fragmentation and dislocation and thence to a breakdown in social networks

Fragmentation and dislocation and thence to a

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fragmentation and dislocation, and thence to a breakdown in social networks, mutuality and trust; these, in their turn, jeopardise health and well-being. Social capital is critically diminished. Some commentators hold that prolonged stress due to psychosocial factors results in an increase in ‘allostatic load’: if too many negative changes occur too rapidly, bodily adjustment is compromised, resulting in overload and exhaustion. An inconsiderate manager would be harder to accommodate in a workplace that was overly hot, cold or noisy, or when the individual had been on an inadequate diet. There is prima facie evidence for an association between SECs and allostatic overload. Of course these three subsections do scant justice to the research programmes they purport to represent, but then these are literatures that are exhaustively, one might almost say tediously, reviewed. Nor do they by any means exhaust the range of perspectives on health inequalities either emanating from or addressed by sociologists. If the behavioural, material and psychosocial orientations are mainstream, each with its evidence base, it would be remiss not to mention other, divergent perspectives. One example focuses on what in the Black Report (1980) was called ‘social selection’. Canning and Bowser (2010: 1223) see the socioeconomic gradient in health ‘to be in large part the result of differentials in health, reversing the direction of causality put forward in the Marmot reports’. They advocate direct health interventions, especially in child health, as mechanisms for improving both health and socioeconomic outcomes. Ironically, as we shall see, this emphasis on health interventions in childhood mirrors Marmot’s own recommendations. Another argument is that it is intelligence, or IQ, that strikes as the most impressive independent variable for health inequalities (see for example Batty and Deary 2004). Although more vehicle than theory, life-course approaches to explaining health inequalities call on the temporal dimension and warrant a special mention. The underlying premise is that factors disadvantageous for health and longevity tend both to cluster and to accumulate over time. The phenomenon of clustering comes as no surprise: people residing in low- income households and sub-standard housing are most likely to find themselves in neighbourhoods lacking in social amenities and to be impoverished socially as well as economically (although there are of course exceptions). Childhood emerges in the research literature and in rival paradigms alike as a pivotal time for health, and this is reflected in the later discussion; but childhood is not of course the only life-stage of significance for health. Health inequalities 135 Ó 2011 The Author Sociology of Health & Illness Ó 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd
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In a contribution on life-course influences on health at older ages, Bartley and Blane (2009) develop the themes of clustering and accumulation to address the issue of how the social becomes biological. They cite their own work on the ‘inverse housing law’ to show that
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