Structural Violence

Encyclopedia Term: Structural Violence

Overview

         In 1969, Johan Galtung, a sociologist, mathematician, and principal founder of peace and conflict studies, published Violent, Peace, and Peace Research. In the years preceding this publication, Galtung researched the extreme inequality that many people around the world face. From his research, Galtung developed the theory of structural violence to define the large inequalities he observed. Structural violence is a hidden, and usually unacknowledged, form of violence embedded in the everyday roles of social structures and established social institutions, that harm and disadvantage individuals by preventing them from meeting their basic needs (Galtung 168). Today, this adversely affects many people in virtually all aspects of life, including health. The collective beliefs, values, and norms within a social structure impact how people relate to each other, which in turn affects the actions of social institutions that often lead to inequality, discrimination, and injustices. Structural violence is indirect, and should not be confused with direct, physical violence. Within a social structure, one specific person does not have to harm another directly for violence to occur which is where structural violence has the opportunity to go unnoticed (Galtung 174). Therefore, the violence is built into the structure and shows up as unequal power and consequently as unequal life chances (Galtung 175). Because there is no one person to blame, structural violence is continually perpetuated as stabilized social institutions continue to disadvantage powerless individuals (Hass 1352). Institutionalized racism and sexism are some examples of structural violence. Physicians and Anthropologists, such as Paul Farmer, have built on Galtung’s work by redefining or extending the meaning of “structural violence”. With a further understanding of structural violence and its unfavorable implications, scholars are better able to bring awareness to the silence behind structural violence and bridge the gap between fortunate and marginalized groups. For example, with his extensive research on health disparity and structural violence, Paul Farmer was able to co-find Partners in Health, an international social justice and health organization. A better understanding of structural violence will also help physicians treat patients that come from disadvantaged backgrounds in a more appropriate manner by knowing that they did not have access to the same resources other groups were able to access.

Background

        Johan Galtung coined the term “structural violence” in Violence, Peace, and Peace Research to describe a theory based on an “extended concept of violence,” and referred to it as any restraint on human growth and personal needs being met as a result of social, economic, and political structures (Galtung 176). As a sociologist, Galtung mainly focused on inequality as a result of social systems, and how an individual’s interaction with each social system affects their life. Galtung used “structure” to refer to patterned relationships within components of a social system. Contrastingly, Paul Farmer is a professor of medical anthropology, an attending physician in infectious diseases, and co-founder of Partners in Health. Farmer researched the impacts structural violence has on one’s suffering in On Suffering and Structural Violence: A View from Below. Farmer wanted to identify the factors that worked together to promote suffering in order to figure out why certain people were more at risk for suffering than others. Paul Farmer added on to structural violence to explain “structural” as embedded social organizations, while “violence” refers to harming those of a lesser social status (Farmer 12). He defined structural violence as suffering that “is structured by historically given (and often economically driven) processes and forces that conspire– whether through routine, ritual, or, as is more commonly the case, these hard surfaces– to constrain agency” (Farmer 12-13). To Farmer, health and basic human rights are especially affected by structural violence. Examples of structural violence provided by Galtung “include racism, sexism, ageism, unequal access to education, healthcare, or legal standing” (Hass 1352). In the issue of sexism, Galtung would most likely view it as a systemic issue that cannot be blamed on individuals inflicting the harm. However, Farmer would view sexism as a way for those at the top to stay powerful and continue to oppress those at the “bottom”. Farmer uses his ethnographic research as a medical anthropologist and experience as a physician to identify the lack of basic human rights amongst the poor.

Perspectives                

Farmer believed that structural violence was a direct cause from historical and economic factors affecting poor individuals. “Our society ensures that large numbers of people, in the United States and out of it, will be simultaneously put at risk for disease and denied access to care” (Farmer 14). Farmer believed that those in power perpetuate the marginalization of poor people to stay in power. The individual suffered at the hands of those in power.

Loic Wacquant, an anthropologist from the New School for Social Research, did not fully agree with Farmers’ claims. Wacquant did not believe Farmer’s claim could extend globally as his definition of slavery did not imply to every group in the world. Furthermore, he believed “Violence is a slippery concept that goes beyond physicality to include assaults on self-respect and personhood. The social and cultural dimensions of violence are what give it its force and meaning: (Farmer 22)

Historical Context

“Dr. R.L. Anderson and nurse Lillie Mae Chavis with a patient; Before integration led to its closure in 1971, FAMU Hospital served as the only facility of its kind for African-Americans within 150 miles of Tallahassee. The FAMU hospital symbolized efforts by the black community to provide for its own health and wellness during segregation.” (FAMU)

Continuous health disparities grow towards African Americans despite decades of work to erase the effects of racism in the United States. An example of structural violence in the United States were the Jim Crow laws that banned African Americans from receiving proper health care. Jim Crow laws “enforced racial segregation in almost every aspect of Southern life”, leading to racial prejudices that allowed “discriminatory measures to be passed by state and local governments” (Modern World Reference). Through the Jim Crow laws, black people were kept at a lower social and economic position, creating beliefs about the inferior nature of black people (Modern World Reference). With the implementation of Jim Crow Laws, African Americans had limited access to healthcare. African Americans were often denied the right to proper care, and were forced to begin using the resources within their own communities. The image above shows Dr. R.L. Anderson treating a pregnant woman at one of the very few hospitals in the area that treated black people. Through institutionalized racism, African Americans suffered from structural violence. By legally denying African Americans the access to proper healthcare, the United States government also denied them the right to an equal quality of life.

Although progress has been made with regards to racial issues in the United States, institutionalized racism still exists which manifests as structural violence. A more recent example of structural violence in the United States is breast cancer amongst black women. According to David Ansell, a physician and social epidemiologist, it is a “gruesome fact” that in the United States, “black women are 40 percent more likely to die from breast cancer than white women” (Ansell 114). Although black and white women in America currently develop breast cancer at the same rates, more black women will die of the disease (Ansell 114). Although an oncologist will “tell you that black women first seek treatment with larger, more deadly, later stage breast cancers,” the truth is that the breast cancer death gap is a consequence of structural violence (Ansell 114). The neighborhood a woman comes from, and consequently her access to medical resources and socioeconomic status, can “determine whether she will survive breast cancer or die from it” (Ansell 114).  

Politics of health

        Structural violence is related to politics of health because it is linked to the concepts of biological citizenship and racialization. Biological citizenship is a way for people to claim their citizenship by gaining access to medical resources or protection provided by the government (Petryna 251). Structural violence promotes biological citizenship. For example, a person could be denied proper access to healthcare due to structural violence their entire lives until an injury or illness renders them disabled and ill. This person could use their now damaged body to receive benefits, or “citizenship”. A person’s suffering, usually induced or perpetuated by a social institution or government, is used as a tool to access social equity (Petryna 264).

        Racialization is the process of giving a racial character to something or ascribing racial identities to a relationship, social practice, or group (Murji and Solomos 2). Because structural violence usually occurs to people of low socioeconomic background and minorities like Hispanics and African Americans, the negative impacts of structural violence (i.e. not having access to healthcare) are associated with these races. Therefore, structural violence is a racialized issue primarily affecting minorities. A study conducted by professors of the Department of Family and Community Medicine in Meharry Medical College found a continuing health disparity in the United States amongst the age-adjusted mortality rates. African Americans “remain significantly and consistently more at risk for early death than do similar white Americans” (Levine et. al 474). As a result, African Americans may be seen as more “unhealthy” when compared to white Americans because they die sooner.

(Jeffrey Sterling)

 

        Structural violence also impacts the quality of life someone receives. Psychologists and other social scientists at the University of California- Los Angeles believe that African Americans’ “continuing experiences with discrimination may lie at the root of the many documented race-based physical health disparities that affect this population” (Mays et. al 202). For example, racism could cause severe stress that can manifests as a physiological problem due to persistent high levels of cortisol. Racism could also lead to the onset of a mental illness, which has a negative impact on one’s health and lifestyle. The picture above depicts a young black girl holding a sign that says mental illness to illustrate the seriousness of the many problems African Americans deal with in their day-to-day life and how they can negatively impact their health. Denying a person the access to healthcare also has a negative impact on someone’s health. Overall, structural violence is tied to many key issues regarding the politics of health.

Works Cited

Ansell, David A., and ProQuest. The Death Gap : How Inequality Kills. 2017. Print.

Dianti, Lida. “Black History Month is why “black lives matter”.” University Wire, February 2,2016.http://login.proxy.library.vanderbilt.edu/login?url=https://search.proquest.com/docview/1761957090?accountid=14816. Accessed September 22, 2017.

Expectant mother being examined by Dr. R.L. Anderson and nurse Lottie Mae Chauisat the FAMU Hospital in Tallahassee. 1953. Black & white photonegative, 5 x 4 in. State Archives of Florida, Florida Memory. <https://www.floridamemory.com/items/show/259877>, accessed 24 September 2017.

Farmer, Paul. “On Suffering and Structural Violence: A View from Below.” Race/Ethnicity:

Multidisciplinary Global Contexts 3, no. 1 (2009): 11-28. JSTOR, http://www.jstor.org/stable/25595022.

Galtung, Johan. “Violence, Peace, and Peace Research.” Journal of Peace Research 6.3

(1969): 167-91. doi:10.1177/002234336900600301. Accessed September 22, 2017.

Hass, Emily. “Structural Violence and Health.” Encyclopedia of Health Communication.

Thousand Oaks, CA: SAGE Publications, Inc. 1352-1354. Accessed September 20, 2017. EBSCOhost.

Levine, R. S. et al. “Black-White Inequalities in Mortality and Life Expectancy, 1933-1999:

Implications for Healthy People 2010.” Public Health Reports 116.5 (2001): 474–483. Print.

Mays, Vickie M., Susan D. Cochran, and Namdi W. Barnes. “Race, Race-Based Discrimination,

and Health Outcomes Among African Americans.” Annual review of psychology 58 (2007): 201–225. PMC. Web. 16 Oct. 2017.

Murji, Karim and John Solomos. Racialization : Studies in Theory and Practice. OUP Oxford,

2005. EBSCOhost, proxy.library.vanderbilt.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=162465&site=ehost-live&scope=site.

Petryna, Adriana. “Biological Citizenship: The Science and Politics of Chernobyl-Exposed

Populations.” Osiris, vol. 19, 2004, pp. 250–265., doi:10.1086/649405. Accessed 22 Sept. 2017.

“Racial Segregation in the American South: Jim Crow Laws.” In Prejudice in the Modern World

Reference Library, 333-357. Vol. 2, Almanac. Detroit: UXL, 2007. U.S. History in Context (accessed September 23, 2017). http://link.galegroup.com/apps/doc/CX2831400031/UHIC?u=engl88921&xid=e5280d34.

Sterling, Jeffrey. Mental Health image.

https://jeffreysterlingmd.com/2017/04/17/straight-no-chaser-in-the-news-african-americans-and-mental-health/

 

 

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