European Sociological Review 11:219-241 1995
© 1995 Oxford University Press
research-article |
Explaining Health Inequalities: Beyond Black and Barker
A Discussion of some Issues Emerging in the Decade Following the Black Report
Swedish Institute for Social Research, Stockholm University S–191, Stockholm, Sweden
School of Social Sciences University of Bath, Claverton Down, Bath
Why does social class continue to exercise so important an influence on health? We examine the explanatory framework provided by the Black Report on ‘Inequalities in Health’. We also examine a new medical theory, praised as representing a paradigmatic shift in medicine, developed by the British epidemiologist David Barker. The answers given by Black and Barker to the above question are related. And both are riddled with problems.
The typology of four explanations introduced by Black reveals a number of unspoken sociological assumptions. The typology is sometimes obscuring, sometimes not helpful. The favoured explanation is also ambiguous, particularly since there is no clear idea about how poverty is translated into disease in modern society. Barker's theory that disease results from poverty-driven ‘biological programming’ in foetus, or in infancy, moves the focus of explanation back to the social conditions that existed when the generations now living were born. The link between childhood conditions and adult health, however, need not be biological in character. We suggest an alternative interpretation based on studying health inequalities across the life cycle and in their historical context. Co-evolution of health and social achievement could provide an explanation beyond those of Black and Barker.
Manuscript received: February 1, 1994.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  Y Almquist Peer status in school and adult disease risk: a 30-year follow-up study of disease-specific morbidity in a Stockholm cohort J Epidemiol Community Health, December 1, 2009; 63(12): 1028 - 1034. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Hemmingsson and I. Lundberg Can large relative mortality differences between socio-economic groups among Swedish men be explained by risk indicator-associated social mobility? Eur J Public Health, October 1, 2005; 15(5): 518 - 522. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. R. Pedersen, B. E. Holstein, and L. Kohler Parents' labour market participation as predictor of children's well-being: changes from 1984 to 1996 in the Nordic countries Eur J Public Health, August 1, 2005; 15(4): 431 - 436. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Arntzen and A. M. N. Andersen Social determinants for infant mortality in the Nordic countries, 1980 - 2001 Scand J Public Health, October 1, 2004; 32(5): 381 - 389. [Abstract] [PDF]
|
|
|
|
 |
|
 J. I. Elstad Health and Status Attainment: Effects of Health on Occupational Achievement among Employed Norwegian Men Acta Sociologica, June 1, 2004; 47(2): 127 - 140. [Abstract] [PDF]
|
|
|
|
|
|
G. Bostrom and M. Rosen Measuring social inequalities in health - politics or science? Scand J Public Health, May 1, 2003; 31(3): 211 - 215. [Abstract] [PDF]
|
|
|
|
|
|
P Carlson Risk behaviours and self rated health in Russia 1998 J Epidemiol Community Health, November 1, 2001; 55(11): 806 - 817. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Ringback-Weitoft Chapter 9. Social Differences, Vulnerability and Ill-health Scand J Public Health, September 1, 2001; 29(58_suppl): 199 - 218. [PDF]
|
|
|
|
|
|
O. Backman and J. Palme Social Background and Sickness Absence: A Study of a Stockholm Cohort Acta Sociologica, January 1, 1998; 41(4): 349 - 362. [Abstract] [PDF]
|
|
|
|
 |
|
 Bibliography Current Sociology, January 1, 1998; 46(1): 128 - 144.
|
|