Book review: A medical sociology perspective
โ Scribed by Stephen Platt
- Publisher
- John Wiley and Sons
- Year
- 1998
- Tongue
- English
- Weight
- 90 KB
- Volume
- 8
- Category
- Article
- ISSN
- 1052-9284
No coin nor oath required. For personal study only.
โฆ Synopsis
diculties with which domestic life has to cope and cannot be separated from a range of what are seen as family problems. It is not just that worries about money, jobs and housing spill over into domestic conยฏict . . .It is also that lack of money, of choices, play space, the need for enough indoor space to accommodate incompatible family activitiesรin short the lack of resources of all kinds (including time)รmeans that people's needs and demands are brought into conยฏict with each other . . . (p. 163).
It's hard to see from this and several similar passages why there is any need to oppose material' to psychosocial' or subjective'. We are biological entities, our experience is embodied, and our social environment is structured by power. Certainly, as the evidence cited by Wilkinson shows, it is not lack of money per se which results in distress, illness and higher mortality rates, but the powerlessness which relative inequality of income creates. But power is through-and-through material: it matters not to your sense of' security, but to your security full stop.
Absolutely rightly, Wilkinson makes much of the importance for health and happiness of social cohesion, but here again one must be careful not to cast this as an immaterial `sense of' cohesion. The public world constitutes a kind of exoskeleton of power which, near enough literally, we need to hold ourselves together as individuals (I tried to elaborate this notion in my book, The Origins of UnhappinessรSmail, 1993). The unbridled market economy attacks and erodes the social institutions which provide us with the possibility of social solidarity (virtually the only form of power available to the economically deprived). This again is a thoroughly material matter, its remedies to be sought in equally material measures.
Those material measures are not going to be achieved easily, and there is an implicit optimism about Wilkinson's book which one fears may prove displaced. I have my doubts that any government imaginable at the present time will set the public policies in place which the understanding of income inequality would seem to any rational and well-intentioned mind to indicate. Indeed, I am reminded yet again of the sobering words of Fernand Braudel that however much we may dream `of a society from which inequality would have disappeared, where one man would not exploit another': . . . no society in the world has yet given up tradition and the use of privilege. If this is ever to be achieved, all the social hierarchies will have to be overthrown, not merely those of money or state power, not only social privilege but the uneven weight of the past and of culture (Braudel, 1985, p. 628).
Those who seek greater equality have a battle on their hands. Richard Wilkinson has provided us with a valuable weapon. Community clinical psychologists, among others, should make the best use of it they can.
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