Persistence of social inequalities in modern welfare states: Explanation of a paradox

2016 ◽  
Vol 45 (2) ◽  
pp. 113-120 ◽  
Author(s):  
Johan P Mackenbach
Keyword(s):  
Social Inequality ◽  
Health Inequalities ◽  
Social Inequalities ◽  
Welfare States ◽  
Short Supply ◽  
Individual Level ◽  
Self Interest ◽  
Sociological Literature ◽  
Underlying Mechanisms ◽  
Specific Manifestation

Aims: Social–epidemiological explanations of health inequalities usually take the existence of social inequality as a given and ignore the fundamental questions of why social inequality exists in the first place and why it is so persistent. I review here theories of the explanation of social inequality to identify the processes and/or structures responsible for its persistence. Methods: This paper is a review of the relevant sociological literature. Results: The sociological literature suggests that what persists over long periods of time is not a specific manifestation of social inequality but a ‘meta-phenomenon’: the fact that there are different social positions, that these social positions give access to different levels of resources in some graded way and that the distribution of individuals over social positions follows rules that create inequalities in the opportunities for achieving a more advantaged social position. The durability of social inequality in this generic form can then be understood from the persistence of the underlying mechanisms and processes – for example, humans are driven by self-interest, while most objects of their striving are in short supply, therefore a struggle for rewards is present in all societies; humans are unequally endowed, therefore some are more successful in this struggle for resources than others; and the inequalities resulting from these individual level actions are structurally fixated through the intergenerational transmission of (dis)advantage, various societal institutions, and cultural factors. Conclusions: The sociological literature suggests that some mechanisms producing and perpetuating social inequality are more ‘benign’ than others. Health inequalities may be more than a consequence of social inequality and may play a more profound part by amplifying social inequalities.

Health inequalities

2019 ◽  
Author(s):  
Johan P. Mackenbach
Keyword(s):  
Social Inequality ◽  
Health Inequalities ◽  
Social Stratification ◽  
Premature Mortality ◽  
Welfare States ◽  
Comprehensive Overview ◽  
Systematic Analysis ◽  
State Reform ◽  
Lower Socioeconomic ◽  
National Governments

‘Health inequalities—persistence and change in European welfare states’ studies why frequencies of disease, disability, and premature mortality are higher among people with a lower socioeconomic position, even in countries with advanced welfare states. Drawing upon data from 30 countries covering more than three decades, it provides a comprehensive overview of trends and patterns of health inequalities, showing that these are not only ubiquitous and persistent, but also highly variable and dynamic. It provides a critical assessment of recent research into the explanation of health inequalities, discussing methodological pitfalls, summarizing findings from epidemiological, sociological, economic, and genetic studies, and reviewing nine overarching theories. Based on in-depth studies of the determinants of health inequalities in European countries, it shows that the persistence of health inequalities is due to a combination of mostly favourable changes in social stratification, massive but differential health improvements, and persistence of social inequality in material and non-material living conditions. It discusses why social inequality is so persistent, and whether welfare state reform could contribute to reducing health inequalities, and provides a systematic analysis of the inequitableness of health inequalities according to five theories of justice. It reviews recent attempts by European national governments to reduce health inequalities, showing that it is realistic to expect evidence-based policies to reduce absolute but not relative inequalities in health. This title is written for scientists and advanced students from various disciplines, as well as for public health professionals and policymakers, and is profusely illustrated and referenced.

Introduction

2019 ◽  
pp. 1-12
Author(s):  
Johan P. Mackenbach
Keyword(s):  
Welfare State ◽  
Social Inequality ◽  
Health Inequalities ◽  
Population Level ◽  
Welfare States ◽  
Short History ◽  
History Of ◽  
Micro Level ◽  
Per Se

Chapter 1 (‘Introduction’) provides a short history of the discovery and rediscovery of health inequalities, as well as a short history and typology of the welfare state, and lays out the paradox that this book tries to explain: the persistence of health inequalities in even the most universal and generous European welfare states. It argues that micro-level studies alone cannot resolve this paradox, and that macro-level studies are needed to identify the determinants of health inequalities as seen at the population level. This will also make it easier to put health inequalities into a broader perspective, for example, that of social inequality per se. This chapter ends with an extensive preview of the main conclusions of the book.

scholarly journals Trends in social inequalities in breastfeeding and infant formulas in Latin American countries between the 1990 and 2010 decades

2021 ◽  
pp. 1-10
Author(s):  
Camila S Ferreira ◽  
Catarina M Azeredo ◽  
Ana Elisa M Rinaldi
Keyword(s):  
Dominican Republic ◽  
Social Inequality ◽  
Latin American ◽  
Low Income ◽  
Social Inequalities ◽  
Weighted Least Squares ◽  
Cross Sectional Study ◽  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Simultaneous Decrease

Abstract Objective: To analyse trends of social inequality in breastfeeding and infant formula (IF) use in Latin America between 1990 and 2010 decades. Design: Time-series cross-sectional study with data from Demographic and Health Surveys. We described the prevalence of exclusive breastfeeding (EBF), breastfeeding between 6 and 12 months (BF6-12) and IF for infants under 6 months (IF < 6) and between 6 and 12 months (IF6-12). Social inequalities were assessed using the slope index of inequality (SII) and concentration index (CIX). Trends in the prevalence of breastfeeding, IF and index of social inequality were analysed by a linear regression model with weighted least squares variance. Setting: Bolivia, Colombia, Dominican Republic, Guatemala, Haiti and Peru. Participants: 51·358 alive infants younger than 12 months. Results: Five countries showed an increasing trend for EBF and BF6-12, four increased for IF < 6 and six for IF6-12. Simultaneous decrease in IF < 6 (Colombia: −0·3/year; Haiti: −0·02/year) and increase in EBF (Colombia: +2·0/year; Haiti: +1·9/year) were observed only in two countries. EBF prevalence was high in the lowest income quintiles in five countries, and IF prevalence was high in the highest income quintiles in all countries and over the decades. For BF6-12, a decrease in inequality (prevalence increased in the highest quintile) was observed in Guatemala (SII1995 = −0·42; SII2015 = −0·28) and the Dominican Republic (SII1996 = −0·54; SII2013 = −0·26). Guatemala was the only country showing a decrease in inequality for BF (SII = −0·005; CIX = −0·0035) and an increase for IF (SII = 0·022; CIX = 0·01). Conclusions: The inequality in BF and IF remained over time. However, inequality in IF < 6 has decreased because low-income infants have increased use and high-income infants have decreased.

Confinement risks and social inequality in Latin America: Evidence from Argentina

2021 ◽  
pp. 001139212199001
Author(s):  
Fiorella Mancini
Keyword(s):  
Latin America ◽  
Social Inequality ◽  
Social Inequalities ◽  
Well Being ◽  
Vulnerable Groups ◽  
Cultural Aspects ◽  
Sociological Approach ◽  
Using Data ◽  
The Relationship ◽  
Health And Well Being

Social distancing and isolation measures in response to COVID-19 have confined individuals to their homes and produced unexpected side-effects and secondary risks. In Latin America, the measures taken by individual governments to mitigate these new daily and experiential risks have varied significantly as have the responses to social isolation in each country. Given these new social circumstances, the purpose of this article is to investigate, from the sociological approach of risk-taking, the relationship between confinement, secondary risks and social inequality. The author argues that secondary risks, despite their broad scope, are deeply structured by social inequalities in contemporary societies, especially in developing countries. To corroborate this hypothesis, a quantitative comparative analysis is performed for the Argentine case. Using data from a web-survey and correspondence analysis (CA), there are three major findings: (1) there are some widespread experiences similarly distributed across all social strata, especially those related to emotional and subjective matters; (2) other risks follow socio-structural inequalities, especially those corresponding to material and cultural aspects of consumption; (3) for specific vulnerable groups, compulsory confinement causes great dilemmas of decision-making between health and well-being.

scholarly journals Levelling up: Global examples of reducing health inequalities

2021 ◽  
pp. 140349482110224
Author(s):  
Clare Bambra
Keyword(s):  
Civil Rights ◽  
Health Inequalities ◽  
Health Care Access ◽  
Economic Status ◽  
Population Level ◽  
Welfare States ◽  
State Expansion ◽  
Care Access ◽  
The Social ◽  
The 1950S

There are significant inequalities in health by socio-economic status, race/ethnicity, gender, neighbourhood deprivation and other axes of social inequality. Reducing these health inequalities and improving health equity is arguably the ‘holy grail’ of public health. This article engages with this quest by presenting and analysing historical examples of when sizeable population-level reductions in health inequalities have been achieved. Five global examples are presented ranging from the 1950s to the 2000s: the Nordic social democratic welfare states from the 1950s to the 1970s; the Civil Rights Acts and War on Poverty in 1960s USA; democratisation in Brazil in the 1980s; German reunification in the 1990s; and the English health inequalities strategy in the 2000s. Welfare state expansion, improved health care access, and enhanced political incorporation are identified as three commonly held ‘levellers’ whereby health inequalities can be reduced – at scale. The article concludes by arguing that ‘levelling up’ population health through reducing health inequalities requires the long-term enactment of macro-level policies that aggressively target the social determinants of health.

scholarly journals Emergence of cultural intelligence and global mindset capital: a multilevel model

2016 ◽  
Vol 24 (2) ◽  
pp. 106-122 ◽  
Author(s):  
Jase R. Ramsey ◽  
Amine Abi Aad ◽  
Chuandi Jiang ◽  
Livia Barakat ◽  
Virginia Drummond
Keyword(s):  
Multilevel Model ◽  
Cultural Intelligence ◽  
The Other ◽  
Global Mindset ◽  
Firm Level ◽  
Content Type ◽  
Individual Level ◽  
Other Hand ◽  
Underlying Mechanisms ◽  
Conceptual Study

Purpose The purpose of this paper is to establish under which conditions researchers should use the constructs cultural intelligence (CQ) and global mindset (GM). The authors further seek to understand the process through which these constructs emerge to a higher level and link unit-level knowledge, skills and abilities (KSAs) capital to pertinent firm-level outcomes. Design/methodology/approach This paper is a conceptual study with a multilevel model. Findings This paper differentiates two similar lines of research occurring concordantly on the CQ and GM constructs. Next, the authors develop a multilevel model to better understand the process through which CQ and GM emerge at higher levels and their underlying mechanisms. Finally, this paper adds meaning to the firm-level KSAs by linking firm-level KSAs capital to pertinent firm-level outcomes. Research limitations/implications The conclusion implies that researchers should use CQ when the context is focused on interpersonal outcomes and GM when focused on strategic outcomes. The multilevel model is a useful tool for scholars to select which rubric to use in future studies that have international managers as the subjects. The authors argue that if the scholar is interested in an individual’s ability to craft policy and implement strategy, then GM may be more parsimonious than CQ. On the other hand, if the focus is on leadership, human resources or any other relationship dependent outcome, then CQ will provide a more robust measure. Practical implications For practitioners, this study provides a useful tool for managers to improve individual-level commitment by selecting and training individuals high in CQ. On the other hand, if the desired outcome is firm-level sales or performance, the focus should be on targeting individuals high in GM. Originality/value This is the first theoretical paper to examine how CQ and GM emerge to the firm level and describe when to use each measure.

Wzbogacona rzeczywistość a nierówności społeczne

2021 ◽  
Vol 66 (2) ◽  
pp. 80-93
Author(s):  
Piotr Nieradka ◽  
Keyword(s):  
Social Inequality ◽  
Digital Divide ◽  
Social Inequalities ◽  
Individual Characteristics ◽  
Advanced Technology ◽  
Original Research ◽  
Augmented Reality Technology ◽  
Digital Gap ◽  
The One ◽  
The Impact

This paper focuses on the technology of extended reality, whereby the aim is to draw attention to selected issues related to technology and solutions in the extended reality area in the context of social inequalities. The first part of the article discusses the essence of extended reality technology, paying attention to its place in the modern economy, along with a description of such solutions. The remainder of the study focuses on the issue of social inequality, with particular emphasis on the impact of extended reality on the problem of the digital gap and digital divide. The article presents the results of original research undertaken on a group of 88 respondents with both CAWI and equipment supporting augmented reality technology, of which 39.36% declared testing with this type of equipment in the past. The article also presents the results of original research with the use of XR equipment. XR-related solutions are currently still perceived as luxury goods, despite both the increasing availability for users and undoubtedly unique advantages. These include realism of generated experiences and the phenomenon of immersion in the synthetic world. The analysis of the role of such solutions in the context of social inequality provides a conclusion about their dichotomous nature. On the one hand, by popularizing the XR technology, the possibility of overcoming barriers and inequalities resulting from individual characteristics or social position is created, which leads to the improvement in the life situations of some people who have been struggling with exclusion so far. On the other hand, it provides the conclusion that such advanced technology entering everyday life has the potential to create another digital divide, which in the long term will result in increasing digital disproportions and exclusion.

NEOLIBERALISM PHILOSOPHY IN LEGAL REGULATION AND HUMAN RIGHTS POLICY AS DIRECTION TO HANDLE WITH SOCIAL INEQUALITY IN COMPANY’S PURPOSE

2017 ◽  
Author(s):  
Maryna Toporkova ◽  
◽  
Olena Fedotova ◽  
Anna Zhukova ◽  
◽  
...  
Keyword(s):  
Soviet Union ◽  
Social Inequality ◽  
Social Inequalities ◽  
Ronald Reagan ◽  
The United States ◽  
Legal Regulation ◽  
Significant Feature ◽  
Government Officials ◽  
Active Involvement ◽  
The United Kingdom

Our research lies in the field of correlation between the companies' development and philosophy of neoliberalism, philosophy that stood behind the policies of Margaret Thatcher in the United Kingdom and Ronald Reagan in the United States. The common significant feature of the above was government spending reduction and, as logically follows, reduction of government active involvement; this led to the policy of privatisation, market deregulation, lesser budgets and reduced numbers of government officials. Any opinion on neoliberalism inevitably depends on one’s ideology, it cannot be purely objective. This is what makes it more controversial and less “scientific”, but also more interesting. This question in itself shows us conflict between two common views: that focus on shareholders’ profit slows companies’ development, and an opposing one, suggesting that it enhances efficiency. There is also a third part of it: connection of neoliberalism to social inequalities. Yet the latter are hardly connected to efficiency and development; these are separate issues. Economy may be strong and fast-developing, yet having a great social inequality (as it often happened in 19th century), it may be based primarily on social policies, and even seem strong, but bear a flaw that would eventually cause its downfall (as proved by Soviet Union), or it may try to focus on both development and society (as many countries try to do now). Every combination has its own strengths and weaknesses; here is when an ideology becomes important, since ideology sets a list of priorities, thus allowing to decide which one is “better”. Although most academic works tend to avoid such decision, it becomes extremely important when a question of governmental policies arise, so it should not be ignored. Another important mental aspect are moral standards of a particular society; should at least those be common, they could have become a ground for standardisation. But, as philosophy of moral relativism suggests, they are not, [6] so current local ideology and practical considerations remain chief reasons to make a choice.

scholarly journals Antimicrobial Resistance and Social Inequalities in Health: Considerations of Justice

2020 ◽  
pp. 257-278
Author(s):  
Lynette Reid
Keyword(s):  
Global Health ◽  
Health Inequalities ◽  
Social Inequalities ◽  
Tertiary Care ◽  
Practical Importance ◽  
Social Inequalities In Health ◽  
Inequalities In Health ◽  
Catching Up ◽  
The Impact

Abstract Within-country social inequalities in health have widened while global health inequalities have (with some exceptions) narrowed since the Second World War. On commonly accepted prioritarian and sufficientist views of justice and health, these two trends together would be acceptable: the wealthiest of the wealthy are pulling ahead, but the worst off are catching up and more are achieving sufficiency. Such commitments to priority or sufficiency are compatible with a common “development” narrative about economic and social changes that accompany changes (“transitions”) in population health. I set out a very simple version of health egalitarianism (without commitment to any particular current theory of justice) and focus on two common objections to egalitarianism. Priority and sufficiency both address the levelling down and formalism objections, but these objections are distinct: giving content to equality (I argue here) places in question the claimed normative superiority of priority and sufficiency. Using examples of the role of antimicrobials in both these trends – and the future role of AMR – I clarify (first) the multiple forms and dimensions of justice at play in health, and (second) the different mechanisms at work in generating the two current patterns (seen in life course narratives and narratives of political economy). The “accelerated transition” that narrowed global health inequalities is fed by anti-microbials (among other technology transfers). It did not accelerate but replaced the causal processes by which current HICs achieved the transition (growing and shared economic prosperity and widening political franchise). The impact of AMR on widening social inequalities in health in HICs will be complex: inequality has been fed in part by tertiary care enabled by antimicrobials; AMR might erode the solidarity underlying universal health systems as the well-off seek to maintain current expectations of curative and rehabilitative surgery and chemotherapy while AMR mounts. In light of both speculations about the impact of AMR on social and global health inequalities, I close with practical and with theoretical reflection. I briefly indicate the practical importance of understanding AMR from the perspective of health justice for policy response. Then, from a broader perspective, I argue that the content by which I meet the formalism objection demonstrates that the two trends (broadening within-country inequality and narrowing global inequality) are selective and biased samples of a centuries-long pattern of widening social inequalities in health. We are not in the midst of a process of “catching up”. In light of the long-term pattern described here, is the pursuit of sufficiency or priority morally superior to the pursuit of equality as a response to concrete suffering – or do they rationalize a process more objectively described as the best-off continuing to take the largest share of one of the most important benefits of economic development?

scholarly journals Social Inequality among the Female Merchants of Ethnic Malay and Chinese

Society ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 1-12
Author(s):  
Eraskaita Ginting ◽  
Yusnaini Yusnaini
Keyword(s):  
Hong Kong ◽  
Social Inequality ◽  
Social Inequalities ◽  
Literature Study ◽  
Chinese Market ◽  
Study Approach ◽  
Advantages And Disadvantages ◽  
The City ◽  
Depth Interviews

People in Jambi city assume that Pasar Hong Kong, a traditional market located in Jelutung sub-district, is “a Chinese market”, even some areas in the city of Jambi such as Jelutung, Koni, and Talang Banjar are dominated by the ethnic of Chinese. This research aims to explore how social inequality that occurs due to the advantages and disadvantages of an ethnic group so that it can affect individual attitudes that damage social capital. This research uses a case study approach with in-depth interviews and literature study as data collection techniques. The subjects of this study were ethnic Malay and Chinese female merchants in Pasar Hong Kong, Jambi city, Indonesia. This research found that social inequalities that occur among the female merchants of ethnic Malay and Chinese in Pasar Hongkong occur naturally, where both merchants and buyers have a high tolerance when interacting. Although sometimes there are differences in attitude when the merchants serve different ethnic buyers. The involvement of traditional leaders in managing social inequalities is very important due to the lack of assimilation among ethnic Malay and Chinese.

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