Theorising social class and its application to the study of health inequalities
Theorising social class and its application to the study of health inequalities
复制标题
DOI：
10.1016/j.ssmph.2018.10.015
复制
发表时间：
2019-04-01
影响因子：
4.7
通讯作者：
Wami, Welcome
中科院分区：
文献类型：
--
作者：
McCartney, Gerry;Bartley, Mel;Wami, Welcome
关于健康不平等的文献经常务实地使用社会经济地位的衡量标准对人口进行排名，以描述健康方面的不平等，而不是理解群体之间的社会和经济关系。关于不同措施的含义、它们所描述的社会过程以及这些措施可能如何与健康联系的理论考虑往往是有限的。本文以赖特的社会阶级理论的综合为基础，提出了一个新的综合模型来理解社会阶级，并将其应用于健康。这个模型包含了几种社会阶级机制：社会背景和早年的环境；布迪厄的习惯和区别；社会封闭和机会囤积；马克思主义关于生产(统治和剥削)的冲突；以及韦伯式的分配冲突。歧视和偏见在决定群体机会方面的重要性也得到了明确的承认，与健康行为的关系也是如此。在将不同的社会阶层过程联系起来的过程中，我们创建了一个关于社会阶层如何以及为什么导致健康不平等的综合理论。需要进一步的工作来测试这一方法，促进研究人员更好地理解不同措施背后的社会过程，并了解如何在未来收集关于这些社会阶层过程范围的更好和更全面的数据。
The literature on health inequalities often uses measures of socio-economic position pragmatically to rank the population to describe inequalities in health rather than to understand social and economic relationships between groups. Theoretical considerations about the meaning of different measures, the social processes they describe, and how these might link to health are often limited. This paper builds upon Wright's synthesis of social class theories to propose a new integrated model for understanding social class as applied to health. This model incorporates several social class mechanisms: social background and early years' circumstances; Bourdieu's habitus and distinction; social closure and opportunity hoarding; Marxist conflict over production (domination and exploitation); and Weberian conflict over distribution. The importance of discrimination and prejudice in determining the opportunities for groups is also explicitly recognised, as is the relationship with health behaviours. In linking the different social class processes we have created an integrated theory of how and why social class causes inequalities in health. Further work is required to test this approach, to promote greater understanding of researchers of the social processes underlying different measures, and to understand how better and more comprehensive data on the range of social class processes these might be collected in the future.