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Will we have ‘dry January’ under socialism?

Apps, gadgets and diet plans promoting ‘wellness’ are a multi trillion pound industry. But Judy Cox says the system won’t let us be well, and asks how a workers’ state would promote well-being
A closeup of a glass of red wine

Pour decisions—capitalist ideology blames individuals (Picture: Wikimedia/Creative Commons)

The second week of January has barely begun and we’ve already been hit by a tidal wave of adverts for ways to improve our well-being. We must cleanse our bodies of impurities and our souls of weariness, stress and anxiety with January detox, a vegan veg box, a mindfulness app and, of course, a diet plan.

The idea of “well-being” has been embraced by policy makers, corporations and public institutions and permeates our culture. Looking good is no longer good enough—now, it’s all about feeling good and making good lifestyle choices. 

We are directed away from identifying the cause of our problems in over-work, pressure to achieve unrealistic goals and juggling complex, intergenerational family needs. Instead, we’re pointed towards buying apps, gadgets and exercise equipment. 

As GP Margaret MacCartney writes, “The worse thing about modern incarnations of wellbeing is that they devolve responsibility for health onto individuals via a commercial market”. And it is a very big market. 

The global wellness industry is worth nearly £4 trillion dollars and is growing so quickly it is estimated that it will grow to £4.9 trillion this year. Despite the pandemic, wellness tourism will be worth almost £680 billion this year. 

This is driven partly by corporate wellness programmes where companies subject their workers to stress-inducing scrutiny, exhausting long hours and permanent insecurity. And then they’re told to well-wash themselves with a lunch time yoga class no one has time to go to. 

The rich can indulge in endless pampering, with their basement swimming pools, cryo chambers and infrared saunas. Wellness has become another site of conspicuous consumption. The rest of us can download an app, walk to work, cut down on the drinking/sugar/takeaways. 

But our individual efforts are inevitably constrained by society. Real wellness means not having to worry about paying bills and not watching your children grow up in a damp flat. It’s being able to afford healthy food, to fit childcare around erratic shifts and long hours and not being one paycheck away from homelessness.

Work makes us sick, poverty makes us sick, pollution makes us sick and capitalism, having created these multiple health crises, offers us a “solution”– buy more commodities and services. Capitalism is a dynamic, but crisis-prone system which must constantly seek to create new needs and to profit from the crises it creates. Our desire to be well is both stimulated and thwarted by a system which develops a bewildering range of commodities that claim to help us in the quest for wellness.

Karl Marx and Frederick Engels were not the first to recoil in horror from the appalling working conditions in emerging capitalism’s “dark, satanic mills”. Early socialists and communists developed radical critiques of capitalist competition and inequality. Their solution was to create communes where people could liberate themselves from capitalism and experiment with different ways of living. 

Returning to the land also resonated with workers labouring in factories, consuming adulterated food or starving and living in disease-ridden slums. Communes were established in Scotland, England, France, the US and in Latin America. 

Marx and Engels organised alongside these early socialists, but they developed a radically different solution. Theirs was based not on withdrawing from industrial production, but on subordinating it to satisfy the needs of working class people. 

Engels’ 1845 book, The Condition of the Working Class in England, was one of the most important early explorations of how capitalism destroyed the health of working-class people. He described in detail the impact of poor housing, lack of ventilation, inadequate drains, insidious damp, poor clothing, and tainted and adulterated food on working-class communities. 

Engels’ descriptions of cholera epidemics are instantly recognisable to those trying to survive our own pandemic. During epidemics, he wrote, the capitalist “remembered the unwholesome dwellings of the poor, and trembled before the certainty that each of these slums would become a centre for the plague, from whence it would spread desolation in all directions through the houses of the propertied classes.” 

This physical deprivation had psychological dimensions. Engels described how cities breed ‘social warfare’ and atomisation as people are forced to compete for jobs, for homes and for living space. He famously used the term “social murder” to describe how the poor were killed through starvation and through malnutrition and atrocious living conditions which made people susceptible to fatal diseases. 

Marx also wrote widely on the appalling effect of work on worker’s bodies and their health. Industrialisation meant that machines dominated people, their bodies were deformed, crushed, maimed and destroyed by machines, repetitive tasks and long hours. This “mortifies their flesh and ruins their minds”. 

Bosses driven to constantly compete, demanded ever-longer days. Prolonging the working day, Marx wrote, “Quenches only in a slight degree the vampire thirst for the living blood of labour. To appropriate labour during all the 24 hours of the day is, therefore, the inherent tendency of capitalist production.” Night work and shift work has an injurious effect on health—which has only intensified since Marx’s day. 

More fundamentally, Marx understood that capitalism was incompatible with the well-being of workers. That’s because it depended on alienating them from their capacity to work creatively and to collectively plan interactions with the natural world. 

Marx captured the contradictory nature of capitalist production. “It is true that labour produces marvels for the rich, but it produces privation for the worker,” he wrote. “It produces palaces, but hovels for the worker. It procures beauty, but deformity for the worker.” 

Capitalism created the capacity to produce a previously unimaginable quantity of commodities, but this process was dependent on the exploitation of the working class. Physical and mental health were incompatible with capitalism. Yet the solution was not to attempt to carve out communal, liberated spaces within the system. but to overthrow it.

Moderate socialists in the later 19th century sought to turn workers’ desire for a better life into a political strategy based on “self-improvement”. The idea that individual workers should be temperate, educated and respectable was articulated by Samuel Smiles’ hugely influential book Self-Help, published in 1859. Revolutionary socialists argued that it was competition, exploitation and alienation which shaped the health of the working class, not individual failings to make good life choices.   

The Marxist strategy depended on the capacity of workers to organise collectively to force the bosses to concede reforms, which could secure them time for enriching their lives. Marx called the eight-hour day the “prerequisite for human freedom” because it could create the space for workers to forge an existence outside the demands of work. 

In the 1880s, Marx’s daughter Eleanor Marx fought to make the eight-hour day a central demand of the labour movement. This demand fuelled militant working class activism and confrontations with the state, both in Britain and the US. The demand for a shorter working day and a shorter working week is still a central demand in today’s labour movement.

In Russian in 1917, workers’ councils (soviets) took power in a socialist revolution. This huge achievement by ordinary people took place in an appalling health context. In the early 20th century, Moscow and St Petersburg resembled the English cities Engels had described in the 1840s and were known as the unhealthiest in Europe. 

Alcoholism, overcrowding and child labour were as common in Russia as they had been in Manchester 60 years earlier. The country’s infrastructure collapsed during the First World War. And the new workers’ state faced more devastation as 14 imperialist armies invaded to crush the revolution. Between 1919 and 1923, three quarters of the Russian population suffered famine. By 1920 half the population of Moscow had abandoned the city to go to the countryside to find food. 

Pre-war Russia was known as a land of epidemics and after the war, cholera, plague, typhus, flu, smallpox swept the country. In 1922 an allied blockade of quinine led to a devastating outbreak of malaria. Between 1918-20 there were some 16 to 20 million cases of typhus with at least 5 million deaths. No wonder Vladimir Lenin, a leader of the revolutionary Bolshevik party, declared, “The fight for socialism is a fight for health.” 

In 1920 the new workers’ state was fighting a bitter civil war against Western armies and counter-revolutionaries. Even at this moment of crisis, Lenin had other enemies in his sights. “Either the lice will defeat socialism, or socialism will defeat lice,” he declared to a congress in 1919. 

Russian revolutionary propaganda was full of images of cleansing society from the capitalist, the exploiter and the priest who were frequently described as vermin, filth and parasites. Revolutionaries agitated for health as a matter of survival and as a political strategy to implement change. 

The government set up dispensaries, outdoor treatment centres and sanatoriums. Revolutionary hygienists advocated preventative measures such as fresh air, sunshine, exercise and cleanliness. 

The new People’s Commissariat for Health, known as Narkomzdrav, organised a huge propaganda effort aimed at preventing illness by encouraging healthy practices. Between January 1919 and June 1923 Narkomzdrav produced 13 million pieces of health literature, with titles including, “Why is tobacco dangerous?” and, “To the book or for a Beer?’ Such printed material was supplemented by plays, films, posters and traveling exhibitions.

The workers’ state also enacted a series of practical reforms. To address the housing crisis, working class families were resettled in the homes of the rich. In 1920, the Soviet government requisitioned a Tsarist palace in Moscow and turned it into the first of thousands of Halls of Leisure where workers could spend their holidays, rest and exercise and learn about diet and self-care. 

Narkomzdrav organised a small army of inspectors who were sent to factories, public buildings and apartments. They were supported by around 30,000 workers mobilised in Health Cells who checked protocols were being followed. 

New labour legislation ensured that workers had regular breaks, weekends off and two weeks annual paid holiday. Narkomzdrav promoted good ventilation, discouraged smoking and advised people to cough into handkerchiefs. Crucially, the Soviet government gave free health insurance to all workers, guaranteeing them medicine and treatment, something the US has still not managed to do.

One of the greatest changes the revolutionary regime encouraged was the appalling conditions endured by working women and their children. Revolutionary Alexandra Kollontai described how the workers’ state organised institutions which could lighten the burden of motherhood and combat high infant mortality rates. 

Women were given paid maternity leave and maternity hospitals were opened to all women. Creches, baby food dispensaries, clinics and nurseries were introduced by the new Department for the Protection of Mothers and Infants. 

These practical reforms were essential elements of the Bolsheviks strategy to emancipate women from the privatised labour of the home. This depended on the provision of nurseries, creches, canteens and laundrettes to lessen women’s burden and create alternatives to family life. 

Sadly, such experiments could not be sustained in the desperately impoverished, besieged and isolated workers’ state. And after Joseph Stalin pushed through a counter-revolution in 1929, Russia became a “state capitalist” regime. It celebrated women’s role as mothers, banned abortion and women faced the double burden of work in the home and in workplaces just like under capitalism. 

The appalling health inequalities described by Marx and Engels have not been overcome by decades of capitalist development. 

Before the creation of the NHS, health care was unaffordable to many, but the NHS cannot overcome the inequalities rooted in capitalism. A recent report by the Kings Fund found that between 2017 and 2019 men living in the most affluent areas of Britain lived for a decade longer than men in the most deprived. For women the difference was eight years. 

Rich people can expect to live without chronic health problems for two decades longer than the working-class. Homeless people can expect to live for 31-38 years less than the rest of the population. 

Covid has led to the sharpest decline in life expectancy since the Second World War. The Office for National Statistics reports that wellbeing crashed during the pandemic which has prompted a huge increase in anxiety. 

And any wellbeing we do manage to achieve is necessarily precarious in a society stricken by pandemics, climate change and economic insecurity.

Health and well-being have always been a central question for the socialist movement. So yes, by all means go for a walk, do more yoga, eat better, relax and destress with things you enjoy. Better still, prepare to fight for better work life balance, for better housing, for higher wages—and a better socialist society. 

As Marx wrote, “Capital therefore takes no account of the health and the length of life of the worker, unless society forces it to do so. Its answer to the outcry about the physical and mental degradation, the premature death, the torture of over-work, is this: should that pain or trouble us, since it increases our pleasure (profit)?” 

Capitalism is a system that will not let us be well.   

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