Page 158 - The ISA Handbook in Contemporary Sociology

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HEALTH SOCIOLOGY 129

The Foucauldian view of power contrasts mechanisms, was again perceived as crucial
with realist approaches, including neo-Marxist for the maintenance of health. The social-
and neo-Weberian approaches as well as the network thesis has captured a variety of the-
work of many feminists, all of which make it oretical concerns about the relationship
clear that power and status are possessed between social integration or social cohesion
and exercised by individuals or groups, and health. A renaissance of the Durkheimian
sometimes to consciously repressive ends. argument of the importance of social integra-
However, the ‘competition theme’ within the tion in understanding social behaviour has
sociology of health is concealed in the typi- been promoted in Lisa Berkman’s work,
cally neo-Weberian conceptualizations of where the concepts of social networks and
society that underlie most social epidemio- psychosocial environment have drawn atten-
logical research on health inequalities tion to relationships between the individual
(e.g., Mackenbach et al., 1999). The concep- and the primary group, measured by a person’s
tualization of social groups by means of their integration into social networks (Berkman,
socio-economic characteristics, transformed 1984; Berkman et al., 2000).
into background variables, reflects the In the 1990s, the same theme of social
Weberian status categorization of the distri- integration, consensus, and cooperation was
bution of economic and social resources in developed further, but with a focus on com-
society. As Shim (2002) relates, this distils munity or place, especially in terms of sense
the effects of social and relational ideologies, of trust and social cohesion, and social sup-
structures, and practices port as an explanation for social differences
in health. This community-level analysis has
into characteristics of discrete and self-contained
individuals. Disciplinary paradigms and practices developed into the so-called social-capital
effectively deny that historical changes in social theory of health. Communitarian researchers
policies, ideologies and prevailing meanings of dif- see the restoration of a sense of community
ference ‘get under the skin’ and fundamentally and voluntary organizations as the social
affect well-being. Epidemiology thereby renders
invisible the very social relations of power structur- capital that will improve both individual and
ing material and psychic conditions and life social health. Others, who profess libertarian
chances that contribute to the stratification of views, give social capital a more market-
health (Shim, 2002: 134) oriented meaning. They perceive the restora-
This is reflected in studies of gender and tion of trust as the necessary normative and
health inequalities where European research social infrastructure for both the workings of
has tended to use neo-materialist and society and the market. In the more conserva-
Weberian approaches to measure the rela- tive political climate of today, terms like trust
tionship between social factors and ill health. and social capital have become a way of ana-
The North American tradition has continued lyzing the ‘health’ of society (Lemke, 2001;
to be based on a role theory of health (e.g., Navarro, 2002).
Rosenfield, 1992; Waldron et al., 1998), The turn to psychosocial theorizing seems
which has its origins in the Parsonian sex- to be a particular European trend of the late
role theory (Annandale and Hunt, 2000). 1990s onwards. For example, a Special Issue
examining health inequalities as a product of
the psychosocial environment was published
The revitalization of the theme of by Social Science & Medicine in 2004
social integration as a prerequisite (Marmot and Siegrist, 2004). Furthermore,
British researchers Richard Wilkinson
for health
(1996, 2005) and Michael Marmot (2005)
The theme of cooperation was revitalized in have argued that there is a psychosocial link
the mid-1980s, when social cohesion, meas- to health through the influence of social
ured by social networks and psychosocial inequality on social relationships. It is