Health-related economic inactivity, or sickness as surplus? Governing worklessness in post-pandemic capitalism

Abstract

Responding to growing political concerns that posit health-related economic inactivity (HREI) as simultaneously a threat to economic growth and a matter of individual behaviour and labour market participation, this commentary critically interrogates the structural foundations of worklessness within capitalist polities. We argue that HREI cannot be understood as either a residual labour market issue or an individual problem of poor health. Rather, inactivity is symptomatic of deeper systemic logics that determine who is deemed economically valuable and who is rendered surplus. We examine contemporary UK ‘workfare’ policy, in which welfare payments are made conditional on work related activity, and thus extend labour market logics into health and welfare systems. These systems are increasingly tasked with prioritising productivity over care. Policy imperatives discipline the inactive through mechanisms such as activation, conditionality and welfare reform, while obscuring the structural determinants of ill health and labour market exclusion, reinforcing a moral economy in which health is instrumentalised for economic ends. This commentary champions a politics of care over activation whilst calling for a reimagining of the relationship between public health, work and employment; one that prioritises a politics of care, centring equity, solidarity and unconditional support whilst resisting reductionist, orthodox economic models that use labour market participation as a core measure of human value.