Capitals and capabilities: Linking structure and agency to reduce health inequalities
AbstractWhile 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.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Bibliographic InfoArticle provided by Elsevier in its journal Social Science & Medicine.
Volume (Year): 74 (2012)
Issue (Month): 2 ()
Contact details of provider:
Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Rütten, Alfred & Abu-Omar, Karim & Frahsa, Annika & Morgan, Antony, 2009. "Assets for policy making in health promotion: Overcoming political barriers inhibiting women in difficult life situations to access sport facilities," Social Science & Medicine, Elsevier, vol. 69(11), pages 1667-1673, December.
- Singh-Manoux, Archana & Marmot, Michael, 2005. "Role of socialization in explaining social inequalities in health," Social Science & Medicine, Elsevier, vol. 60(9), pages 2129-2133, May.
- Frances Stewart, 2005. "Groups and Capabilities," Journal of Human Development and Capabilities, Taylor and Francis Journals, vol. 6(2), pages 185-204.
- Marmot, Michael & Allen, Jessica & Goldblatt, Peter, 2010. "A social movement, based on evidence, to reduce inequalities in health," Social Science & Medicine, Elsevier, vol. 71(7), pages 1254-1258, October.
- Abel, Thomas, 1991. "Measuring health lifestyles in a comparative analysis: Theoretical issues and empirical findings," Social Science & Medicine, Elsevier, vol. 32(8), pages 899-908, January.
- Ingrid Robeyns, 2005. "The Capability Approach: a theoretical survey," Journal of Human Development and Capabilities, Taylor and Francis Journals, vol. 6(1), pages 93-117.
- Frohlich, Katherine L. & Potvin, Louise & Chabot, Patrick & Corin, Ellen, 2002. "A theoretical and empirical analysis of context: : neighbourhoods, smoking and youth," Social Science & Medicine, Elsevier, vol. 54(9), pages 1401-1417, May.
- Donahue, John M. & McGuire, Meredith B., 1995. "The political economy of responsibility in health and illness," Social Science & Medicine, Elsevier, vol. 40(1), pages 47-53, January.
- Rütten, Alfred & Gelius, Peter, 2011. "The interplay of structure and agency in health promotion: Integrating a concept of structural change and the policy dimension into a multi-level model and applying it to health promotion principles a," Social Science & Medicine, Elsevier, vol. 73(7), pages 953-959.
- Popay, Jennie & Thomas, Carol & Williams, Gareth & Bennett, Sharon & Gatrell, Anthony & Bostock, Lisa, 2003. "A proper place to live: health inequalities, agency and the normative dimensions of space," Social Science & Medicine, Elsevier, vol. 57(1), pages 55-69, July.
- Murray, Susan F. & Akoum, Mélanie S. & Storeng, Katerini T., 2012. "Capitals diminished, denied, mustered and deployed. A qualitative longitudinal study of women's four year trajectories after acute health crisis, Burkina Faso," Social Science & Medicine, Elsevier, vol. 75(12), pages 2455-2462.
- Farmer, Jane & Prior, Maria & Taylor, Judy, 2012. "A theory of how rural health services contribute to community sustainability," Social Science & Medicine, Elsevier, vol. 75(10), pages 1903-1911.
- Verhaeghe, Pieter-Paul & Tampubolon, Gindo, 2012. "Individual social capital, neighbourhood deprivation, and self-rated health in England," Social Science & Medicine, Elsevier, vol. 75(2), pages 349-357.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Wendy Shamier).
If references are entirely missing, you can add them using this form.