Marxist concepts of alienation in relation to health: a narrative review of the evidence

Public health scholars are increasingly interested in the Marxist concept of alienation to explain the existence of health inequities. Marx's use of the term stresses the crucial role of political economic structural factors in creating alienation. This article reports on a narrative review of literature that used Marx's theory of alienation and focuses on the mental and/or physical health effects of alienation. Our search resulted in 34 relevant articles. Collectively, they demonstrate the ongoing relevance of the concept of alienation to the creation of health inequities in contemporary society. Alienation results from the structure of class relations which are reflected in poor working conditions in which people do not receive the true worth of their labour and are alienated from themselves, others and nature. Alienation affects both workers and managers with effects resulting from their class positions. Consumption has also been identified as a cause of alienation particularly seen through the ceaseless advertising to persuade people to consume objects which do not yield satisfaction. Consumption creates alienation when bodies are commodified, and health services run for profit. We conclude that alienation is highly relevant to contemporary public health advocacy and practice by focusing attention on structural causes of health inequities.