Two decades of Neo-Marxist class analysis and health inequalities: A critical reconstruction
Two decades of Neo-Marxist class analysis and health inequalities: A critical reconstruction
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DOI：
10.1057/sth.2015.17
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发表时间：
2015-08-01
影响因子：
1.6
通讯作者：
Prins, Seth J.
中科院分区：
文献类型：
--
作者：
Muntaner, Carles;Ng, Edwin;Prins, Seth J.
大多数人口健康研究者将社会阶层概念化为一组个人生活的属性和物质条件。“阶级作为个体属性”的唯物主义传统将阶级等同于“观察”，排除了对不可观察的社会机制的研究。这种社会阶级观的另一个后果是，它不能在中观或宏观层面上被概念化、测量或干预，而是被简化为个人属性。因此，人口健康学科边缘化了马克思主义理论中的丰富传统，即“阶级”被理解为“隐藏的”社会机制，如剥削。然而，在过去的20年里，新马克思主义社会阶级被用于人口健康研究，作为理解健康不平等如何产生的一种方式。新马克思主义的方法从阶级关系的角度看待社会阶级，这种关系使人们能够控制生产性资产和他人的劳动力（财产和管理关系）。我们批判性地评价了新马克思主义方法在过去二十年中的贡献，并提出了现实主义的修正案，以了解健康和健康结果的社会决定因素的阶级效应。我们认为，当社会阶层被视为一种社会因果机制，它可以告知社会变革，以减少健康不平等。
Most population health researchers conceptualize social class as a set of attributes and material conditions of life of individuals. The empiricist tradition of 'class as an individual attribute' equates class to an 'observation', precluding the investigation of unobservable social mechanisms. Another consequence of this view of social class is that it cannot be conceptualized, measured, or intervened upon at the meso- or macro levels, being reduced to a personal attribute. Thus, population health disciplines marginalize rich traditions in Marxist theory whereby 'class' is understood as a 'hidden' social mechanism such as exploitation. Yet Neo-Marxist social class has been used over the last two decades in population health research as a way of understanding how health inequalities are produced. The Neo-Marxist approach views social class in terms of class relations that give persons control over productive assets and the labour power of others (property and managerial relations). We critically appraise the contribution of the Neo-Marxist approach during the last two decades and suggest realist amendments to understand class effects on the social determinants of health and health outcomes. We argue that when social class is viewed as a social causal mechanism it can inform social change to reduce health inequalities.