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

Authors

  • D. Adjaye-Gbewonyo Johns Hopkins Bloomberg School of Public Health

DOI:

https://doi.org/10.5195/hcs.2017.239

Keywords:

culture, Bourdieu, income distribution, public health

Abstract

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.

Author Biography

D. Adjaye-Gbewonyo, Johns Hopkins Bloomberg School of Public Health

Dzifa Adjaye-Gbewonyo is a recent PhD graduate from the Department of Health, Behavior & Society at the Johns Hopkins Bloomberg School of Public Health. Her research interests are in social and structural determinants of global population health. Her focus specifically encompasses health transitions related to social change processes including globalization, urbanization, and economic development. In her current work, she desires to engage in cross-national and comparative studies to assess differences in health outcomes as they relate to socio-structural factors such as political economy, cultural values, social capital, lifestyle factors, and built environments. Previous publications are as follows:

Adjaye‐Gbewonyo, D., Bednarczyk, R. A., Davis, R. L., & Omer, S. B. (2014). Using the Bayesian Improved Surname Geocoding Method (BISG) to create a working classification of race and ethnicity in a diverse managed care population: a validation study. Health services research, 49(1), 268-283.

Richards, J. L., Hansen, C., Bredfeldt, C., Bednarczyk, R. A., Steinhoff, M. C., Adjaye-Gbewonyo, D., ... & Omer, S. B. (2013). Neonatal outcomes after antenatal influenza immunization during the 2009 H1N1 influenza pandemic: impact on preterm birth, birth weight, and small for gestational age birth. Clinical Infectious Diseases, 56(9), 1216-1222.

van Santen, K. L., Bednarczyk, R. A., Adjaye-Gbewonyo, D., Orenstein, W. A., Davis, R., & Omer, S. B. (2013). Effectiveness of pneumococcal conjugate vaccine in infants by maternal influenza vaccination status. The Pediatric infectious disease journal, 32(11), 1180-1184.

Bednarczyk, R. A., Adjaye-Gbewonyo, D., & Omer, S. B. (2012). Safety of influenza immunization during pregnancy for the fetus and the neonate. American journal of obstetrics and gynecology, 207(3), S38-S46.

Adjaye-Gbewonyo, D., Quaye, E. C., & Wubah, D. A. (2010). The effects of extracts of Piper guineense seed on insect pest damage to cowpea. J Young Investigators, 20(1), 264-256.

References

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.

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Published

2017-12-08

Issue

Perspectives II

Section

Invited Articles

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