Health Inequalities, Social Cohesion and Social Capital: An Exploration

This paper claims that the roots and remedies of health inequalities reflected in the major academic debates that culminated with full force towards the turn of the last century, have done little to usher in a radical change in public health discourse. There has been a hesitation to understand health inequalities in a holistic fashion, which has led to the formulation of individual centric remedies and prevention. Even Wilkinson’s theory of social cohesion, modelled in the Durkheimian tradition of moral individualism distances itself from a true population perspective. In fact, it creates a smokescreen through its claim as an alternative paradigm, and thereby pushes the task of public health further back. A genuine desire to make people live longer and healthily cannot be dissociated from the larger need to question and reorganise class structures. In the dominant paradigm of public health however, the focus has always been on the individual responsibility for self-care. Relegating to the background, the larger social, cultural and economic context in which lifestyles are adopted, public health policies have continuously harped on behaviour modification.