1. The document discusses how contemporary economic structures and employment conditions stem from historical figures like Max Weber, Immanuel Kant, and Friedrich Hayek and their theories of capitalism, work ethic, and neoliberalism. It analyzes how these have influenced concepts like time poverty and precarious employment. 2. It then examines how health promotion frameworks like the Ottawa Charter emphasize upstream social and economic determinants of health in contrast to approaches focused solely on individual behaviors and disease treatment. The capabilities approach and principles of advocacy, empowerment and coordination across sectors are discussed. 3. Examples are given of how neoliberal policies have manifested problems like increased casual and insecure work in New Zealand, impacting workers

1. Critical Assessment.
1
A preceding essay on employment and work conditions as a health determinant asked what
function the economy serves, concluding that ideally it enables citizens to flourish (Korten,
2003). While for some this happens, others experience harm. The influence of neoliberal
policies over three decades has seen a growth in temporary labour and multiple job holding
(Spoonley & Davidson, 2004). The meaning of conditions was applied to processes within
people, and regarded as constituting an ‘economy’ independent of prevailing definitions.
These internal conditions tend to exist across workplaces, though are differentiated by the
nature of activity and use of time. An example of external conditions is social capital
(Bordieu, 1986) containing the central element of trust, and relevant to a public health
settings approach (to be discussed). The economic principle of exchange is accepted as
synonymous with mediating factors that define social relations. Finally, it was acknowledged
that use of gross domestic product (GDP) is a poor measure of overall productivity by
valuing detrimental activity and overlooking properties conducive to health (de Graaf &
Batker, 2011). An example is large multinational business motivated by profit at the expense
of public health and grass-roots communities (Hastings, 2012).
Some form of rationale underpins human activity, and various perspectives determine the
impact of global, economic and social change processes on health. Therefore, the
philosophical basis of political economy can be classified as a determinant with flow-on
effects. This essay first considers how contemporary economic structures stem from historical
figures, and a subsequent process of time poverty or ‘squeeze’ (Schor, 1992: de Graaf, 2003)
that impacts on employment and working conditions. As health determinants, these are
classified as upstream factors, though the first is further upstream and more ingrained.
It is clear that different perspectives pay attention to different dimensions of social life (Ryan,
2005). This observation addresses various health sociological perspectives, resembling

2. Critical Assessment.
2
Chang’s (2016) stance on economics: a diversified approach is necessary since nine different
schools of theory exist with their own specific assumptions and underlying ethical values. To
understand how the world operates (including the economy as a central element) people have
to interpret situations as a guide to actions. Signal and Ratima (2015: 44) provide key points
about the internal design facilitating this process: “A worldview is a set of basic beliefs
accepted on faith that provides a framework for interpreting the world”. Chapman and Lupton
(1994: 196) allude to the predominantly subjective nature at the basis of health policy
practice in claiming that since there is no objective reality, initiatives are “open to a range of
interpretations”.
These points seek to lay the foundation for discussing the impact of political and economic
thought on contemporary societal structures (such as the economy) with flow-on effects for
employment and work conditions. As these approaches are the product of historical
circumstances each individual responded to, temporal context matters.
Despite the variability, several key points can be identified and elaborated upon for their
influence. The first is the perspective of Max Weber (1864-1920) regarded as the father of
modern sociology, who theorised that capitalism was fuelled by Protestant Christianity
(specifically Calvinism) and a work ethic that stemmed from a belief in predestination and a
need to resolve anxiety about personal salvation (Cook, 1992; Rojek, 1985; Solomon &
Higgins, 1996). Growing up immediately following the Industrial Revolution (circa 1730-
1850) Weber saw an ‘elective affinity’ between the ethics of capitalism and Protestantism,
and observed an association between emergence of capitalism in nations where Protestantism
was dominant (Kivisto, 1998).
His theory allowed for exceptions, and did not attribute capitalism solely to religious belief.
Additional factors were new technical and scientific expertise, law and order specialisation,

3. Critical Assessment.
3
trained officials within state bureaucracies, growth of individuation, and developments in
communication (Rojek, 1985). Weber is also associated with an ‘iron cage’ metaphor he
used to describe the threat of industrialism to individuality and freedom (as components of
democracy), and with analysis of bureaucratic organisational structure as contributing to this
threat (Kivisto, 1998). The expression ‘one does not work to live; one lives to work’
originates with Weber, describing a prevailing attitude of his day (Pieper, 1952: 26).
These are the main points of Weberian thought. As noted, the notion of elective affinity
allows for exceptions between Protestant thought and capitalism. One such exception is from
Josef Pieper (1904-1997) who described a ‘work-centred reality’ in post-war Germany (1945
onwards) as originating from Immanuel Kant (1724-1804). Kant exaggerated the value of
work and disregarded effortless activity as of value, and subsequent generations have come to
emphasise servile (utility) over liberal arts (Pieper 1952).
The eighteenth century Enlightenment was characterised by a rise in science and faith in the
ability of human reason to explain the world independent of church authority, of which Kant
was a leading proponent despite his devout religious faith (Solomon & Higgins, 1996).
Therefore, because Kantian ethics mean human activity is characterised by duty, he
contributed to the growth of Industrialism. This does not presuppose the outcomes of activity
as beneficial, but that individuals become functionaries within social systems, and this posed
a threat to human dignity (Pieper, 1952).
Such an external purpose of duty might be economic activity (contemporary or historical) and
irrespective of the particular industry, it is a type of functionalism. As a sociological
perspective, functionalism implies that to run smoothly, there are certain societal demands to
be met (Ryan, 2005). These demands have implications for personal capacities and health,

4. Critical Assessment.
4
such as the example of meat workers who attributed depersonalising and risky work
conditions to increased market demand (Dew, 2012).
As a component of the economy, employment and working conditions anywhere are based
upon a given function, and this relates to the economic concept of utility: ‘the capacity of a
good or service to satisfy a human want’ (Beynon, 1999: 343). How much individuals gain a
sense of fulfilment and control through work depends upon alignment of their capacities with
the demands placed on them by specific tasks. This relates to the categorical imperative as
another aspect of Kantian thought, which contains utility as a theme: ‘One ought always act
so as to treat humanity, in oneself or in another, as an end in itself, and not as a mere means’
(Solomon & Higgins, 1996: 212).
Industries and their component organisations exist for given purposes, operating with specific
goals in mind. Therefore, this generally accepted law applies in terms of all people affected
by these activities. Comparing these Kantian principles with Aristotle (384-322 B.C.) reveals
that contemporary economic structures have departed from Kant’s original intent, by
observing his emphasis on utility, but not the categorical imperative.
Solomon and Higgins (1996: 64) describe Aristotelian ethics as teleological or ‘the ends of
being human’. This defines a natural human purpose, where the central concept of
eudaimonia is often translated as ‘doing well’ or ‘flourishing’ (Solomon & Higgins, 1996:
64). This contrasts with employment where individual needs are subservient to commercial
imperatives at the expense of wellbeing, such as with the precariat class (Standing, 2014).
According to the philosopher Zygmunt Bauman, the word ‘precariat’ comes from the French
‘precarite’, which loosely translated means “walking on moving sands, not having firm
ground under your feet” (Barr, 2016: 13.30) implying a need for stability or a ‘secure
foundation’ (WHO, 1986). Therefore, the features defining this group undermine personal

5. Critical Assessment.
5
capacities to flourish consistent with Aristotelian thought. It is also synonymous with the
Māori ‘turangawaewae’ as the basis for moving between contexts sure of one’s identity (Pere,
1997: 50) and ‘the occupational narrative’ (Standing 2014: 22). The precariat is summarised
as an emerging social group: with distinctive relations of production (insecurity, transiency);
of distribution (remuneration) and to the state (dependent on another’s will); with a lack of
occupational identity (narrative) and control over time (time poverty or ‘squeeze’); a
detachment from labour (as not defining the true self); as having low social mobility (lack of
freedom); as being over-qualified for current tasks (underemployment); with uncertainty
(reduced capacity to deal with future events, less resilience, fewer resources); and subject to
poverty and precarity traps (state coercion) (Standing, 2014: 16-28).
In other words, there is a distortion of means and ends where commercial imperatives take
precedence over human welfare, and the resources (determinants) of it. On this basis, it can
be argued that several business practices breach the categorical imperative. For example,
bonded-labour ‘sweat-shop’ conditions pay workers below ten cents per hour in exchange for
fourteen hour, six day weeks with no health or social benefits (Labonté & Laverack, 2008).
The underlying intent of these conditions is a search for cheap and exploitable labour by
multinational companies, especially in developing nations (Klein, 2014) that frequently
involve the use of child labour (Labonté & Laverack, 2008). These free market forces are
products of business-friendly policies to aid business access to global markets and reduce
trade barriers (Beder, 2006; Klein, 2007).
This economic rationale stems from Friederich Hayek (1899-1992) as a proponent of
neoliberal political economy. This binds governments to act according to an economic
freedom logic that overrides standard political decisions (Kelsey, 2015) and implies the
definition of liberty is changed to suit business interests rather than workers impacted by
government policies. Hayek claimed individuals in an open liberal society are “left free to set

6. Critical Assessment.
6
their own goals and determine how best to achieve them” (Maloney, 2010: 83) though his
definition of freedom assumes an equality of resources (including time) which does not exist.
The impact of time poverty on a precariatised workforce due to free market principles is
summarised by Schor’s (1992: 139) ‘squirrel cage’ metaphor to resemble Max Weber’s ‘iron
cage’ (Kivisto, 1998: 54). The description is inspired by nineteenth century penitentiary
methods (Roenfeld & Warner, 2016) to symbolise loss of freedom. People working multiple
jobs and overtime have become ‘keenly aware of the price of time’ but ‘may have forgotten
the real worth of time’ (Schor, 1992: 139). Like Weber, Schor (1992) sees an unfolding
capitalist economy impacting on work conditions (in this case, time consciousness of price
over value) where commodification of time is intended to deploy it for economic use. Time is
regarded of no value unless commercial gain is the motive (Rowe, 2003) just as GDP values
detrimental activity (de Graaf & Batker, 2011). Contrasting this mentality is research
advocating three day weeks for workers (aged over forty) to maximise productivity (Kajitani,
McKenzie, & Sakata, 2016).
Onerous conditions are manifested in New Zealand. Labour hire companies offering ‘arms-
length’, ‘as-needed’ employment are increasingly present in construction, information
technology, horticulture, and the healthcare system (cleaners, orderlies, kitchen staff, and
security) as primary businesses seek to reduce costs and risks (Chapman, 2016a). The effect
for workers is greater risk and uncertainty, many of whom rely on welfare to survive. Despite
a traditional egalitarianism, New Zealand has adopted the same victim-blaming, punitive
approach as promoted internationally by neo-liberal government policies (Chapman, 2016b)
In the healthcare system, time poverty can be demonstrated for providers and recipients of
critical services. In a complex, changing environment where patients increasingly present
with co-morbidities, addressing fatigue and staff burnout (depletion of coping resources)

7. Critical Assessment.
7
through administrative pathways affects valuable clinical time (Ryan, 2016). The work lives
of this group are typified by long hours. The punitive approach to welfare is demonstrated by
placement of cancer patients (many of whom are already employed) on job-seeker benefits
rather than supported living payments as they receive treatment. The criteria for receipt of
these benefits is completion of time-consuming paperwork declaring availability for work,
placing demands on the treating doctor required to make a prognosis (Espiner & Ferguson,
2015; 2016). The element of time is inherent to this process, and the policy emphasis is one
of economic utility rather than compassion.
The implementation of neo-liberal policies in New Zealand commenced in 1984 with
Rogernomics (Moon, 2013) preceding the World Health Organisation (WHO) Ottawa
Charter by two years, though coinciding with thematic discussion on health promotion
(Green & Tones, 2008). The Charter was based on over a century of social and health
movements, and strengthened use of the term ‘new public health’ (Baum, 2008: 37) from its
1974 Canadian Lalonde report origins (Dew, 2012) emphasising upstream factors. The
Charter’s core belief is that health depends on prerequisite determinants of peace, shelter,
education, food, income, a stable ecosystem, social justice, and equity (Baum 2008: 36).
Following these are guiding principles of advocacy (making conditions conducive to health)
enabling (building capacity to promote equity) and mediating (going beyond the health sector
to coordinate activities) (WHO, 1986). This describes a settings approach that includes
workplaces along with cities, schools, and hospitals (Baum, 2008).
The emphasis on upstream factors describes a shift beyond an individual physical focus and
treatment of disease, to a broader perspective where health promotion takes the initiative to
address these determinants. This begins to define health promotion as a unique discipline,
summarised as: ‘health education x healthy public policy’ and making ‘the healthy choice the
easy choice’ (Green & Tones, 2008: 14).

8. Critical Assessment.
8
The five strategies that define health promotion are: building healthy public policy; creating
supportive environments; strengthen community action; develop personal skills, and reorient
health services (WHO, 1986). All of these elements are consistent with Māori health
promotion which situated the Charter within a Treaty of Waitangi framework simultaneously
with a renewal of Māoritanga (Signal, Ratima & Raeburn, 2015).
The word charter implies a granting of rights; a written constitution; a contract for services,
and a navigational tool (Thompson, 1992). These aspects are present in the Ottawa Charter
(WHO, 1986); People’s Charter for Health (People’s Health Movement, 2001); A Public
Health Charter for Aotearoa New Zealand (Prior Policy Centre, 2011) and The Precariat
Charter (Standing, 2014). Their principles serve as guides to health promotion practice (along
with Treaty of Waitangi articles) in key domains: settings, community development, and
public policy. A prevailing ethos of health promotion is a capabilities approach proposed by
Sen (1999) and Nussbaum (2000) referring to a societal obligation “to ensure that all its
members have access to the minimum resources required for them to live a valued life”
(Labonté & Laverack, 2008: 42). By using absolute terms (all members, minimum resources)
the focus goes beyond the individual onto the key domains (settings) where health promotion
activity occurs. The ‘health for all’ expression in the Ottawa Charter preamble and
description of health promotion as “the process of enabling people to increase control over
and to improve their health” (WHO, 1986) are synonymous with the capabilities approach.
The contemporary term ‘economics’ stems from Oikonomikos which taken literally means
household management, though is better translated as estate management (Backhouse, 2002:
16, original emphases). These definitions serve to explain the Whare Tapa Whā, or ‘four-
sided house’ Māori intervention framework made up of four dimensions: taha wairua
(spiritual), taha hinengaro (thoughts and feelings), taha tinana (physical) taha whanau
(family) (Durie, 1999a: 68).

9. Critical Assessment.
9
The synonymous nature of the translation with the model generates several associations. Both
contain examples of structure (strength, form); function (utility, or purpose); productivity (in
that each has inputs and outputs, and needs resources); each has their own form of regulation
(laws compared with homeostatic balance); each is constituted of material and non-material
factors, and is subject to a principle of exchange (interaction) by existing within a particular
setting (physical, social, and historical). Another association can be drawn from distinction
between the terms household and estate: for Māori, health is viewed in wider contextual
systems as an integrative, interrelated phenomenon (Durie, 1999a). This is consistent with
the Ottawa Charter strategies of creating supportive environments and strengthening
community action. This broader perspective aligns with Adam Smith’s (1723-1790) moral
philosophy based on Aristotelian ideals conducive to character development and harmonious
communities (Solomon & Higgins, 1996). These ideals resemble Bordieu’s (1986) concept of
social capital, and specifically the habitus: ‘the ensemble of dispositions by which actions and
attitudes in the everyday world are habituated and taken for granted, because they are
embodied’ (Blaxter, 2004: 87).
The parliamentary setting for legislation is referred to as ‘in the House’ (New Zealand
Parliament/Pāremata Aotearoa, 2016) expressing a relationship between the original
definition of ‘economy’ above (Backhouse, 2002) and the need for a ‘Health in All Policies’
approach or HiAP (Freilar & O’Campo, 2013). The Whare Tapa Whā model contains internal
regulatory conditions impacted by legislation. HiAP seeks to coordinate activities across
sectors beyond health (Frielar & O’Campo, 2013) and aligns with the Ottawa Charter strategy
of developing healthy public policy, where each area of government operates with health in
mind (Baum, 2008). The 1988 Royal Commission on Social Policy advocated economic and
social policies promoting broad work opportunities as vital to population and societal health
(Boston, 2013). Emphasising strong occupational health policies, fairness, safety,

10. Critical Assessment.
10
opportunities for beneficiaries and people with disabilities, and low unemployment are work-
related components of reducing health inequities in New Zealand (Blakely and Simmers,
2011) and achievement of the United Nations Sustainable Development Goals (SDGs)
requires business and economic collaboration (Council for International Development, 2015).
These forms of advocacy have policy implications beyond the health and business sectors,
and therefore represent HiAP.
The Te Pae Mahutonga model (Durie, 1999b; Ratima, Durie & Hond, 2015) as a health
promotion tool relates to utility by addressing effects of economic policy (precariatisation)
and time poverty in work settings that breach the categorical imperative. As a model, it is a
framework for interpreting the world (Ratima et al, 2015) influenced by economic structures.
Based on the Southern Cross constellation, it contains two prerequisites for action: Ngā
manukura (leadership) and te mana whakahaere (autonomy) (Ratima et al, 2015: 52). An
upstream focus implies a ‘navigational’ quality, indicating why Ngā manukura is important:
the problem of ‘downstream bias’ (Lindstrōm, Eriksson & Wikstrōm, 2010) that allows harm
to occur. Te mana whakahaere is synonymous with the self-determination or ‘tino
rangitiratanga’ provision in Article Two of the Treaty of Waitangi (Durie, 1999: 175).
An example of upstream thinking is anticipating future employment needs, accounting for
changes in technology, demographics, and global warming. Advocates for a Living Wage
(Brown, Newman, & Blair, 2014; Hodgetts, cited in Chapman, 2016a) and an Unconditional
Basic Income (Standing, 2014; Morgan & Guthrie, 2010) demonstrate the potential of Te Pae
Mahutonga’s properties to address employment inequities created by existing conditions.
Antonovsky’s Salutogenesis (Lindstrōm et al, 2010) and Freire’s empowerment approach
(Freire, 1996) involve education based on lived experience, enabling adaptation to a complex
world through development of personal resources. Therefore, they benefit three Ottawa

11. Critical Assessment.
11
Charter activity strands: Create supportive environments; Strengthen community action, and
Develop personal skills (WHO, 1986). These strands are in turn compatible with the four key
tasks of Te Pae Mahutonga: Mauriora (reinforce cultural identity and facilitate access to the
Māori world); Waiora (environmental protection); Toiora (promote healthy lifestyles); Te
oranga (facilitate Māori participation in society). (Ratima, Durie & Hond, 2015: 52).
The underlying dynamics of political economy is an inherent focus for public health activity
(Macfarlane & Irwin, 2009). The rationale for considering historical perspectives is
retrospective application of a ‘causes of the causes’ focus (Baum, 2008: 42). Despite a non-
material nature, these upstream factors are environmental, impacting contemporary economic
structures and therefore work-life balance. Time is also non-material, though commodified by
commercial interests to serve economic purposes. The effect of time poverty demonstrates its
importance as a resource.
Conceptual health promotion frameworks such as the Ottawa Charter, Whare Tapa Whā, and
Te Pae Mahutonga are examples of worldviews (interpretive approaches) with potential
application to employment policies and settings by applying the economic concept of utility
to promoting health equity as part of a new public health dynamic.

12. Critical Assessment.
12
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Ibid. Ch 3. Ratima, M., Durie, M., & Hond, R. Māori health promotion. pp. 42-63
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(Word Count: 3250)