Four - The structure/culture axis

Summary

Health affords an excellent lens through which to view rentier capitalism's fractured society. We now inhabit a society in Britain in which the super- rich have entered a stratosphere of capital and income prosperity; their close class allies – Byrne and Ruane's (2017) ‘concierge class’ – are being well rewarded for their services; middle- class incomes are typically being squeezed; and many working- class families are struggling to make ends meet, with some of their number falling through the increasingly parsimonious welfare safety net to indebtedness and even homelessness. This is not unique to Britain, though, as we shall see, the gap between ‘top and bottom’ in Britain's notably extreme form of rentier capitalism is well documented (Christophers, 2020). Social theorist Peter Engelmann (Badiou and Englemann, 2019: ix) comments in general terms on the shift that has occurred with the advent of rentier capitalism in and beyond the Occident:

The gap between rich and the poor, both in national and international terms, is widening in grotesque fashion. … None of the privileged groups, however, needs fear being called to account for making bad decisions or causing social damage on a scale that would match exorbitant incomes. For a long time, poverty seemed concentrated in the Third World, but now the Third World is coming to us, and the falling wages and reduced income possibilities resulting from globalisation create a fear of social decline, even in Western societies, and accelerate actual decline.

Box 4.1 provides a broad- brush characterisation of what I have analysed in detail elsewhere as our currently fractured society (Scambler, 2018). As I hope to show in this chapter, this set of compelling features of ‘a fractured society in a fractured world’ afford a context that extends and lends further empirical sustenance to Engels’ proposition that the health effects of capitalist exploitation can be categorised as ‘social murder’ (Medvedyuk et al, 2021).