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BOX N - Theories of the state and social determinants of health Print E-mail

Ontario Public Health PractionersDifferent concepts of how the state (governance, bureaucracy, institutions and authorities) functions also affect how we approach trying to change social inequities. Pluralists see the state as a neutral arbitrator among competing groups that have equal access to decision-makers. Pluralism holds the state does not serve the interests of a single social group or class; instead it represents society as a whole, coordinates other institutions and maintains order.

Marxism says the state is the means by which the dominant class exerts and maintains power. Economic relations, rather than the state itself, are the source of societal and political power. In capitalist democracies such as Canada, the dominant economic class becomes the dominant political class.

In between these two extremes are other theories, which see the power of the state lying somewhere between being a neutral body and being controlled by the dominant class (Elliott & Fleras, 1992; Galper, 1975; Mishra, 1980; Ng,Walker & Muller, 1990).

Last Updated on Monday, 01 June 2009 08:16