intellectual inspiration for a long time, wrote that: 'A platform and a period of time and listeners who choose to be there creates a threshold of mortality. If you never say anything else to them (you might not) and if you die right afterward (you could), what would have been worth this time?'  Students are listeners who choose to be there, and we as teachers should always ask ourselves this question.

Postgraduate teaching

2018-19:  Module lead, HSC8056/8057 (Introduction to Global Health/Global Health, 10/20 credits), available to multiple taught programmes and (8057) MRes.

       Sample readings:

      A short history of AIDS. In UNAIDS (2015). How AIDS Changed Everything - MDG6: 15 Years, 15 Lessons of Hope from the AIDS Response (pp. 80-95). Geneva: UNAIDS (concise history of the AIDS epidemic). 

      Birn, A-E. (2014). Philanthrocapitalism, past and present: The Rockefeller Foundation, the Gates Foundation, and the setting(s) of the international/global health agenda. Hypothesis, 12, e6. 

Dieleman, J.L., Schneider, M.T., Haakenstad, A., Singh, L., Sadat, N., Birger, M. et al. (2016). Development assistance for health: Past trends, associations, and the future of international financial flows for health. The Lancet, 387, 2536-2544. 

      Livingston, J. (2013). Revealed in the Wound. Journal of Clinical Oncology, 31, 3719-3720. Note that a ‘toilet mastectomy’, a term used in the article, does not refer to a mastectomy that is actually performed in a toilet. Rather, it describes a mastectomy performed as therapy for an advanced (bleeding, ulcerated, infected) breast cancer of a type almost never seen today in the high-income world. This reference is usefully read in conjunction with watching a presentation by Prof. Livingston at https://www.youtube.com/watch?v=Wh4Ou06uqNA (her presentation starts at the 9-minute mark).

      Moodie, R., Stuckler, D., Monteiro, C., Sheron, N., Neal, B., Thamarangsi, T. et al. (2013). Profits and pandemics: prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries. The Lancet, 381, 670-679.

      Sassen, S. (2010). When complexity produces brutality. Sens Public, article 753. 

      Taylor, S. (2018). 'Global health': meaning what? BMJ Global Health, 3 (a very thoughtful discussion of what people mean when they talk about 'global health').


GLOBAL HEALTH POLICY AND POLITICS SELF-TEST

 

How familiar are you (if at all) with the following?

- structural adjustment programmes (SAPs)

- the TRIPS agreement

- the double burden of disease

- the United Nations’ Sustainable Development Goals

- capital flight

- Investor-state dispute settlement (ISDS) provisions under bilateral investment treaties (BITs)

- the history of the past 15 years’ expansion in the number of people in low- and middle-income countries (LMICs) in access to antiretroviral therapy for HIV/AIDS

- the World Bank’s definitions of poverty

- global health diplomacy

- the resource curse affecting resource-rich LMICs

- what export credit agencies (ECAs) are and what they do

HSC8056/8057 will explore the relevance of these and many other concepts and topics to global health research, policy and practice

     

      2018-19: Module lead, HSC8003 (Advanced Social Determinants of Health; new module, 10 credits), available to multiple taught programmes

      Sample readings:

Atkinson, R., Parker, S., & Burrows, R. (2017). Elite Formation, Power and Space in Contemporary London. Theory, Culture & Society, 34, 179-200

Basu, S., Carney, M. A., & Kenworthy, N. J. (2017). Ten years after the financial crisis: The long reach of austerity and its global impacts on health. Social Science & Medicine, 187, 203-207. **

Benzeval, M., Bond, L.,  Campbell, M. Egan, M., Lorenc, T., Petticrew, M. et al. (2014). How Does Money Influence Health? York: Joseph Rowntree Foundation. .

McEwen, B. & Seeman, T. (2009). Research: Allostatic Load Notebook. John D. and Katherine T.MacArthur Foundation [On-line].

Pickett, K.E., Wilkinson, R.G. (2015). Income inequality and health: a causal review. Social Science & Medicine, 128, 316-326.

** This is the one sample reading that prospective students without a current university login may have difficulty obtaining, but it’s an extremely important and current overview of the topic.

     

2018-19: Contribution to HSC8007 (Global Health in the Anthropocene; new module, 10 credits) - details to follow


Lead, Global Health strand, M.Sc. Global Health and M.Res. Global Health

Supervision

I advise two Ph.D. students from Durham, both of whom are nearing completion, and one who is just starting.  Interested in supervising students wishing to develop a critical (political economy) perspective on global health.


Publications