Power and privilege
Power and privilege are dynamic and constantly changing across society.
Power
is a complex concept that describes the ability to act or not act in the context of a broader environment linked with control, relationships and outcomes. Power (or lack of power) can affect people's circumstances and health. For example, power can correspond to social inequalities that shape health inequities within populations; power, income and wealth lead to varying advantages within society. Power also influences and governs other aspects of life connected to health, such as housing, education and employment.
-
Power over
Where some are able to influence or coerce others
-
Power to
Where individuals are broadly able to organize and change existing hierarchies
-
Power with
The collective power of communities or organizations
-
Power within
Individual capacity to exercise power
(WHO, 2010)
In their Conceptual Framework for Action on the Social Determinants of Health, the World Health Organization identifies four types of power:
Privilege
operates on personal, interpersonal, cultural and institutional levels. It gives advantages, access, favours and benefits to members of dominant groups at the expense of those who have been marginalized (Allies for Change, 2003).
Privilege is characteristically described as being invisible to those in dominant groups. This is because the belief (or underlying assumption) is that much of what is enjoyed through privilege has been earned or is easily accessible to others. In fact, privilege is unearned and granted to people in dominant groups whether they want privileges or not and regardless of their stated intent. The absence of privilege often triggers more awareness than its presence. These privileges are granted and maintained through the intersections of many factors (e.g., race, gender, age, language, class, socioeconomic status) (Allies for Change, 2003).
A similar concept is white privilege, which describes the personal privileges in everyday life, afforded specifically to white people that contribute to a racial privilege gap and racism.
Across society, the depersonalization of white privilege (e.g., using words such as “invisible” to describe it) collectively:
-
Obscures the recognition of the painful effects of racism
-
Diminishes personal responsibility that people should or can change their perceptions of racial privilege
Privilege in health care or social services involves merging personal and institutional privilege and power, which leads to:
-
Differential care experiences
-
Poorer health outcomes
-
More frequent experiences of discrimination for racialized and marginalized communities
Although tasked to serve all people, individuals of privilege most frequently occupy leadership positions in both settlement and health care. The system has the tendency to project values and provide services that do not fully recognize those who have been marginalized (Hobbs, 2018).