Individualism as Habitus: Reframing the Relationship between Income Inequality and Health

D. Adjaye-Gbewonyo


Public health literature has demonstrated a negative effect of income inequality on a number of health outcomes. Researchers have attempted to explain this phenomenon, drawing on psychosocial and neo-materialist explanations. This paper argues, however, that these approaches fail to recognize the crucial role of culture, focusing specifically on the cultural value of individualism. Through a review of the literature and Pierre Bourdieu’s theory of practice as a theoretical framework, I provide support for the proposition that an ideology based in individualism is the context within which income inequality, social fragmentation, material deprivation, and consequently poor health outcomes are produced. I further offer recommendations for continued research into the role of cultural determinants in the income inequality-health relationship.


culture, Bourdieu, income distribution, public health

Full Text:



Allik, J., & Realo, A. (2004). Individualism-collectivism and social capital. Journal of Cross-Cultural Psychology, 35(1), 29-49.

Babones, S. J. (2008). Income inequality and population health: Correlation and causality. Social Science & Medicine, 66(7), 1614-1626. doi:10.1016/j.socscimed.2007.12.012

Bourdieu, P. (1986). The Forms of Capital. In J. Richardson (Ed.), Handbook of Theory and Research for the Sociology of Education (pp. 241-258). New York: Greenwood Press.

Bourdieu, P. (1990). Structures, Habitus, Practices. In P. Bourdieu (Ed.), The Logic of Practice. Standford, CA: Stanford University Press.

Coburn, D. (2000). Income inequality, social cohesion and the health status of populations: the role of neo-liberalism. Social Science & Medicine, 51(1), 135-146.

Coburn, D. (2004). Beyond the income inequality hypothesis: class, neo-liberalism, and health inequalities. Social Science & Medicine, 58(1), 41-56.

De Maio, F. (2012). Advancing the income inequality–health hypothesis. Critical Public Health, 22(1), 39-46.

Eckersley, R. (2006). Is modern Western culture a health hazard? International Journal of Epidemiology, 35(2), 252-258. doi:10.1093/ije/dyi235

Fiske, A. P. (2002). Using individualism and collectivism to compare cultures--a critique of the validity and measurement of the constructs: comment on Oyserman et al. (2002). Psychologial Bulletin, 128(1), 78-88.

Glass, T. A. (2006). Commentary: culture in epidemiology--the 800 pound gorilla? International Journal of Epidemiology, 35(2), 259-261; discussion 263-255. doi:10.1093/ije/dyi237

Hofstede, G., Hofstede, G. J., & Minkov, M. (2010). Cultures and Organizations: Software of the Mind, Third Edition: McGraw-Hill Education.

Kawachi, I., & Kennedy, B. P. (1999). Income inequality and health: pathways and mechanisms. Health Services Research, 34(1 Pt 2), 215-227.

Kawachi, I., Kennedy, B. P., Lochner, K., & Prothrow-Stith, D. (1997). Social capital, income inequality, and mortality. American Journal of Public Health, 87(9), 1491-1498.

LaCapra, D. (1988). Culture and Ideology: From Geertz to Marx. Poetics Today, 9(2), 377-394. doi:10.2307/1772695

Lochner, K., Kawachi, I., & Kennedy, B. P. (1999). Social capital: a guide to its measurement. Health & Place, 5(4), 259-270. doi:10.1016/S1353-8292(99)00016-7

Lynch, J. (2000). Income inequality and health: expanding the debate. Social Science & Medicine, 51(7), 1001-1005. doi:10.1016/S0277-9536(00)00080-0

Lynch, J. W., Smith, G. D., Kaplan, G. A., & House, J. S. (2000). Income inequality and mortality: importance to health of individual income, psychosocial environment, or material conditions. BMJ, 320(7243), 1200-1204.

Mansyur, C., Amick, B. C., Harrist, R. B., & Franzini, L. (2008). Social capital, income inequality, and self-rated health in 45 countries. Social Science & Medicine, 66(1), 43-56. doi:10.1016/j.socscimed.2007.08.015

Mansyur, C. L., Amick, B. C., 3rd, Harrist, R. B., Franzini, L., & Roberts, R. E. (2009). The cultural production of health inequalities: a cross-sectional, multilevel examination of 52 countries. International Journal of Health Services, 39(2), 301-319.

Mansyur, C. L., Amick, B. C., Franzini, L., & Roberts, R. E. (2009). Culture and the social context of health inequalities. International Journal of Health Services, 39(1), 85-106.

Muntaner, C., & Lynch, J. (1999). Income inequality, social cohesion, and class relations: a critique of Wilkinson's neo-Durkheimian research program. International Journal of Health Services, 29, 59-82.

Muntaner, C., Lynch, J., & Oates, G. L. (1999). The social class determinants of income inequality and social cohesion. International Journal of Health Services, 29(4), 699-732.

Muntaner, C., Lynch, J., & Smith, G. D. (2001). Social capital, disorganized communities, and the third way: understanding the retreat from structural inequalities in epidemiology and public health. International Journal of Health Services, 31(2), 213-237.

Pickett, K. E., & Wilkinson, R. G. (2015). Income inequality and health: a causal review. Social Science & Medicine, 128, 316-326.

Realo, A., & Allik, J. (2009). On the Relationship between Social Capital and Individualism–Collectivism. Social and Personality Psychology Compass, 3(6), 871-886.

Realo, A., Allik, J., & Greenfield, B. (2008). Radius of trust Social capital in relation to familism and institutional collectivism. Journal of Cross-Cultural Psychology, 39(4), 447-462.

Realo, A., & Beilmann, M. (2012). Individualism-collectivism and social capital at the individual level. Trames(3), 205-217.

Schimmack, U., Oishi, S., & Diener, E. (2005). Individualism: a valid and important dimension of cultural differences between nations. Personality and Social Psychology Review, 9(1), 17-31. doi:10.1207/s15327957pspr0901_2

Schwarzbach, M., Luppa, M., Forstmeier, S., König, H. H., & Riedel‐Heller, S. G. (2014). Social relations and depression in late life—a systematic review. International Journal of Geriatric Psychiatry, 29(1), 1-21. doi:10.1002/gps.3971

Singelis, T. M., Triandis, H. C., Bhawuk, D. P., & Gelfand, M. J. (1995). Horizontal and vertical dimensions of individualism and collectivism: A theoretical and measurement refinement. Cross-Cultural Research, 29(3), 240-275.

Singh-Manoux, A., & Marmot, M. (2005). Role of socialization in explaining social inequalities in health. Social Science & Medicine, 60(9), 2129-2133. doi:10.1016/j.socscimed.2004.08.070

Triandis, H. C., Bontempo, R., Villareal, M. J., Asai, M., & Lucca, N. (1988). Individualism and collectivism: Cross-cultural perspectives on self-ingroup relationships. Journal of Personality and Social Psychology, 54(2), 323.

Wilkinson, R. G. (1999a). Income inequality, social cohesion, and health: clarifying the theory--a reply to Muntaner and Lynch. International Journal of Health Services, 29(3), 525-543.

Wilkinson, R. G. (1999b). Two pathways, but how much do they diverge? BMJ, 319(7215), 956-957.

Wilkinson, R. G. (2000). Deeper than "neoliberalism". A reply to David Coburn. Social Science & Medicine, 51(7), 997-1000; discussion 1009-1010.

Wilkinson, R. G., & Pickett, K. E. (2006). Income inequality and population health: a review and explanation of the evidence. Social Science & Medicine, 62(7), 1768-1784. doi:10.1016/j.socscimed.2005.08.036

Wilkinson, R. G., & Pickett, K. E. (2009). Income inequality and social dysfunction. Annual Review of Sociology, 35, 493-511.



  • There are currently no refbacks.