SEE ALSO disability; health promotion; inequalities agenda; power; social determinants of health; women’s health
A zero-sum situation exists when one can only possess x amount of power to the extent that someone else has an absence of an equivalent amount of power (Laverack, 2004).
Power is often interpreted as a finite entity in which one person, group or organization has influence and control over others. Zero-sum power creates a ‘win/lose’ situation. My power-over you, plus your absence of that power, equals zero (thus the term, ‘zero-sum’). I win and you lose. For you to gain power, you must seize it from me. If you can, you win and I lose. It is important to understand that power has to be gained or seized by those who want to achieve it, by raising the position of one person or group, while simultaneously lowering it for another person or group (Laverack, 2004).
Zero-sum power is often used in association with economic or political accounts where power is equated to wealth and income, authority and status, and is particularly dominant in Western societies. At any one time there will be only so much wealth possessed within a society. This distribution and the decision-making authority that goes with it is zero-sum. One has authority or social status by virtue of others not having it. There is a degree of flexibility here since someone may have authority or status in one situation, relative to others, but not in another. For example, an immigrant may hold the position of a community leader or hereditary chief within their own community, but within his workplace have only a low-paying menial job with little responsibility or power (Laverack, 2004, p. 41). At the same time there are dominant social forms of status or privilege, such as class, gender, education, ethnic background, age and even physical ability or sexual preference, which tend to structure power-over relations in most social situations.
In a zero-sum construction of power the role of public health is to assist others to gain power, meaning more control over resources or decision-making that influence their health, from other groups. Within communities, this can become a difficult issue as a dominant minority may dictate the community needs unless adequate precautions are taken to involve marginalized populations.
There is another important use of power, one that regards it not as fixed and finite, but as infinite and expanding. This is a ‘non-zero-sum’ form of power that is ‘win/win’, since it is based on the idea that if any one person or group gains, everyone else gains too. Knowledge, trust, caring, counselling, facilitation and other aspects of our social relationships with one another are examples of non-zero-sum power (Laverack, 2004).
In public health practice, zero-sum and non-zero-sum formulations of power are used simultaneously. Power cannot be given and therefore people must be enabled to take the power that they need from others through the development of their capacity so as to seize control over the influences on their health.
KEY TEXTS
•Gallarotti, G. (2011) ‘Soft Power: What Is It, Why Is It Important and the Conditions for Its Effective Use’, Journal of Political Power, 4 (1): pp. 25–47
•Laverack, G. (2004) Health Promotion Practice: Power and Empowerment (London: Sage), pp. 34–36
•Scott, J. (2001) Power (Cambridge: Polity Press)