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Understanding the Micro and Macro Politics of Health

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A Research Agenda by Project HiNEWS

by Anna Gkiouleka

We live in times that austerity, conflict, increased forced migration and socio-political instability fuel traditional and new social struggles. In this climate, health inequalities emerge as the outcome of structural forces and unequal power relations reframing health as a social and political notion. Hence, to understand and tackle health inequalities, we need an integrative theoretical framework which will account for the impact of a range of established social determinants of health beyond socioeconomic position – like gender, race, migration status and sexuality – as well as for the significant role of institutions in the politics of health. We suggest that this is possible by bridging intersectionality as a context informed analytical tool and institutional insights on health inequalities research. This way we can shed new light upon relationships of health inequalities that have remained neglected and on how certain multiply marginalised groups are excluded from health-inequalities discourses. Moreover, we can overcome the dualism between the context and the individual and integrate in our analysis the simultaneous health effects of both vertical (e.g institutional factors) and horizontal (e.g. individual/ community factors) social stratifications. This synthesis can bridge the different streams of health inequalities scholarship (i.e. socioeconomic, gender, racial inequalities etc.) that seem to have developed independently from each other. Moreover, it fuels a new research agenda that interrogates the mechanisms that reproduce health inequality instead of individual attributes, generates a series of urgent research questions and challenges us to stretch our limits across all the phases of the research process.

To read the full article by Anna Gkiouleka, Tim Huijts, Jason Beckfield and Clare Bambra, go to doi.org/10.1016/j.socscimed.2018.01.025.