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Structural Violence and the Working-Class Family

Reading Lillian Rubin’s “Families on the Fault Line…? made me think of a word often used in the books of medical anthropologist Paul Farmer: structural violence. Structural violence is the social, political, and economical processes which make individuals or groups of people, in high risk of, or vulnerable to diseases, poverty, and exploitation, among others things.

In Rubin’s interviews, it is very clear that the central problem is economic; however, that economic problem transforms into more complex web of social (both family and society), political (how much the state values working class families), and economical (job availability and generated family income) processes which shape the families interviewed in this study. Due to their socioeconomic status, these families are struggling to make ends meet. Majority of them are two-parent workers, often in alternating shifts. Income generated by parents is not enough to pay the necessities, let alone pay for childcare. Hence, childcare becomes a problem for the two working parents. The economically challenged parents then worry about the safety and behavior of their children, especially those old enough to be influenced by defiant peers. A white mother of two teens states, “My son got into bad company and had some trouble, so mike [the husband] and I decided one of us had to be home. But we can’t make it without my check so I cant quit,? however, “this is when [teen years] they need someone to be here all the time to make sure they stay out of trouble?(p.250). Hence, her husband works in the daytime and stays with the children after school, while she works in the night time. Similar to all the families interviewed in this article, this couple rarely have time for small chat or a downtime together alone. Romance does not figure in this equation of adding and subtracting money, something the couples complain about in different ways with respect to their gender. The frustrations and the emotions conveyed in these interviews are enough to help us understand the struggles that working class families, especially two-parent-working families, have to endure.

Structural violence, therefore, can be used as means of understanding the social processes at work for putting these families in high risk of social, biological, and psychological problems, in addition to their economical challenges. From a public health perspective, since majority of the 46 million uninsured people living in America are from the working class, these families are susceptible to diseases, and might not get medical attention for treatable medical problems due to their economical problems (Hollywood version of this reality: Danzel-starter “John Q“). In addition, the economic challenges pushes them deeper into urban poverty. In terms of housing, they are more likely to live in a cheap apartments where landlords do not take care of the apartments needs, such as heating, plumping, water, and broken window/door. Furthermore, since both parents work, and are more likely to live in a poor neighborhood, their children have higher chances of joining gangs, doing drugs, and going to jail compared to children who reside in higher levels of the socioeconomic ladder.

“Inner-city poor neighborhoods often shelter a vigorous drug trade, numerous opportunities for strangers to engage in drug-mediated, unprotected sex, and numerous locations where these and other risk behaviors go virtually unchallenged? (Fulllilove quoted in Farmer, 1998).

In microbiology terminology, opportunistic pathogen is an otherwise nonpathogenic (does not cause disease) organism which becomes pathogenic under certain conditions, such as when the immune system becomes weak, or when normal flora (normal bacteria living on/in humans/animals) which would create competition, is deteriorated. In a similar fashion, poverty, disease, and exploitation, among others negative factors, are opportunistic, striking only when activated by the complex web of social, political, and economical processes. This ‘opportunistic pathogen’ is obviously more likely to attack the poor than the rich. Therefore making the poor, poorer, and more susceptible to social and biological problems. One might think of these descriptions as exaggerations of the realities of working families. However, these are realistic risks faced by families as a result of their poorness. Hence, this articles clearly illustrates the interconnection of complex social processes, economic being a big one, which determine the livelihoods of the working class families.


In what way does the economy make working-class families vulnerable? Is the free market, or capitalist system to blame?

What are other factors (race, gender, sexual orientation, etc.) determine the accepted (by the dominant ‘culture’) definition of Family? Compared to categories such as race and gender, how does iconological status different in creating structural violence?

How can the U.S. government help working class families? Does the government even care?

Reading this articles, and the interviews of these families, do you think the inequalities they experience, whether it is due to racial or economic status, is beneficial to the prosperity of this country? In other words, how does their lack of economic and social privileges help others exploit them?


It is so easy to exploit people who are desperate. Those who need the money will take whatever hours and pay that they are offered, and so we are able to exploit those who do not have the means to say no and stand up for themselves. Because the people in the working and lower class already are being exploited it makes it easier to exploit them further because of their desperation.

I find it so sad that the people who need the support of family and relationships are not able to even take the time to take part in the family and are instead forced to work until they are about to pass out, sleep, and then do it all over again. Never again will I complain that I am too busy.