Show Navigation

Resource Library

Austerity and the embodiment of neoliberalism as ill-health: Towards a theory of biological sub-citi

This theoretical article from Matthew Sparke sheds light on the growing global health inequities that he argues are a direct consequence of the austerity policies of neoliberal governments. In this resource, Sparke, a professor of politics at the University of California Santa Cruz, shows how austerity creates “radically unequal health risks and risk management options” and extends beyond national borders. Referencing Canadian academics Ronald Labonté and Ted Schrecker, Sparke refers to his work as a theory of biological sub-citizenship where people are “actively prevented from becoming fully enfranchised biological citizens.”

Sparke divides his argument into three categories:

  1. Health disenfranchisement through exclusion and conditionalization refers to national health service cuts, user fees and privatization plans.
  2. Biological sub-citizenship through biovalue extraction and exploitation refers to the growing inequity between those who benefit from biomedical advances and those who are used in the process.
  3. Disenfranchisement through financialized experimentation refers to pro-market efforts to correct injustices in specific disease streams and in specific locations, leaving millions of people either “fleetingly enfranchised” or further non-enfranchised.

Use this resource to

  • deepen your understanding of the multiple pathways to health inequity;
  • find counter-arguments for government austerity measures; and
  • learn about the inequitable global health impacts of austerity and pro-market policies.


Sparke, M. (2016). Austerity and the embodiment of neoliberalism as ill-health: Towards a theory of biological sub-citizenship. Social Science and Medicine 187 (2017) 287-295. Retrieved from:

Tags: Critical works in health equity, Healthy public policy, Income inequality, Key concepts, Policy analysis, Socioeconomic status , Document

Sign up for our E-News