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Among the developed countries it is not the richest societies which have the best health, but those which have the smallest income differences between rich and poor. Inequality and relative poverty have absolute effects: they increase death rates. But why? How can smaller income differences raise average life expectancy? Using examples from the USA, Britain, Japan and Eastern Europe, and bringing together evidence from the social and medical sciences, Unhealthy Socities provides the explanation. Healthy, egalitarian societies are more socially cohesive. They have a stronger community life and suffer fewer of the corrosive effects of inequality. As well as inequality weakening the social fabric, damaging health and increasing crime rates, Unhealthy Societies shows that social cohesion is crucial to the quality of life. The contrast between the material success and social failure of modern societies marks an imbalance which needs attention. The relationship between health and equality suggests that important social needs will go unmet without a larger measure of social and distributive justice. This path-breaking book is essential reading for health psychologists, sociologists, welfare economists, social policy analysts and all those concerned with the future of developed societies.
Among the developed countries it is not the richest societies which
have the best health, but those which have the smallest income
differences between rich and poor. Inequality and relative poverty
have absolute effects: they increase death rates. But why? How can
smaller income differences raise average life expectancy?
Using examples from the USA, Britain, Japan and Eastern Europe, and
bringing together evidence from the social and medical sciences,
"Unhealthy Socities" provides the explanation. Healthy, egalitarian
societies are more socially cohesive. They have a stronger
community life and suffer fewer of the corrosive effects of
inequality. As well as inequality weakening the social fabric,
damaging health and increasing crime rates, "Unhealthy Societies"
shows that social cohesion is crucial to the quality of life.
The contrast between the material success and social failure of
modern societies marks an imbalance which needs attention. The
relationship between health and equality suggests that important
social needs will go unmet without a larger measure of social and
distributive justice. This path-breaking book is essential reading
for health psychologists, sociologists, welfare economists, social
policy analysts and all those concerned with the future of
developed societies.
Originally published in 1986, this book discusses issues such as
social class differences in health; the effect of unemployment on
health; the relationship between income and health; how much of the
class differences in death rates can be explained in terms of
medically recognized factors. Presenting empirical research to
resolve these issues, the book takes health to the centre of the
political stage and raises fundamental issues about the direction
of modern economic and social development and its impact on
inequality. As relevant now as when it was first published the book
reviews twenty of the most important longitudinal studies in the
area of health and class that had been carried out in the UK at the
time.
In this book, pioneering social epidemiologist Richard Wilkinson,
shows how inequality affects social relations and well-being. In
wealthy countries, health is not simply a matter of material
circumstances and access to health care; it is also how your
relationships and social standing make you feel about life. Using
detailed evidence from rich market democracies, the book addresses
people's experience of inequality and presents a radical theory of
the psychosocial impact of class stratification. The book
demonstrates how poor health, high rates of violence and low levels
of social capital all reflect the stresses of inequality and
explains the pervasive sense that, despite material success, our
societies are sometimes social failures. What emerges is a new
conception of what it means to say that we are social beings and of
how the social structure penetrates our personal lives and
relationships.
Eswar ein besonderes Privileg fur mieh, in denvergangenen zwanzig
ahren tiber die bestimmenden sozialen und wirtsehaftliehen Fakto
ren im Gesundheitswesen arbeiten zu durfen, Angefangen hat alles
mit einem Zeitungsartikel, den ieh 1976 naeh Beendigung meiner
Magisterarbeit in Form eines offenen Briefes an den damaligen Mi
nister fur Gesundheit und Soziales David Ennals in der Labour-Re
gierungvon Callaghanrichtete. ' Mitdem Hinweis, dass er alsLabour
Minister die damalsbekannten groBten sozialen Klassenuntersehiede
in Bezugaufdie Sterbliehkeitverwalte, forderte ieh ihn auf,
eine"dring liehe Anfrage" einzubringen. Drei Monate spater, naeh
Lekture mei nes Artikels, kundigte er
dieEinsetzungeinerArbeitsgruppe des Mi nisteriums unter dem Vorsitz
von Sir Douglas Black an. Drei Jahre spater brachte diese den
Black-Report mit dem Titel "Inequalitiesin Health "heraus und
lautete damit eine neueArazur Erforschungder sozialen Ursachen von
Gesundheit und Krankheit in der entwickel ten Welt ein. Sir Douglas
Black, ChiefMedical Officer (Anm. d. Obs.: hochster medizinischer
Beamter) in David Ennals Ministerium, be sehrieb seinen Minister-
mit fur ihn charakteristischenWorten - als "einen Menschen, der
versuchte, Gutes zu tun, und alles in allem Erfolg hatte," Die
durch diesen Bericht angeregte Forschung verandert seitdem standig
das Bild, das wir uns von der Gesellschaft wie auch von der
Gesundheit machen. Nach einer Anfangsphase, in der es urn Fragen
derGlaubwiirdigkeitdergrundlegenden Zahlen ging, mutetederwis
senschaftlicheFortschrittwie ein langer, schwierigerAufstieg an,
nun eroffnetsich unsjedochder erste Blickaufdie vorunsliegende Land
schaft. Waswirjetztsehenkonnen, istdazubestimmt, die Sozial- und
Wirtschaftspolitik- unddamithoffentlichauch die Richtungder so-
Vorwort XXII zialen Entwicklung moderner Gesellschaften - zu
verandern."
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