The psychosocial effects on health of socioeconomic inequalities
Stephen Abbott
Critical Public Health, 17(2), 151-158 (June 2007)
http://tinyurl.com/23cqgb
Abstract
Socioeconomic inequalities are thought to impair health in a way
that is independent of the effect of material deprivation on
health. But the mechanisms whereby inequalities have such an
effect have not been thoroughly explained or explored. Two
linked but distinct mechanisms have been suggested: social
comparison and hierarchical conflict. In the first case, people
compare their social status with that of others, and where this
comparison is to their disadvantage they experience negative
emotions that impact on their health. Epidemiological data
suggest that this is a large area effect but psychological
studies of social comparison suggest that small-group
comparisons are important for social comparison. No explanation
as yet embraces both large and small scales, and much about
social comparison and its possible effects on health is poorly
understood. Hierarchical conflict has been well documented in
non-human primate societies (although with variable effects on
health), and it is hypothesized that human hierarchies, in so
far as they are structures based on domination, may affect
health by means of the chronic stress associated with
subordination. However, the degree to which human and non-human
behaviour is comparable is unclear; nor is it clear that
hierarchy as such is necessary conflictual: this may depend on
how it is organized socially and experienced by subordinate
groups. Much work needs to be done to understand both
hypotheses, although at present the social comparison hypothesis
appears to have more explanatory power.
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