In the aftermath of WWII, working class people begun to organize around a number of struggles for health to become recognised as a common good and a human right. Many fought for healthcare to be provided as a public service, universal and free at the point of use (that is, paid for through general taxation).
In our research, we focused on one of such struggles that took place in Italy in the 1960s and 1970s. We believe that reactivating some of the stories, techniques and imaginaries that came out of these struggles can be a useful exercise in our present days, in the aftermath of a syndemic event, whose death poll would have been in large part, preventable.
We focus on Italy not only because it is our context of origin, but also because during the decades 1960s and 1970s, it was an extremely lively political laboratory that became significant beyond its own context, including by inspiring a number of working class’ mobilization for healthcare in South America, for instance.
Moreover, Italy was the second country in Western capitalist Europe (after the UK, 1948) to achieve the right to a public healthcare system in 1978. To these days, the Italian national healthcare system remains an odd story of success despite many counter-reforms. As Chiara Giorgi noted,
> According to the 2017 OECD data, life expectancy at birth in Italy is 83.1 years, compared to the 80.9 years of the European Union average: but the total health expenditure per inhabitant is 2,483 euros, against 2,884 of the average EU (a 15% gap). It is a paradox worth probing that the European country with the longest life expectancy has achieved this result with reduced spending.
However, in the ‘60s, the national health conditions were dire. Italy had an average was of one death in the workplace per hour and one accident per minute (by comparison, today there are 3 deaths per day and 800.000 accidents per year). So in the ‘60s, as the country was undergoing massive industrialization, the idea of a “class war” was really a reality that workers could witness every day. And these were only numbers linked to direct deaths at work, without taking into consideration the indirect effects of environmental degradation and chronic conditions that begun to flare up at the time.
David Harvey remarked that under capitalism, to be healthy is defined simply by the ability to perform labour - this is why people need a doctor’s note to certify that they are sick so they can skip work. However, many do not agree with this narrow definition.
The struggles for health and healthcare in Italy begun as the political questioning of its opposite – which these movements identified not as sickness nor as fitness, or the capacity to optimally perform work. Rather, political movements begun to focus on the key term nocività – translatable as noxiousness in English.
Noxiousness instead is the property of damaging a living process and to provoke pathologies, both to a singular organism and to an entire ecosystem. A noxious process or substance can have temporary or permanent damaging effects on health; it can move fast or become chronic; it can cause death or “merely” negatively impact the capacity of living beings to reproduce and thrive.
So by focusing on noxiousness - which is produced and not a condition of the individual body, as sickness is - these movements open up the problem of health in a strategic way. They linked the wellbeing of workers, who were exposed to toxicity at work, with that of their living conditions in their neighbourhoods which were destitute and polluted, and with the conditions of domestic labour, and with the impact of capitalist production over the broader environment.
