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Income inequality, social cohesion and the health status of populations: the role of neo-liberalism


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  • Coburn, David
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    There has been a recent upsurge of interest in the relationship between income inequality and health within nations and between nations. On the latter topic Wilkinson and others believe that, in the advanced capitalist countries, higher income inequality leads to lowered social cohesion which in turn produces poorer health status. I argue that, despite a by-now voluminous literature, not enough attention has been paid to the social context of income inequality -- health relationships or to the causes of income inequality itself. In this paper I contend that there is a particular affinity between neo-liberal (market-oriented) political doctrines, income inequality and lowered social cohesion. Neo-liberalism, it is argued, produces both higher income inequality and lowered social cohesion. Part of the negative effect of neo-liberalism on health status is due to its undermining of the welfare state. The welfare state may have direct effects on health as well as being one of the underlying structural causes of social cohesion. The rise of neo-liberalism and the decline of the welfare state are themselves tied to globalization and the changing class structures of the advanced capitalist societies. More attention should be paid to understanding the causes of income inequalities and not just to its effects because income inequalities are neither necessary nor inevitable. Moreover, understanding the contextual causes of inequality may also influence our notion of the causal pathways involved in inequality-health status relationships (and vice versa).

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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 51 (2000)
    Issue (Month): 1 (July)
    Pages: 135-146

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    Handle: RePEc:eee:socmed:v:51:y:2000:i:1:p:135-146

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    Keywords: Income inequality Health inequalities Political economy of health Class and health;


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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Hidden costs of the recession
      by Sam Watson in The Academic Health Economists' Blog on 2013-04-26 10:30:57
    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
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    Cited by:
    1. Shortt, S. E. D., 2004. "Making sense of social capital, health and policy," Health Policy, Elsevier, vol. 70(1), pages 11-22, October.
    2. Chung, Haejoo & Muntaner, Carles, 2007. "Welfare state matters: A typological multilevel analysis of wealthy countries," Health Policy, Elsevier, vol. 80(2), pages 328-339, February.
    3. Barbara Seed & Tim Lang & Martin Caraher & Aleck Ostry, 2013. "Integrating food security into public health and provincial government departments in British Columbia, Canada," Agriculture and Human Values, Springer, Springer, vol. 30(3), pages 457-470, September.
    4. Abdul Karim, Syahirah & Eikemo, Terje A. & Bambra, Clare, 2010. "Welfare state regimes and population health: Integrating the East Asian welfare states," Health Policy, Elsevier, vol. 94(1), pages 45-53, January.
    5. Zheng, Hui & George, Linda K., 2012. "Rising U.S. income inequality and the changing gradient of socioeconomic status on physical functioning and activity limitations, 1984–2007," Social Science & Medicine, Elsevier, Elsevier, vol. 75(12), pages 2170-2182.
    6. Carmen Sánchez-Cantalejo & Ricardo Ocana-Riola & Alberto Fernández-Ajuria, 2008. "Deprivation index for small areas in Spain," Social Indicators Research, Springer, Springer, vol. 89(2), pages 259-273, November.
    7. Viladrich, Anahí, 2012. "Beyond welfare reform: Reframing undocumented immigrants’ entitlement to health care in the United States, a critical review," Social Science & Medicine, Elsevier, Elsevier, vol. 74(6), pages 822-829.
    8. Tim Krieger & Jens Ruhose, 2011. "“Honey, I shrunk the kids’ benefits!” — Revisiting intergenerational conflict in OECD countries," Working Papers CIE 46, University of Paderborn, CIE Center for International Economics.
    9. Raphael, Dennis & Curry-Stevens, Ann & Bryant, Toba, 2008. "Barriers to addressing the social determinants of health: Insights from the Canadian experience," Health Policy, Elsevier, vol. 88(2-3), pages 222-235, December.


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