Social Class, Politics, and the Spirit Level: Why Income Inequality Remains Unexplained and Unsolved

Muntañer, Carles; Rai, Nanky; Ng, Edwin; Chung, Hwan Hoon

doi:10.2190/hs.42.3.a

Cited by 8 publications

(4 citation statements)

References 10 publications

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“…An ostensible goal of all research on the social production of health inequalities is not merely to describe or explain such inequalities, but to effectively reduce them ( Muntaner and Lynch, 2002 ; O'Campo and Dunn, 2011 ; Muntaner et al , 2012b ). A Neo-Marxist class approach has implications for the way that researchers think about and engage with efforts to reduce health inequalities, implications that invert the mainstream relationship between research and action.…”

Section: Discussionmentioning

confidence: 99%

Two decades of Neo-Marxist class analysis and health inequalities: A critical reconstruction

Muntaner

Ng²,

Chung

et al. 2015

Soc Theory Health

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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.

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Section: Discussionmentioning

confidence: 99%

Two decades of Neo-Marxist class analysis and health inequalities: A critical reconstruction

Muntaner

Ng²,

Chung

et al. 2015

Soc Theory Health

Self Cite

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“…27 Ignoring these “upstream” social class mechanisms also has policy implications. As argued by both Navarro 34 and Muntaner and colleagues 39 in this journal, paying inadequate attention to political and economic explanations can limit the policy impact of social inequalities research.…”

Section: Social Class and Healthmentioning

confidence: 99%

Retrenched Welfare Regimes Still Lessen Social Class Inequalities in Health

et al. 2017

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This article builds on recent work that has explored how welfare regimes moderate social class inequalities in health. It extends research to date by using longitudinal data from the EU-SILC (2003-2010) and examines how the relationship between social class and self-reported health and chronic conditions varies across 23 countries, which are split into five welfare regimes (Nordic, Anglo-Saxon, Eastern, Southern, and Continental). Our analysis finds that health across all classes was only worse in Eastern Europe (compared with the Nordic countries). In contrast, we find evidence that the social class gradient in both measures of health was significantly wider in the Anglo-Saxon and Southern regimes. We suggest that this evidence supports the notion that welfare regimes continue to explain differences in health according to social class location. We therefore argue that although downward pressures from globalization and neoliberalism have blurred welfare regime typologies, the Nordic model may continue to have an important mediating effect on class-based inequalities in health.

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“…Socioeconomic differences in COPD risk remains when controlling for smoking [6], so other independent mechanisms could explain those differences [8–12]. An open discussion in social epidemiology concerns the relative importance of material versus psychosocial factors in the genesis of socioeconomic differences in health [13–15].…”

Section: Introductionmentioning

confidence: 99%

Absolute rather than relative income is a better socioeconomic predictor of chronic obstructive pulmonary disease in Swedish adults

Fisk

Merlo

2017

Int J Equity Health

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BackgroundWhile psychosocial theory claims that socioeconomic status (SES), acting through social comparisons, has an important influence on susceptibility to disease, materialistic theory says that socioeconomic position (SEP) and related access to material resources matter more. However, the relative role of SEP versus SES in chronic obstructive pulmonary disease (COPD) risk has still not been examined.MethodWe investigated the association between SES/SEP and COPD risk among 667 094 older adults, aged 55 to 60, residing in Sweden between 2006 and 2011. Absolute income in five groups by population quintiles depicted SEP and relative income expressed as quintile groups within each absolute income group represented SES. We performed sex-stratified logistic regression models to estimate odds ratios and the area under the receiver operator curve (AUC) to compare the discriminatory accuracy of SES and SEP in relation to COPD.ResultsEven though both absolute (SEP) and relative income (SES) were associated with COPD risk, only absolute income (SEP) presented a clear gradient, so the poorest had a three-fold higher COPD risk than the richest individuals. While the AUC for a model including only age was 0.54 and 0.55 when including relative income (SES), it increased to 0.65 when accounting for absolute income (SEP). SEP rather than SES demonstrated a consistent association with COPD.ConclusionsOur study supports the materialistic theory. Access to material resources seems more relevant to COPD risk than the consequences of low relative income.

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Social Class, Politics, and the Spirit Level: Why Income Inequality Remains Unexplained and Unsolved

Cited by 8 publications

References 10 publications

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

Retrenched Welfare Regimes Still Lessen Social Class Inequalities in Health

Absolute rather than relative income is a better socioeconomic predictor of chronic obstructive pulmonary disease in Swedish adults

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