What Is Structural Violence?

Structural violence refers to any scenario in which a social structure perpetuates inequity, thus causing preventable suffering. When studying structural violence, we examine the ways that social structures (economic, political, medical, and legal systems) can have a disproportionately negative impact on particular groups and communities.

The concept of structural violence gives us a way to consider how and in what forms these negative impacts occur, as well as what can be done to curtail such harm.

Background

The term structural violence was coined by Johan Gultang, a Norwegian sociologist. In his 1969 article, “Violence, Peace, and Peace Research,” Gultang argued that structural violence explained the negative power of social institutions and systems of social organization among marginalized communities.

It is important to distinguish Gultang’s concept of violence from the term as it is traditionally defined (physical violence of war or crime). Gultang defined structural violence as the root cause of the differences between people’s potential reality and their actual circumstances. For example, potential life expectancy in the general population might be significantly longer than the actual life expectancy for members of disadvantaged groups, due to factors like racism, economic inequality, or sexism. In this example, the discrepancy between the potential and the actual life expectancy results from structural violence.

Significance of Structural Violence

Structural violence enables more nuanced analyses of the social, cultural, political, economic, and historical forces that shape inequality and suffering. It creates an opportunity to consider seriously the role of different types of marginalization—such as sexism, racism, ableism, ageism, homophobia, and/or poverty—in creating lived experiences that are fundamentally less equal. Structural violence helps explain the multiple and often intersecting forces that create and perpetuate inequality on multiple levels, both for individuals and communities.

Structural violence also highlights the historical roots of modern inequality. The inequities and suffering of our time often unfold within a broader history of marginalization, and this framework provides a critical context for understanding the present in terms of its relationship to the past. For instance, marginalization in post-colonial countries often connects closely with their colonial histories, just as inequality in the U.S. must be considered with respect to complex histories of slavery, immigration, and policy.

Structural Violence and Health

Today, the concept of structural violence is widely used in the fields of public health, medical anthropology, and global health. Structural violence is particularly useful for examining suffering and inequity in the sphere of health. It highlights the complex and overlapping factors that influence health outcomes, such as in the case of health disparities (or inequity) between different racial or ethnic communities in the U.S. or elsewhere.

Paul Farmer’s research, writing, and applied work in the field of global health has brought significant attention to the concept of structural violence. An anthropologist and physician, Dr. Farmer has worked in this field for decades, using the lens of structural violence to show the connections between vast differences in wealth accumulation and related disparities in health care and outcomes around the world. His work emerges from the intersections of public health and human rights, and he is the Kolokotrones University Professor of Global Health and Social Medicine at Harvard University.

Dr. Farmer co-founded Partners in Health, an international organization that aims to improve preventable negative health outcomes in disadvantaged—and disproportionately ill—communities. Why is it that some of the world’s poorest countries are also the sickest? The answer is structural violence. Farmer and Partners in Health began working in Haiti in the mid-1980s, but the organization has since expanded to multiple sites and projects around the world. Projects related to structural violence and health include:

• The aftermath of the 2010 earthquake in Haiti
• Tuberculosis epidemics in Russian prisons
• Reconstructing Rwanda’s health care system after the 1994 genocide
• HIV/AIDS interventions in Haiti and Lesotho

Structural Violence in Anthropology

Many cultural and medical anthropologists are influenced by the theory of structural violence. Key anthropological texts on structural violence and health are:

• "Pathologies of Power: Health, Human Rights, and the New War on the Poor" (Paul Farmer)
• "Death Without Weeping: The Violence of Everyday Life in Brazil" (Nancy Scheper-Hughes)
• "Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United States" (Seth Holmes)
• "In Search of Respect: Selling Crack in El Barrio" (Philippe Bourgois)

Structural violence is particularly prominent in medical anthropology, including the anthropology of global health. It has been used to analyze a variety of topics, including but not limited to substance abuse, migrant health, child mortality, women's health, and infectious disease.

Sources

• Farmer, Paul. Haiti After the Earthquake. Public Affairs, 2011.
• Kidder, Tracy. Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a M an Who Would Cure the World. Random House, 2009.
• Rylko-Bauer, Barbara and Paul Farmer. "Structural Violence, Poverty, and Social Suffering." The Oxford Handbook of the Social Science of Poverty. April 2017.
• Taylor, Janelle. "Explaining Difference: 'Culture,' 'Structural Violence,' and Medical Anthropology." Office of Minority Affairs at Diversity, The University of Washington.