Capitals and capabilities: Linking structure and agency to reduce health inequalities
Capitals and capabilities: Linking structure and agency to reduce health inequalities
复制标题
DOI：
10.1016/j.socscimed.2011.10.028
复制
发表时间：
2012-01-01
影响因子：
5.4
通讯作者：
Frohlich, Katherine L.
中科院分区：
文献类型：
--
作者：
Abel, Thomas;Frohlich, Katherine L.
虽然经验证据继续表明，社会经济地位低与身体健康的可能性较低有关，但我们对为什么会这样的理解仍然不太清楚。在本文中，我们研究了结构代理方法的理论基础，以减少健康方面的社会不平等。我们利用马克斯·韦伯关于生活方式的研究来解释生活机会（结构）和基于选择的生活行为（代理）之间的二元论。为了解释物质和非物质资源的不平等分配如何导致当代社会中不平等的生活机会和选择限制的再生产，我们应用了皮埃尔·布迪厄的资本相互作用和习惯理论。然而，我们发现，布迪厄的习性概念在结构变化的代理作用方面是不够的，因此不能轻易地提供从社会学解释到公共卫生行动的理论支持。因此，我们建议Amartya Sen的能力方法作为资本相互作用理论与减少健康方面的社会不平等的行动之间的有用联系。这种联系允许考虑结构条件以及个人作为减少这些不平等的代理人的积极作用。我们建议，在公共卫生实践中，应将人们积极维护自身健康的能力视为一个关键概念，以减少健康不平等。德国正在进行的健康促进项目提供的例子将我们的理论观点与实际经验联系起来。(C) 2011 Elsevier Ltd.版权所有。
While empirical evidence continues to show that low socio-economic position is associated with less likely chances of being in good health, our understanding of why this is so remains less than clear. In this paper we examine the theoretical foundations for a structure agency approach to the reduction of social inequalities in health. We use Max Weber's work on lifestyles to provide the explanation for the dualism between life chances (structure) and choice-based life conduct (agency). For explaining how the unequal distribution of material and non-material resources leads to the reproduction of unequal life chances and limitations of choice in contemporary societies, we apply Pierre Bourdieu's theory on capital interaction and habitus. We find, however, that Bourdieu's habitus concept is insufficient with regard to the role of agency for structural change and therefore does not readily provide for a theoretically supported move from sociological explanation to public health action. We therefore suggest Amartya Sen's capability approach as a useful link between capital interaction theory and action to reduce social inequalities in health. This link allows for the consideration of structural conditions as well as an active role for individuals as agents in reducing these inequalities. We suggest that people's capabilities to be active for their health be considered as a key concept in public health practice to reduce health inequalities. Examples provided from an ongoing health promotion project in Germany link our theoretical perspective to a practical experience. (C) 2011 Elsevier Ltd. All rights reserved.