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Structural factors

The health impacts of neoliberalism within the United States: A scoping review of the definitions, & analytic frameworks utilized, and the health processes and outcomes considered within the public health literature

Presenting Author
Maren Spolum
University of Michigan
Submitting Author
Maren Spolum
Additional Authors

Abstract

Public health research identifies the structural determinants of health as the factors that have the greatest impact on population health outcomes and health inequities. Neoliberalism has been the dominate political-economic system in the United States since the 1980s. Noting that U.S. life expectancy began to deviate from other high income peer nations also beginning in the early 1980s, for over a decade, population health scientists have been calling for investigations into the health impacts of neoliberal changes to U.S. political economy around that time period. While in the last two decades there has been a marked increase in scholarship on the health impacts of neoliberalism, it is unclear how much of that literature has focused on United States, as no know literature review focused specifically on this topic has been conducted. In this presentation I will review the results from a scoping review conducted to assess the body of scholarship focused on how neoliberalism has impacted health within the United States. Through database searches of the public health literature, I identified 87 articles published between 1987 and 2025 for inclusion. I will present my findings regarding: the range of definitions offered of neoliberalism, the analytic frameworks guiding the studies, the health processes that neoliberalism was proposed to impact, and outcomes across the studies. I will also offer an assessment of the gaps in this literature, particularly around the relationship between neoliberalism and social-structural patterning of health inequities in the U.S., and directions for future work.