Health, disability, and debility are largely absent from early discourses around the surplus populations that Marx and Engels responded to, except in cases of characteristic pathologizing of the poor. (Malthus again: “The labouring poor . . .seem always to live from hand to mouth. Their present wants employ their whole attention, and they seldom think of the future.”) Engels and Marx do, however, share concerns for the public health of the surplus population and the disablement wrought by industrial production. Engels’ The Condition of the Working Class in England can be regarded as an early work of “social” epidemiology, locating capital’s impact on the social determinants of health just as the idea of public health was at its formation. Marx notes of the relationship between health, private sector industrialization, and the state, that
health officers, the industrial inquiry commissioners, the factory inspectors, all repeat, over and over again, that it is both necessary for [factory] workers to have these 500 cubic feet [of space per person], and impossible to impose this rule on capital. They are, in reality, declaring that consumption and the other pulmonary diseases of the workers are conditions necessary to the existence of capital.
A contemporary understanding of what it is to be “surplus” is necessarily more expansive. Major societal shifts in the late modern period, discussed at length in our chapter LABOR, solidified the worker/surplus binary in public consciousness in part by incorporating a conception of workers’ health or disability as a central facet in their certification as surplus.
The surplus, or surplus populations, can therefore be defined as a collective of those who fall outside of the normative principles for which state policies are designed, as well as those who are excluded from the attendant entitlements of capital. It is a fluid and uncertifiable population who in fact should not be rigidly defined, for reasons we discuss below. Crucially, this definition also elides traditional left conceptions of the working class or the “worker.”...the idea that the worker is not a part of the surplus populations, yet faces constant threat of becoming certified as surplus, is one of the central social constructions wielded in support of capitalist hegemony. Similarly, the methods the state employs to certify delineations between surplus populations constitute effective tactics in maintaining this hegemony. An understanding of the intersectional demands of those subjected or excluded by capital constitutes the potential for building solidarity, which is definitionally a threat to capital. An understanding that the marking and biocertification of bodies as non-normative or surplus constitutes a false, socially constructed imposition of negative value is also a threat to capital. An understanding that illness, disability, and debility are driven by the social determinants of health, with capital as the central social determinant, itself constitutes such a threat. We argue therefore that in order to truly mount a challenge to capitalism it is necessary that our political projects have and maintain the surplus at their center.
While the surplus population does contain those who are disabled, impaired, sick, mad, or chronically ill, the characteristic vulnerability of the surplus is not inherent to their existence—that is, it is not any illness, disability, or pathologized characteristic that itself makes the surplus vulnerable. Their vulnerability is instead constructed by the operations of the capitalist state. The precarity of the surplus population is made through what Ruth Wilson Gilmore calls “organized abandonment,” the deliberate manipulation and disproportionate dispossession of resources from Black, Brown, Indigenous, disabled, and poor communities, rendering them more vulnerable to adverse health.
Understanding the shifting social constructions of surplus under capitalism, and the organization of this “organized abandonment,” is uniquely illustrative of the imbrication of health and capital. At the time of its initial formulation, surplus populations are largely discussed in the sense of surplus constituting “superfluous” (another term wielded synonymously for this population at the time) or otherwise irrelevance, waste. We can see this literalized in early American labor benefits: the few national unions that offered a permanent disability benefit paid a sum equal to the meager benefit a worker’s family would receive on the worker’s death. A worker becoming disabled thus not only constitutively passed the boundary from “worker” to “surplus”—their social value following disablement was, effectively, as good as dead.
This categorization and certification of surplus has become a focal struggle in the history of capitalism, socially reproducing a collective imaginary of who is a worker, who is property, and who is surplus—and to what degree of personhood each category is “entitled” under the scope of law. Those who are deemed to be surplus are rendered excess by the systems of capitalist production and have been consequently framed as a drain or a burden on society. But the surplus population has become an essential component of capitalist society, with many industries built on the maintenance, supervision, surveillance, policing, data extraction, confinement, study, cure, measurement, treatment, extermination, housing, transportation, and care of the surplus. In this way, those discarded as non-valuable life are maintained as a source of extraction and profit for capital.
This rather hypocritical stance—the surplus are at once nothing and everything to capitalism—is an essential contradiction Liat Ben-Moshe identifies this characteristic through the intersection of disability and incarceration: “Surplus populations are spun into gold. Disability is commodified through [a] matrix of incarceration”. Jasbir Puar, in The Right to Maim, writes: “Debilitation and the production of disability are in fact biopolitical ends unto themselves . . . Maiming is a source of value extraction from populations that would otherwise be disposable”.
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