Social Inequalities in Health. New Evidence and Policy Implications. J Siegrist and M Marmot (eds).

Abstract

Some of this is actually covered in the introductory chapter. However, the discussion there is partly formed as a critique of the Black report, which is to kick in doors already open. Also, the editors tend to be advocates for the psychosocial approach to understanding health inequalities, which they feel has been neglected ‘… at the expense of an overly favoured material explanation’ (p. 7). While the debate between psycho-social and neo-material views has been central in the scientific discussion around health inequalities for some time, I believe that a continuation of this debate is fairly counterproductive. Rather, there is much to gain from a more integrative approach1. This is also recognized by Siegrist and Marmot when they argue that the social gradient in poor health is likely to be the result of psychosocial factors in interaction with material conditions (p. 6). Therefore, an exclusive emphasis on psychosocial phenomena might be as problematic as an exclusive emphasis on physical life circumstances, and here the book in a sense represents a missed opportunity to advance our understanding of the interplay between the psychosocial and material sides of the coin. Probably this is the unfortunate consequence of this book being a result of a research programme being conceived and launched in the late 1990s when this debate was heated.