Social determinants of health

Stories of positive action from around the world

Story numbers correspond to those in the Report.

Creating fair employment and decent work

7.3: Indian national rural employment guarantee programme

The National Rural Employment Guarantee Act of 2005 obliges the Indian government to provide a social safety net for impoverished rural households, through the guarantee of 100 days of work, at minimum wage, to one family member per household. While its implementation is relatively recent and there have been procedural difficulties, there is evidence to show that it has had a positive impact in several states where it has been implemented properly. It has provided wage security for poor rural families, aided economic empowerment of women, and created public assets.

In Rajasthan, where public awareness of the programme is high, 77 days of employment per rural household were provided in 2006/07. In Uttar Pradesh, major improvements in public works are observed as the scale of employment has increased; minimum wages are being paid and delays to payments have been reduced, and exploitation by private contractors is being pushed out. This is not to say the programme does not have its difficulties, but transparency safeguards and the capacity to enforce procedures have been critical in making major progress. There is also a need to fairly revise the payment rates and extend the number of days and family members covered. To ensure social inclusion, worksite facilities are needed for women with children. Source: The Hindu, 2008; Ganesh-Kumar et al., 2004

7.1: Work and health among the landless and small landed farming population of Brazil

In Brazil, 45% of agricultural land is held by around 1% of landowners, while around 50% of proprietors together own only roughly 2% of all arable land. About 31 million Brazilian people (18.8% of the total population) live in the countryside. These people, known as agregados, are extremely poor and suffer high rates of many psychosocial, educational, and health problems. In 1984, landless families organized into the Movimento dos Trabalhadores Rurais Sem Terra (MST), or Movement of Rural Landless Workers.

MST is probably the largest social movement in Latin America, with around 1.5 million members. Its fundamental success has been the increasing number of landless families being allocated their own piece of land, rising from a few thousand to more than 300 000 in 2000 settlements. Research has shown that members of MST communities enjoy better health than other agricultural workers. The improved health of MST community members was attributed to a higher production of livestock, better nutrition (partly due to a greater diversity of produce), community support in case of need, and direct involvement in community decisions. MST has limitations but, from its inception, it has acted as a catalyst for reform – not only agrarian reform, but also reform of health, with a direct impact on governmental decisions, influence on public policies, and a role in the civil society council of the Bolivarian Alternative for the Americas. Source: EMCONET, 2007

7.7: Fair-wear – workers and civil society action

Over the past decade, the political antisweatshop movement has become a major political claim maker and transnational advocacy network. Large garment corporations are vulnerable targets for antisweatshop activism. Their buyer-driven character forces them to survive in highly competitive markets. To make a profit, they must compete with other sellers over increasingly fickle (non-brand loyal) consumers looking for good-quality clothing at very affordable prices. To maintain and even improve their market shares and profit margins, they outsource their manufacturing to countries where labour is inexpensive and devote considerable resources to competitive logo and image marketing. In the weakly regulated setting of outsourced garment manufacturing, worker welfare is jeopardized by the fast and flexible production needed to keep up with fashion-craving consumers. The antisweatshop movement has used the vulnerable and competitive image situation of the buyer-driven corporate world to push to improve garment workers’ rights and social justice. Wanting profits and a good image among consumers, logo garment corporations are now forced to address sweatshop problems.

Two events in 1995 were crucial formative events in North America: the establishment of the amalgamated Union of Needle, Industrial, and Technical Employees (UNITE! and now UNITE HERE!) and the police raid of domestic sweatshops in El Monte, California. UNITE! triggered a new union activism that used consumer power to pry open space for organizing workers. The El Monte raid was a wake-up call for civil society and created a media sensation with ripple effects far into the future. Shortly afterwards, the antisweatshop movement gained momentum. Internet-based advocacy groups such as Global Exchange used its media talents to focus public and media attention on celebrity corporate leaders. Old and new civil society teamed up in the antisweatshop cause – organizations representing church groups, student groups, think tanks, policy institutes, foundations, consumer organizations, international organizations, local to global labour unions, labour-oriented groups, specific antisweatshop groups, no-sweat businesses, business investors, and international humanitarian and human rights organizations, networks, and groups. Noteworthy is the less common cooperation between unions and consumers, as illustrated by the UNITE! and National Consumers League’s Stop Sweatshop campaign that reached out to more than 50 million consumers globally. The antisweatshop campaign has had success. For example, in Indonesia, exporting and foreign textiles and footwear producers increased wages 20-25% faster than others. Source: Micheletti & Stolle, 2007