Class and health in changing societies: the need for novel approaches

Abstract

Surprisingly little attention has been devoted to the theories, concepts and measurement of social class and socioeconomic position in social epidemiology. This is particularly surprising as the number studies on health inequalities has increased exponentially over the decades.1 Guidelines have though been proposed for the use of socioeconomic position in health research and we have learnt a lot about the nature, measurement and use of various socioeconomic indicators.2–4 However, the suggested socioeconomic classifications have often been pragmatic, based on occupation, education and income, grouped hierarchically following statistical authorities or ad hoc principles. So far, theoretical and conceptual issues and their integration to empirical analysis of health inequalities have remained largely a white spot. The theoretical work within the sociology of class has had almost non-existent consequences for research on health inequalities. Similarly, research on socioeconomic inequalities in health has seldom been considered in the sociology of class. Cross-fertilisation between theoretical and empirical work as well as between sociology of class and social epidemiology would deepen our understanding of social class and socioeconomic position in the production of health inequalities. The Marxian and the Weberian theories are the dominant social class traditions and these have influenced some subsequent class schemes and classifications. Wright’s neo-Marxian class theory draws on the Marxian tradition in its emphasis on people’s location in the occupational hierarchy based on production relations as well as power and control over access to economic and productive resources.5 Additionally, Wright’s theory draws on the Weberian tradition in its emphasis on skill and expertise, rendering the theory a …