The psycho-social perspective on social inequalities in health

Abstract

Doubts about the viability of material explanations of social inequalities in health have led to a renewed focus on the aetiological role of psychological stress, and, moreover, on how psychological stress is generated by society's inequality structures. Some researchers maintain that the emerging psychosocial perspective will become the dominant paradigm in research on health inequalities. After commenting on some aetiological topics, the paper outlines how a comprehensive understanding of health inequalities can be constructed from the social stress model, the self-efficacy approach, the sociology of emotions, and the social cohesion approach. The emerging perspective is a striking attempt to deal with health inequalities, as it seems to solve some of the difficulties that other perspectives have had in accounting for existing empirical patterns. Nevertheless, it is perhaps too much to claim that it signifies a paradigm shift. It should rather be considered as an enrichment of the social causation explanation. The latter, when studying health inequalities, should be developed further by considering both material and psycho-social environments, and their mutual interaction.