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A proper place to live: health inequalities, agency and the normative dimensions of space


  • Popay, Jennie
  • Thomas, Carol
  • Williams, Gareth
  • Bennett, Sharon
  • Gatrell, Anthony
  • Bostock, Lisa


This paper explores the links between lay knowledge, place and health related social action (or agency) at the individual and collective level. It is based on an analysis of in-depth interviews and neighbourhood survey data across four localities in two cities in the North West of England. The qualitative analysis has identified 'guidelines' that we argue provide socially shared understandings of the normative contours of 'proper places' which shape the way people respond to the everyday lived reality of places. The quantitative findings suggest that a substantial minority of people, particularly in disadvantaged areas, are exposed to significant dissonance between the normative dimensions and lived experience of place. The analysis points to potential interactions between individual and collective action which may affect the health of individuals and populations and 'ontological fit'--people's ability to (re) construct a positive identity despite living in what they and others perceive to be an 'improper' place. This is linked to their biographical connections with particular places and the extent to which they can localise problems and people in places at a distance from themselves. The paper contributes to understanding about the processes that generate inequalities in the health experience of people living in sharply contrasting socio-economic circumstances as well as finer-grained health inequalities between the 'poor' and the 'poorest'.

Suggested Citation

  • 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.
  • Handle: RePEc:eee:socmed:v:57:y:2003:i:1:p:55-69

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    2. Rainham, Daniel & McDowell, Ian & Krewski, Daniel & Sawada, Mike, 2010. "Conceptualizing the healthscape: Contributions of time geography, location technologies and spatial ecology to place and health research," Social Science & Medicine, Elsevier, vol. 70(5), pages 668-676, March.
    3. Yamanis, Thespina J. & Maman, Suzanne & Mbwambo, Jessie K. & Earp, Jo Anne E. & Kajula, Lusajo J., 2010. "Social venues that protect against and promote HIV risk for young men in Dar es Salaam, Tanzania," Social Science & Medicine, Elsevier, vol. 71(9), pages 1601-1609, November.
    4. Rainham, Daniel, 2007. "Do differences in health make a difference? A review for health policymakers," Health Policy, Elsevier, vol. 84(2-3), pages 123-132, December.
    5. Davidson, Rosemary & Kitzinger, Jenny & Hunt, Kate, 2006. "The wealthy get healthy, the poor get poorly? Lay perceptions of health inequalities," Social Science & Medicine, Elsevier, vol. 62(9), pages 2171-2182, May.
    6. Burke, Jessica & O'Campo, Patricia & Salmon, Christina & Walker, Renee, 2009. "Pathways connecting neighborhood influences and mental well-being: Socioeconomic position and gender differences," Social Science & Medicine, Elsevier, vol. 68(7), pages 1294-1304, April.
    7. Goldenberg, Shira M. & Strathdee, Steffanie A. & Gallardo, Manuel & Rhodes, Tim & Wagner, Karla D. & Patterson, Thomas L., 2011. ""Over here, it's just drugs, women and all the madness": The HIV risk environment of clients of female sex workers in Tijuana, Mexico," Social Science & Medicine, Elsevier, vol. 72(7), pages 1185-1192, April.
    8. Albor, C. & Uphoff, E.P. & Stafford, M. & Ballas, D. & Wilkinson, R.G. & Pickett, K.E., 2014. "The effects of socioeconomic incongruity in the neighbourhood on social support, self-esteem and mental health in England," Social Science & Medicine, Elsevier, vol. 111(C), pages 1-9.
    9. Lengen, Charis & Blasius, Jörg, 2007. "Constructing a Swiss health space model of self-perceived health," Social Science & Medicine, Elsevier, vol. 65(1), pages 80-94, July.
    10. Cummins, Steven & Curtis, Sarah & Diez-Roux, Ana V. & Macintyre, Sally, 2007. "Understanding and representing 'place' in health research: A relational approach," Social Science & Medicine, Elsevier, vol. 65(9), pages 1825-1838, November.
    11. Pampalon, Robert & Hamel, Denis & De Koninck, Maria & Disant, Marie-Jeanne, 2007. "Perception of place and health: Differences between neighbourhoods in the Québec City region," Social Science & Medicine, Elsevier, vol. 65(1), pages 95-111, July.
    12. Lehoux, Pascale & Daudelin, Geneviève & Poland, Blake & Andrews, Gavin J. & Holmes, Dave, 2007. "Designing a better place for patients: Professional struggles surrounding satellite and mobile dialysis units," Social Science & Medicine, Elsevier, vol. 65(7), pages 1536-1548, October.
    13. Gibson, Barbara E. & Secker, Barbara & Rolfe, Debbie & Wagner, Frank & Parke, Bob & Mistry, Bhavnita, 2012. "Disability and dignity-enabling home environments," Social Science & Medicine, Elsevier, vol. 74(2), pages 211-219.
    14. Abbott, Pamela A & Turmov, Sergei & Wallace, Claire, 2006. "Health world views of post-soviet citizens," Social Science & Medicine, Elsevier, vol. 62(1), pages 228-238, January.
    15. Scammell, Madeleine Kangsen & Senier, Laura & Darrah-Okike, Jennifer & Brown, Phil & Santos, Susan, 2009. "Tangible evidence, trust and power: Public perceptions of community environmental health studies," Social Science & Medicine, Elsevier, vol. 68(1), pages 143-153, January.
    16. Abel, Thomas & Frohlich, Katherine L., 2012. "Capitals and capabilities: Linking structure and agency to reduce health inequalities," Social Science & Medicine, Elsevier, vol. 74(2), pages 236-244.


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