A Systemic Approach to Occupational and Environmental Health

Part 1 of 2:


May 26, 2005

Part 2 of 2:

The Structure of Harm

A Systemic Approach to Occupational and Environmental Health

By Skip Spitzer*

[In this second part of a two-part series, activist campaigner Skip Spitzer continues describing "the structure of harm" -- some of the institutional and cultural features of U.S. society that make large-scale harm inevitable. Corporate power and economic concentration, patriarchy, racism, governments beholden to corporate wealth, media that reflect and reinforce the corporate system, and an international trade regime that has weakened governments' influence on corporate behavior -- make up the "structure of harm." We will all want to continue working locally, but if we can tie our local work to a bigger-picture analysis -- and to a growing global justice movement with a common agenda of democratic inclusion; environmental sustainability; class, racial, and gender justice; diversity; and fundamental change -- perhaps we can transform the "structure of harm" itself into something life-affirming and life-sustaining. That is the hope. --Editor]

Government safeguards the basic needs of industry

That corporate wealth buys broad influence in law and public policy is well documented and widely acknowledged.[1] Yet much government predisposition toward industry is less direct.

Holders of high office themselves frequently have significant ownership in large corporations and other corporate ties and histories. For example, virtually every member of the Bush cabinet has extensive corporate connections,[2] including outgoing Secretary of Agriculture Ann Veneman, who was a director of the biotech company Calgene[3] (now owned by Monsanto) and served on the International Policy Council on Agriculture, Food and Trade, a group funded by Cargill, Nestle, Kraft, and Archer Daniels Midland.[4] Many Clinton cabinet members had similar ties.[5]

Governmental bias toward industry is also based on the state's dependence on economic growth as a generator of tax revenues and creating conditions favorable to perpetuation of political power. This structural position of the state is reflected in a general nonpartisan orientation of government toward ensuring a prosperous business climate, particularly for the largest companies. Clinton Agriculture Secretary Dan Glickman, for example, reflected this "What's good for General Motors is good for the rest of America"[6] perspective when he said that the good news about economic concentration in agriculture is that it means that "We're strengthening our global competitive edge."[7]

Media and other institutions reinforce corporate values and ideas Institutions of beliefs and knowledge-such as the mass media, public relations, science and education-also reflect the exigencies of the corporate system. As with politics, there are direct avenues of corporate influence, including: legal threats; lobbying, flak and other manipulation of journalists; and funding university research, research institutes and think tanks. In education, corporations provide schools with curriculum, funding, teacher training, advisors, exhibits and contest programs to, in the words of one industry newsletter, "get them started young."[8]

Interestingly, while many acts of corporate influence are orchestrated in-house, the market itself generates goods and services for extending corporate influence. For example, Lifetime Learning Systems develops "corporate sponsored" materials for schools and asks corporations to "Imagine millions of students discussing your product in class. Imagine their teachers presenting your organization's point of view."[9]

Many mechanisms of ideological influence are less direct. In science, for example, many researchers sit on corporate boards, own stock or have other financial ties to the companies to which their research relates. One member of a National Academy of Sciences panel on agricultural biotechnology acknowledged, "It would be kind of hard to find [scientists] who didn't have some funding from biotechnology groups."[10]

In media, likely the most important institution of beliefs and knowledge, there are numerous ways in which the structure of the industry passively shapes the range of news and entertainment content. For example, media is itself an extremely concentrated industry and depends on the good graces of business advertisers. Journalists and writers are selected from the ranks of the mainstream.[11] Larry Grossman, former president of NBC News, put it this way: "the press are terribly conventional thinkers.... and that's why they are there. That's why they reach millions."[12]

The general effect of direct and indirect corporate influence is that the mass media portray the world in ways that are consistent with the basic needs of industry. For example, a recent Associated Press story on biomonitoring[13] for pesticides and other industrial chemicals concluded "There's still debate among advocates over which of the 75,000 chemicals to specifically look for when biomonitoring. And even when chemicals are found, there's little an individual can do."[14]

In fact, the more significant discussion among advocates is how best to challenge the chemical industry by mobilizing the public with this new documentation of corporate "chemical trespass." A study of sources for U.S. TV network news found such bias across the board, concluding that there is "a clear tendency to showcase the opinions of the most powerful political and economic actors, while giving limited access to those voices that would be most likely to challenge them."[15]

Much debate about news media focuses on the issue of liberal vs. conservative bias. This framing misses the point that what liberal and conservative outlets have in common is that they rarely question the systemic role industry plays in causing social and environmental problems or its extensive institutional influence, or describe what the public can do to change the structure of harm.

Patriarchy and racism

While the structural features sketched above focus the corporate power, patriarchy and racism are also systemic sources of harm, which interact with the market dynamics.[16] Patriarchy refers to male dominance in a society, a universal condition that predates and is influenced by the market economy. For example, gender relations changed dramatically as industrialization broadly shifted economic production from the home to separate workplaces, and again with the relatively recent mass entry of women into the paid economy.

Today, women in the U.S. workforce face unequal pay, hiring standards, working conditions, training opportunities, prospects for promotion, participation in workplace decision-making, as well as segregation in lower-level occupations. These factors lead directly, and through lower social status, to negative occupational health and other impacts. Assessments of "safe" levels of pesticide and other chemical exposure, for example, have typically relied on male subjects and generally ignore women's greater sensitivity to exposure.[17] For women, patriarchy also results in domestic violence, disproportionate shares of poverty and household work (even when holding a paid job) and other impacts.[18]

Likewise, racism occurs independently of and is influenced by the corporate system. Racism, in the broadest sense, refers to prejudice or discrimination based on race (i.e., perceived physical differences) or ethnicity (i.e., socially defined cultural characteristics), and to institutional discrimination (i.e., differing treatment regardless of individual attitudes about race and ethnicity). Racism plays a significant role in education, occupational, health and other disparities. For example, African American, Latino, Native American and Asian American communities are disproportionately impacted by hazardous waste sites, landfills, incinerators, and polluting industries. In fact, race is the most significant variable associated with the location of hazardous waste sites.[19,20]


The most general expression of the structure of harm is a dominant culture that reflects and reinforces values, beliefs, actions and lifestyles that are essentially consistent with the corporate system. A citizenry engrossed by individualism, the mythology of the free market and the measurement of personal success by wealth, and that is consumption-fixated, inwardly focused and often unaware and too busy for political engagement, enables business and politics as usual and undermines public action. It is difficult, for example, to mobilize the U.S. public in opposition to court appointments given that, according to a recent national poll, 64% of respondents could not name a single member of the Supreme Court, but 66% could name all three characters used to market Rice Krispies cereal.[21,22]

Global dimensions

Of course, the social structures of harm discussed above have important international dimensions. U.S. corporations have remarkable global reach. Exports of goods and services in July 2004 alone were roughly $96 billion[23] and private investment abroad for 2003 was about $7.8 trillion.[24] One result of international investment is the ability of corporations as a group to influence public policy in weaker economies on threat of capital flight.[25]

Likewise, the U.S. government pursues a wide range of foreign political, economic and military policy, often to advance corporate interests. For example, international financial institutions such as the International Monetary Fund and the World Bank are mechanisms through which industrial powers are able to influence national policy, principally within the global South. As conditions of lending, these institutions impose Structural Adjustment Programs, which typically require shifts to export production, slashes in social spending and other terms that prioritize expansion of markets for foreign firms and servicing debt held by foreign banks.[26] Similarly, corporate rights are globalizing through powerful new international trade and investment agreements such as those of the World Trade Organization (WTO) and a battery of new regional and bilateral pacts. These emphasize "freeing" the market through sweeping limits on regulatory policy, while granting corporations new intellectual property and other rights and largely ignoring the anti-competitive nature of multinational corporations.

Military policy is also geared toward corporate interests. Extreme lobbying and other influence by the arms industry to promote military spending and shape U.S. foreign policy constitutes a "military- industrial complex," about which outgoing president Eisenhower warned.[27] Some have argued that this has lead to a "permanent war economy," in which military spending and intervention play a central role in national economic stability.[28] At a minimum, it is clear that in most cases, geopolitical concerns, access to resources and markets, and corporate positioning underlie official pretexts for intervention. In Iraq, for example, the Bush administration brought in business leaders to head up reconstruction (such as former Cargill executive Dan Amstutz in agriculture) and established a neo-liberal interim government with U.S. advisers in all departments.[29] U.S. corporations are acquiring reconstruction contracts (more than $20 billion so far), ownership of Iraqi resources (including oil and water)[30] and intellectual property protections[31] (playing a key role in the corporatization of the nation's agriculture).

Corporate activities overseas, foreign policy, international institutions and military action profoundly exacerbate social and environmental problems. Looking at just pesticides and the WTO, for example, free-trade rules undermine national policy-making and international environmental agreements which can reduce pesticide use, and foster the industrial agricultural model at the center of pesticide-reliant farming.[32]

Seeing structure

Although social structures are by nature difficult to see, the above sketch should begin to form a picture of key underlying institutional features that are the context of contemporary change making. In sum:

** Corporations are pervasive, economically and socially powerful actors compelled to pursue narrow self-interests in a system that drives economic concentration, generates socially and environmentally harmful models of production and requires perpetual growth.

** Those charged with public policy are fundamentally compelled by corporate influences and the primacy of economic growth to safeguard corporate interests.

** Mass media, public relations, science, education-and the dominant consumption- and wealth-oriented culture as a whole-significantly reflect and reinforce the corporate system.

** Patriarchy and racism are sources of harm that interact with the corporate system.

** Corporate interests are projected internationally through economic, military, political and other activity, including a rapidly developing trade and investment framework undermining the ability of governments to control corporate behavior.

From this vantage point, strategies for moving beyond near-term, issue-based action can be more easily assessed. For example, it is clear that there is nothing about incrementalism that necessarily transforms the structure of harm.

Making systemic change

How can those engaged in near-term, issue-oriented approaches advance systemic change? Fortunately, this is not a matter of "reform or revolution." It is true that partial victories and reformism can drain potential for mobilization (as when banning residential uses of a pesticide, while leaving only farmworkers and other marginalized communities affected). This is an important strategic point. However, the notion that conditions should be allowed to worsen so that mobilization for systemic change can more readily take place overlooks the fact that in many ways conditions for deep change already exist. One useful reconciliation of the reform/transformation question is to integrate the near-term with the transformative, such that issue-based action explicitly functions to advance systemic change. This approach accommodates the reality of urgent harm that cannot be ignored. It also maintains a focus on concrete entry points for engaging and mobilizing the public. The point, however, is not that both orientations are useful; it is that they can be integrated so that they are mutually reinforcing.

The following are a few practical points for furthering this integration.

Building a broad, global movement

One crucial insight drawn from a structural perspective is that movements must be bigger, multi-issue and international. Fortunately, if there is anything opportune about the structure of harm it is that it is emerging as a unifying concern of people and progressive movements around the world. For example, most toxics groups in the U.S. taking a "NIMBY" (Not In My Backyard) position in the early 1980's developed at least a perspective of the larger context of harm.[33] Today there are truly global movements (such as the anti- or alternative-globalization movement and Via Campesina[34]), processes (like the World Social Forum[35]) and statements of unity (like the "Rio Earth Summit Declaration of Principles"[36])-all of which emphasize common themes of democratic inclusion; environmental sustainability; class, racial and gender justice; diversity; and fundamental change. There are ample opportunities to tie near-term change efforts to these expressions of the unifying global progressive movement.

Making connections and deeper alliances

Alliance-making based on common near-term goals is an obvious strategy. Yet identifying connections based on a common structural perspective can provide a basis for deeper alliances, fostering new synergies and broader movements. For example, the equitable distribution and growth of organic foods, which often cost more than conventional counterparts, suggest additional reasons for raising prevailing wages. The role of pharmaceutical companies provides a deep connection point for joint action between AIDS and other healthcare activists, opponents of genetically engineered foods and sustainable agriculture advocates. Issues such as corporate power, intellectual property rights and the production of drugs using transgenic "biopharm" crops will appeal to target audiences of multiple movements, which can be mobilized in new ways.

Building alliances between labor and other movements is particularly important. Human labor plays an essential role in production and therefore has the potential to disrupt it. This is a special form of resistance, but one that has been plagued by anti-labor policy, union cooptation, and undemocratic practices and narrow focuses by unions. Fortunately, there is a resurgence of the idea of "social movement unionism," in which the labor movement makes linkages between workplace, civil society issues and the larger structure of harm.[37]

Solidarity and agenda broadening

Deep alliances require deep solidarity-acts of mutual support that extend beyond a group's specific mission or objectives. One way to achieve greater solidarity is to reexamine organizational agendas. Most groups with a particular focus are run and supported by people concerned about a wide range of issues. Reconsidering a group's work in light of the structure of harm can suggest useful restatements of mission that make deep solidarity a more explicit goal, without losing particular focus.

Reframing problems

Another way to integrate systemic change is to recast the problems a group seeks to remedy. Pesticide reform groups, for example, frequently make the case that pesticides are harmful and need to be banned or restricted, and that pesticide manufacturers undermine the regulatory process. A broader framing, however, might include that:

** Most of what happens in the food system is based on the decision- making of an increasingly small set of increasingly large corporations (such as DuPont, Conagra, Kraft Foods and Wal-Mart)-which, by design, pay little attention to externalities such as pesticide poisonings, genetic contamination, excessive energy use, abuse of farm labor and obesity;

** these companies have created an ecologically and socially devastating model of food production and continually develop new technologies which pose new risks or harms (such as biopiracy and contract farming[38]);

** government fundamentally works to support the industrial food system, seeing its success as part of the national interest; and

** media, public relations, science, education and other institutions orient the public in support of the industrial food model through incomplete and tainted information, and the promotion of cultural traits (such as the desire for unblemished produce) that are typically antagonistic to campaigns for reform.

Systemic reframing places big picture issues in plain view, raising public consciousness, identifying connections and suggesting goals and requirements for long-term change.

Integrated campaigning

Campaigns are strategic programs of action designed to move targets and other social forces so that a specific set of goals is obtained. It is a highly focused path to specific victories, generally at the expense of issues outside of the campaign frame. Yet there are ways to integrate systemic transformation goals into campaigns.

In integrated campaigning, campaign goals are determined not simply by asking the question "What do we want our campaign to change?" The broader question is "What larger systemic changes do we want to achieve toward which our campaign will move us?" In this way, near- term, winnable goals can be developed that are important in their own right and serve as a foundation for or step to broader change. For example, if the broader systemic goal is to create a national regulatory system based the Precautionary Principle,[39,40] campaign goals might include:

1. enacting such an approach around a specific local issue, and

2. taking concrete steps to position the movement for a national campaign (through building relationships with untraditional allies, creating an international network, developing popular language about the structure of harm, raising awareness about corporate power and the limits of contemporary regulatory systems, and the like). Developing alternative institutions Just as issue-based change often requires development of alternatives (such as benign methods of pest management), systemic change requires the development of alternative institutions and visions of how societies can be organized to maximize justice and sustainability. There are many intriguing contributions in this area, from alternative global institutions to participatory economics.[41] Yet much more of this work needs to be done. What, for example, would a viable precautionary approach to regulation of production really look like? Developing concrete systemic alternatives helps answer legitimate questions about structural critiques, inspires mobilization for near- and long-term reform, helps activists and the public break out of mainstream ideological frameworks and offers real options when opportunities for deep change occur.


Many projects contribute on a local level to the development of alternative institutions. These include community gardens, local currency ventures, energy independent homesteads, community-run healthcare facilities, and green and worker-owned businesses. Yet much of this work reflects an incrementalist notion of change, with no or little engagement with movements for systemic change.

"Springboarding" entails using such points of public engagement to raise awareness and support action around the structure of harm. Some community gardens, for example, have displays providing information to participants and visitors not only about the merits of organic production or green space, but also about the problems with the industrial food system, corporate power and how to join campaigns. Springboarding helps integrate local alternatives with broader movements.


Systemic change, of course, can be overwhelming, requiring change- makers to communicate a sense of hope. Fortunately, there are in fact good reasons to be optimistic. Virtually all societies are highly contradictory and subject to relatively rapid change. Nominally democratic societies provide at least some avenues to influence the balance of political power. Harmful societies invariably generate resistance. Mechanisms of social control are imperfect. Thus, expansion of popular rights and other fundamental change has occurred over decades, sometimes just years. Arguably, there has never been a time of so much popular action worldwide around so many issues stemming from the structure of harm. The global progressive movement has people-power, rich capacities, moral positions and increasingly a structural awareness, common vision and organization with which to chart a new institutional order in which the earth and popular rights come before the free market.

Ultimately, however, hope is something independent of optimism - something we may therefore always hold and convey. As Vaclav Havel put it:

"Hope is a state of mind, not of the world.... Either we have hope or we don't; it is a dimension of the soul, and it's not essentially dependent on some particular observation of the world or estimate of the situation.... Hope, in this deep and powerful sense, is not the same as joy that things are going well, or willingness to invest in enterprises that are obviously heading for success, but rather an ability to work for something because it is good, not just because it stands a chance to succeed."[42]

Positive systemic change may be daunting, but it is essential. Recognizing this need, understanding underlying structures of harm and creating an integrated activist practice are some key steps in raising the likelihood and pace of success.

This article will appear in a forthcoming special issue of the International Journal of Occupational and Environmental Health.

*Skip Spitzer coordinates corporate accountability and industrial agriculture work at PANNA, Pesticide Action Network North America, in San Francisco. He has worked for almost 25 years as an activist on a wide range of social and environmental issues. As part of PANNA's Resources for Action work, he provides training in grassroots organizing, campaign development, non-violent direct action, and other activist skills.

[1] See for example: Sifry M, Watzman N. Is that a politician in your pocket?: Washington on $2 million a day. Hoboken, NJ: Wiley; 2004.

[2] See for example: Center for Responsive Politics. The Bush administration: corporate connections [Web page]. Available at:
URL: http://www.opensecrets.org/bush/cabinet.asp. Accessed September 22, 2004.

[3] Vidal J. GM lobby takes root in Bush's cabinet. Guardian (UK) 2001 Feb 1.

[4] Center for Responsive Politics. The Bush administration: Ann M. Veneman [Web page]. Available at: URL:
http://www.opensecrets.org/bush/cabinet/cabinet.veneman.asp . Accessed May 20, 2003.

[5] Savio N. The business of government: Clinton's corporate cabinet. Multinational Monitor 1993 Apr;15(4).

[6] General Motors Chairman Charlie Wilson said this to a Senate committee in 1955. See: Hartman D. What's good for General Motors.... Chronicles Magazine 2002 May.

[7] United States Department of Agriculture. Remarks of Secretary Dan Glickman at the USDA Small Farms Commission public forum; Memphis, TN; July 28, 1997; release no. 0251.97 [Web page]. Available at:
URL: http://www.usda.gov/news/releases/1997/07/0251. Accessed September 22, 2004.

[8] Manning S. Students for Sale. Nation 1999 Sep 27.

[9] Jacobson MF, Mazur LA. Marketing madness. Boulder, CO: Westview Press; 1995.

[10] Fred Gould on: National Public Radio. Science Friday: Ag biotech and developing countries [radio program, April 14, 2000]. Available at:
URL: http://www.npr.org/templates/story/story.php?storyId=1072932 .

[11] For more on the structure of the mass media see: Herman E, Chomsky N. Manufacturing consent: the political economy of the mass media. London: Vintage; 1988.

[12] Pack journalism: horde copy [transcript of television program Nightline]. ABC News 1989 Sep 27.

[13] Biomonitoring refers to analysis of blood, urine, serum, saliva or tissue to identify exposure to, or the presence of, chemicals in the human body.

[14] Elias P. Scientists measure pollution in humans. 2003 Dec 27.

[15] The study also reported that 92% of all U.S. sources interviewed were white, 85% were male and, where party affiliation was identifiable, 75% were Republican. Howard I. Power sources. Extra! 2002 May.

[16] For literature emphasizing interactions between race, gender and class see: Belkhir J, American Sociological Association. Race, gender, and class bibliography [Web page]. Available at: URL: http://www.asanet.org/sections/rgcbiblio.html.

[17] Ostlin P. Gender inequalities in occupational health. Harvard Center for Population and Development Studies working papers 2000 Sep;10(9).

[18] For more about patriarchy in the U.S. see: Sapiro V. Women in American society. 4th ed. Mountain View, CA: Mayfield; 1999. For a global survey of the status of women, see: United Nations Statistics Division. The world's women 2000: trends and statistics. New York: United Nations Publications; 2000.

[19] Commission for Racial Justice. Toxic wastes and race in the United States. New York: United Church of Christ; 1987. For an interesting analysis of EPA data, showing disproportionate exposure to environmental hazards in communities with higher concentrations of lower income people and people of color, see Ash M, Fetter RT. Who Lives on the Wrong Side of the Environmental Tracks? Evidence from the EPA's Risk-Screening Environmental Indicators Model. Amherst, MA: University of Massachusetts Political Economy Research Institute; 2002. (Working Paper Series; number 50).

[20] For more on racism in the U.S., see: Shaefer RT. Race and ethnicity in the United States. 3rd ed. Upper Saddle River, NJ: Prentice Hall; 2004.

[21] A lack of awareness about the judicial system is particularly important in advancing business interests, since corporate rights typically have been advanced through court decisions. For an activists's summary of such cases, see: Women's International League for Peace and Freedom, Timeline of Personhood Rights and Powers. Available at http://reclaimdemocracy.org/personhood. Accessed September 22, 2004.

[22] The Polling Company. More Americans can name Rice Krispies characters than Supreme Court justices! April 19, 2002 [Web page]. Available at:
URL: http://www.pollingcompany.com/News.asp?FormMode=ViewReleases&ID=50.

[23] Bureau of Economic Analysis. U.S. international trade in goods and services. Washington, DC: United States Department of Commerce; 2004 Jul.

[24] Includes private U.S.-owned assets and direct investment abroad at market value. Bureau of Economic Analysis. U.S. net international investment position at yearend 2003. Washington, DC: U.S. Department of Commerce; 2004 Jun 30.

[25] This is also true of national policy in the U.S. (were it to become out of kilter with corporate interests), owing to the high degree of foreign investment in the U.S. (which exceeds U.S. investment abroad).

[26] For more on these programs see: The Structural Adjustment Participatory Review International Network (SAPRIN). Structural adjustment: the SAPRI report. London: Zed Books; 2004.

[27] Hartung WD. Eisenhower's warning: the military-industrial complex forty years later. World Policy Journal 2001;18(1).

[28] Melman S. In the grip of a permanent war economy. CounterPunch 2003 Mar 15.

[29] Mekay E. U.S. business pushes for Mideast trade. Inter Press Service News Agency 2004 Oct 7.

[30] Juhasz A. The corporate invasion of Iraq. LeftTurn Magazine 2003 Aug.

[31] Coalition Provisional Authority Order No. 81: patent, industrial design, undisclosed information, integrated circuits and plant variety law of 2004. CPA/ORD/26 April 04/81.
Available at: URL: http://www.iraqcoalition.org/regulations/20040426_CPAORD_81_Patents_Law.pdf. Accessed October 20, 2004.

[32] Spitzer S. The WTO and pesticide reform. Global Pesticide Campaigner 2000;10(1).

[33] Epstein B. Grassroots environmentalism and strategies for social change. New Political Science 1995;32(Summer).

[34] For more see: Via Campesina [Web site]. Available at:
URL: http://www.viacampesina.org/.

[35] For more see: World Social Forum [Web site]. Available at
URL: http://www.forumsocialmundial.org.br/home.asp.

[36] See: Report of the United Nations Conference on Environment and Development June 1992, Annex I: Rio declaration on environment and development. Available at URL: http://www.un.org/documents/ga/conf151/aconf15126-1annex1.htm. Accessed October 20, 2004.

[37] See for example: Lambert R. Globalization: can unions resist? South African Labour Bulletin 1998;22(6).

[38] In contract farming, agribusinesses manage certain aspects of production through highly constrained contracts with farm producers.

[39] In essence, the Precautionary Principle affirms that regulatory restrictions may be appropriate even if causal relationships are not fully established scientifically.

[40] For more see: American Public Health Association. The Precautionary Principle and children's health. In: Policy statements adopted by the governing council of the American Public Health Association, November 15, 2000. Am J Public Health 2001;91:495-496.

[41] See for example: Alternatives Task Force of the International Forum on Globalization. Alternatives to Economic Globalization: A Better World is Possible. San Francisco, California: Berrett-Koehler; 2002. And: Albert M. Parecon: Life After Capitalism. London: Verso; 2003.

[42] Havel V. Disturbing the Peace. London: Faber & Faber; 1990.

Environmental Research Foundation
P.O. Box 160
New Brunswick, N.J. 08903
Fax (732) 791-4603;
E-mail: erf@rachel.org



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