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The characteristic features of 21st-century corporate capitalism – monopoly and financialization – are increasingly being recognized by public health scholars as undermining the foundations of human health. While the "vectors" through which this is occurring are well known – poverty, inequality, climate change among others – locating the root cause of this process in the nature and institutions of contemporary capitalism is relatively new. Researchers have been somewhat slow to study the relationship between contemporary capitalism and human health. In this paper, we focus on one of the leading causes of death in the United States; cancer, and empirically estimate the relationship between various measures of financialization and monopoly in the US healthcare system and cancer mortality. The measures we focus on are for the hospital industry, the health insurance industry, and the pharmaceutical industry. Using a fixed effects model with different specifications and control variables, our analysis is at the state level for the years 2012–2019. These variables include data on population demographic controls, social and economic factors, and health behavior and clinical care. We compare Medicaid expansion states with non-Medicaid expansion states to investigate variations in state-level funded health insurance coverage. The results show a statistically significant positive correlation between the HHI index in the individual healthcare market and cancer mortality and the opioid dispensing rate and cancer mortality. • We analyze how corporate capitalism is related to cancer mortality. • Recently, corporate capitalism has become more common in the healthcare industry. • We find a correlation between hospital net revenue, profit, and cancer mortality. • There is a link between the HHI index in insurance markets and cancer mortality. [ABSTRACT FROM AUTHOR]

Globally, there are 2 billion 'informal' workers, who lack access to social protection while facing profound health risks and socioeconomic exclusions. The informal economy has generated most jobs in Low and Middle-Income Countries (LMICs), but few studies have explored informal workers' complex health vulnerabilities, including in the face of climate change. This paper will discuss recent action-research in Indore (India), Harare, and Masvingo (Zimbabwe) with informal workers like vendors, waste-pickers, and urban farmers. We conducted qualitative interviews (N = 110 in India), focus group discussions (N = 207 in Zimbabwe), and a quantitative survey (N = 418 in Zimbabwe). Many informal workers live in informal settlements ('slums'), and we highlight the interrelated health risks at their homes and workplaces. We explore how climate-related threats—including heatwaves, drought, and floods—negatively affect informal workers' health and livelihoods. These challenges often have gender-inequitable impacts. We also analyse workers' individual and collective responses. We propose a comprehensive framework to reveal the drivers of health in the informal economy, and we complement this holistic approach with a new research agenda. Our framework highlights the socioeconomic, environmental, and political determinants of informal workers' health. We argue that informal workers may face difficult trade-offs, due to competing priorities in the face of climate change and other risks. Future interventions will need to recognise informal workers' array of risks and co-develop multifaceted solutions, thereby helping to avoid such impossible choices. We recommend holistic initiatives to foster health and climate resilience, as well as participatory action-research partnerships and qualitative, intersectional data-collection with informal workers. • Climate change is exacerbating many risks to informal workers' health and livelihoods. • WASH access may foster gender equality and decent work, while tackling heat stress. • Policymakers can partner with informal workers to create inclusive, multi-pronged interventions. [ABSTRACT FROM AUTHOR]

Abstract Local public health authorities often lack the capacity to adapt to climate change, despite being on the 'front lines' of climate impacts. Upper-level governments are well positioned to create an enabling environment for adaptation and build local public health authorities' capacity, yet adaptation literature has not specified how upper-level governments can build local-level adaptive capacity. In this paper we examine how federal and regional governments can contribute to enabling and supporting public health adaptation to climate change at the local level in federal systems. We outline the local level's self-assessed adaptive capacity for public health adaptation in Canadian and German comparative case studies, in terms of funding, knowledge and skills, organizations, and prioritization, drawing upon 30 semi-structured interviews. Based on interviewees' recommendations and complemented by scientific literature, we develop a set of practical measures that could enable or support local-level public health adaptation. We find that adaptive capacity varies widely between local public health authorities, but most report having insufficient funding and staff for adaptation activities. We propose 10 specific measures upper-level governments can take to build local public health authorities' capacity for adaptation, under the interrelated target areas of: building financial capital; developing and disseminating usable knowledge; collaborating and coordinating for shared knowledge; and claiming leadership. Federal and regional governments have an important role to play in enabling local-level public health adaptation, and have many instruments available to them to fulfill that role. Selecting and implementing measures to enable local public health authorities' adaptive capacity will require tailoring to, and consideration, of the local context and needs. Highlights • Local public health authorities often lack capacity to adapt to climate change. • National and regional governments can play supportive or enabling role. • We propose 10 concrete measures to enable local public health adaptation. [ABSTRACT FROM AUTHOR]

The way newspapers frame infectious disease outbreaks and their connection to the environmental determinants of disease transmission matter because they shape how we understand and respond to these major events. In 2017, following an unexpected climatic event named "El Niño Costero," a dengue epidemic in Peru affected over seventy-five thousand people. This paper examines how the Peruvian news media presented dengue, a climate-sensitive disease, as a public health problem by analyzing a sample of 265 news stories on dengue from two major newspapers published between January 1st and December 31st of 2017. In analyzing the construction of responsibility for the epidemic, I find frames that blamed El Niño Costero's flooding and Peru's poorly prepared cities and public health infrastructure as the causes of the dengue outbreak. However, when analyzing frames that offer solutions to the epidemic, I find that news articles call for government-led, short-term interventions (e.g., fogging) that fail to address the decaying public health infrastructure and lack of climate-resilient health systems. Overall, news media tended to over-emphasize dengue as requiring technical solutions that ignore the root causes of health inequality and environmental injustice that allow dengue to spread in the first place. This case speaks to the medicalization of public health and to a long history of disease-control programs in the Global South that prioritized top-down technical approaches, turning attention away from the social and environmental determinants of health, which are particularly important in an era of climate change. • Analyzes 265 articles on Peru's 2017 dengue outbreak following El Niño Costero. • Finds that individualizing narratives are not as prevalent as seen in past studies. • However, calls for government action still emphasize short-term technical solutions. • In particular, eco-social approaches to prevent transmission were overlooked. • Concludes that this narrow view on public health still reflects medicalization. [ABSTRACT FROM AUTHOR]