# Struggles at the intersections of Work, Health and Environment
One of the things that becomes extremely clear to me while looking at health and healthcare from a political perspective, especially in the aftermath of Covid-19, is that HEALTH is a very difficult problem to tackle with a series of linear, direct measures.
Rather, Health, considered an object of knowledge, has boundaries that are fractal, fluid and multi-layered. Health is a condition determined by multiple social, political, environmental factors. It has somatic and affective dimensions, as well as nutritional or cultural ones. It benefits from preventive measures as much as palliative ones. Efforts to preserve or achieve health have to contend with the emergential tempo of epidemics, as well as with the slow deaths sanctioned by endemic processes that determine the premature deaths of lives that are deemed expendable... this list could go on.
So, one way we have found that helps make sense of this complexity is to think of health as one of those objects of knowledge whose mode of existence is best grasped as being a byproduct (Graziano, forthcoming), that is, when it is the resultant of broader processes of care and broader political dynamics that address the justice and sustainability shaping social production as much as social reproduction. In other words, Health is a political battlefield and perspective that rapidly obliges us to proliferate our commitments.
And this attention to health as by-production really comes to the fore when spending sometimes studying the strategies and theories of healthcare struggles and movements from the past.
Specifically, in the Italian context of the 1960s and 1970s we have been researching, a number of new institutions of healthcare were invented and that really operated by following this principle of byproduction, by combining care for the environment with public health mandates, as for instance in the Territorial Units for public medicine; or by bringing together educational provisions with pharmaceutical dispensations, such as in feminist reproductive health centres; or by creating opportunities of employment that operated in tandem with the creation of therapeutic communities, as the social enterprises linked with the radical psychiatry movement have done.
These healthcare institutions operated transversally and porously, as membranes between different social, political, mental and environmental issues, connecting one issue to the next, really committing to the possibilities of political translation - to borrow Rada Ivekovic conceptual framework - making different constituencies accountable to each other in the process, or rather, to invent processes of accountability to and for each other.
For context, it should be mentioned that in Italy in the ‘60s, the national average was of one death in the workplace per hour, and one accident per minute (by comparison, today we have 3 deaths per day and 800.000 accidents per year). So in the ‘60s, as the country is undergoing massive industrialization, the death toll for the workers was extremely heavy, the idea of a “class war” in this case really drives the point home here. 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.
To address this scenario, political movements begun to focus on the key term *nocività*– translatable as 'noxiousness' in English. This choice of term is crucial I think to grasp the practice of political translation here. The struggles for health begun as the political questioning of its opposite – which these movements identified not in sickness – nor in fitness, or the capacity to optimally perform work.
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.
