What makes people healthy or ill? Individual health is surely shaped by individual decisions regarding lifestyle or use of healthcare. However, the systematic social inequalities in health are large and persist over time. People's social position plays a fundamental role in shaping their health. The characteristics of the society as a whole are likely important too. This course offers an introduction to the health consequences of people’s social position and social circumstances.
This 3-part course introduces students to selected topics in health sociology.
The first part discusses key notions of health sociology and the role of social factors in the historical development of population health.
In the second part, we tackle the topic of individual factors associated with health inequalities. We begin by reviewing the role of socioeconomic status and education and discuss the empirical patterns in light of the selection vs. social causation hypothesis. Subsequently, we address the role of gender, work, and migration in creating and sustaining health differences.
In the third part, the course shifts the focus to the macro determinants of health. We begin by reviewing the discussion on income inequalities and health and address the role of gender inequality. To address the underlying mechanisms, we look at the role of perceived (vs. objective) inequality. Subsequently, we discuss the role of social capital, and the role played by policies.
Requirements:
Students are required to attend all classes (two absences will be excused). Credits will be granted for active participation, an oral presentation, and a paper on one of the themes of the seminar.
Active participation. I expect you to attend the class regularly, read the indicated article, prepare questions and comments on the article for the discussion, and contribute to the discussion. All texts will be provided to participants through the student portal ILIAS.
In oral presentations, participants present key aspects of selected articles. Presentations (PowerPoint or similar) should last about 20 minutes, present the summary of the paper and finish with reflections or questions about the paper. Presentations should be submitted to the instructor at least four days before the presentation. Participants may apply for a presentation by writing to the instructor. Please give your first, second and third priority. Themes will be allocated to participants in order of application (first come-first served).
Final papers should discuss relevant literature on a selected topic and usually focus on the same or similar aspect as the presentation. Papers should be about 4,000–4,500 words long (excluding tables and figures) and should be delivered to the instructor in electronic form (preferably as pdf-document) no later than June 12, 2023.
Dates and Themes:
PART 1: INTRODUCTION
1
Feb 15
Overview and organization of the course
Everybody reads:
Bowling, Ann. (1997). Research Methods in Health. Investigating Health and Health Services. Buckingham: Open University Press. (CHAPTER 2)
2
Feb 22
Historical development in population health
Everybody reads & presentation:
Harper, Kristin and George Armelagos, 2010: The Changing Disease-Scape in the Third Epidemiological Transition. International Journal of Environmental Research and Public Health 7: 675–697.
Additional reading:
McKinlay, John B. and Sonja M. McKinlay, 1977: The Questionable Contribution of Medical Measures to the Decline of Mortality in the United States in the Twentieth Century. The Milbank Memorial Fund Quarterly. Health and Society 55: 405–428.
PART 2: INDIVIDUAL CHARACTERISTICS AND HEALTH
3
March 1
Socioeconomic inequalities in health: selection vs. causation
Everybody reads & presentation:
Hu, Y., van Lenthe, F. J., Borsboom, G. J., Looman, C. W., Bopp, M., Burström, B., ... & Mackenbach, J. P. (2016). Trends in socioeconomic inequalities in self-assessed health in 17 European countries between 1990 and 2010. J Epidemiol Community Health, 70(7), 644–652.
Additional readings:
Kröger, H., Pakpahan, E., & Hoffmann, R. (2015). What causes health inequality? A systematic review on the relative importance of social causation and health selection. European Journal of Public Health, 25(6), 951–960.
Sapolsky, R. M. (2004). Social status and health in humans and other animals. Annual review of anthropology, 393–418.
4
March 8
Socioeconomic inequalities in health 2
Everybody reads:
Ross, C. E., & Mirowsky, J. (2010). Why education is the key to socioeconomic differentials in health. In Handbook of medical sociology, 6, 33–51.
Presentation and additional reading:
Clouston, S. A. P., Natale, G., & Link, B. G. (2021). Socioeconomic inequalities in the spread of coronavirus-19 in the United States: A examination of the emergence of social inequalities. Social Science & Medicine, 268, 113554. doi:10.1016/j.socscimed.2020.113554
Schmitz, A. L., & Pförtner, T. K. (2018). Health inequalities in old age: the relative contribution of material, behavioral and psychosocial factors in a German sample. Journal of Public Health, 40(3), e235-e243.
5
March 15
Gender and health
Everybody reads and presentation:
McDonough, P., & Walters, V. (2001). Gender and health: reassessing patterns and explanations. Social science & medicine, 52(4), 547–559.
Additional readings:
Rieker Patricia, P., Bird, C. E., & Lang, M. E. (2010). Understanding Gender and Health: Old Patterns, New Trends, and Future Directions. In Handbook of medical sociology, 6, 52–74.
Heise, L., Greene, M. E., Opper, N., Stavropoulou, M., Harper, C., Nascimento, M., ... & Gupta, G. R. (2019). Gender inequality and restrictive gender norms: framing the challenges to health. The Lancet, 393(10189), 2440-2454.
6
March 22
Work and health
Everybody reads and presentation:
Rietveld, C. A., van Kippersluis, H., & Thurik, A. R. (2015). Self‐employment and health: Barriers or benefits?. Health economics, 24(10), 1302-1313.
Borgmann, L. S., Kroll, L. E., Müters, S., Rattay, P., & Lampert, T. (2019). Work-family conflict, self-reported general health and work-family reconciliation policies in Europe: Results from the European Working Conditions Survey 2015. SSM-population health, 9, 100465.
Additional reading:
Benach, J., Vives, A., Amable, M., Vanroelen, C., Tarafa, G., & Muntaner, C. (2014). Precarious employment: understanding an emerging social determinant of health. Annual Review of Public Health, 35, 229–253.
7
March 29
Migration and race
Everybody reads and presentation:
Malmusi, D. (2015). Immigrants’ health and health inequality by type of integration policies in European countries. The European Journal of Public Health, 25(2), 293–299.
Additional readings:
Brzoska, P., Voigtländer, S., Spallek, J., & Razum, O. (2010). Utilization and effectiveness of medical rehabilitation in foreign nationals residing in Germany. European journal of epidemiology, 25(9), 651–660.
Phelan, J. C., & Link, B. G. (2015). Is racism a fundamental cause of inequalities in health? Annual Review of Sociology, 41, 311–330.
April 5
Easter Break
April 12
Easter Break
PART 3: COUTRY-LEVEL FACTORS AND HEALTH
8
April 19
Income inequality and health 1
Everybody reads:
Wilkinson, R., & Pickett, K. (2011). The spirit level: Why greater equality makes societies stronger. Bloomsbury Publishing USA. (Chapter 3. How inequality gets under the skin.)
Presentation:
Matthew, P., & Brodersen, D. M. (2018). Income inequality and health outcomes in the United States: An empirical analysis. The Social Science Journal, 55(4), 432–442.
Additional reading:
Pickett, K. E., & Wilkinson, R. G. (2015). Income inequality and health: a causal review. Social science & medicine, 128, 316–326.
9
April 26
Income inequality and health 2
Everybody reads and presentation:
Beckfield, J. (2004). Does income inequality harm health New cross-national evidence. Journal of Health and Social Behavior, 45(3), 231–248.
Additional reading:
Truesdale, B. C., & Jencks, C. (2016). The health effects of income inequality: averages and disparities. Annual Review of Public Health, 37, 413–430.
10
May 3
Gender inequality and health
Everybody reads and presentation:
Homan, P. (2017). Political gender inequality and infant mortality in the United States, 1990–2012. Social Science & Medicine, 182, 127–135.
Additional reading:
King, T. L., Kavanagh, A., Scovelle, A. J., & Milner, A. (2020). Associations between gender equality and health: a systematic review. Health promotion international, 35(1), 27–41.
11
May 10
Mechanisms: Perceived inequality and health
Everybody reads and presentation:
Gugushvili, A., Reeves, A., & Jarosz, E. (2020). How do perceived changes in inequality affect health?. Health & Place, 62, 102276.
Additional readings:
Schwartz, J. A. (2017). Long-term physical health consequences of perceived inequality: Results from a twin comparison design. Social Science & Medicine, 187, 184–192.
Du, H., & King, R. B. (2022). What predicts perceived economic inequality? The roles of actual inequality, system justification, and fairness considerations. British Journal of Social Psychology, 61(1), 19–36.
12
May 17
Social capital and health
Everybody reads and presentation:
Jen, M. H., Sund, E. R., Johnston, R., & Jones, K. (2010). Trustful societies, trustful individuals, and health: An analysis of self-rated health and social trust using the World Value Survey. Health & place, 16(5), 1022-1029.
Additional readings:
Moore, S., & Kawachi, I. (2017). Twenty years of social capital and health research: a glossary. J Epidemiol Community Health, 71(5), 513–517.
Ehsan, A., Klaas, H. S., Bastianen, A., & Spini, D. (2019). Social capital and health: A systematic review of systematic reviews. SSM-population health, 8, 100425.
Alvarez, E. C., Kawachi, I., & Romani, J. R. (2017). Family social capital and health–a systematic review and redirection. Sociology of health & illness, 39(1), 5–29.
13
May 24
Policies and health
Everybody reads and presentation:
Coburn, D. (2004). Beyond the income inequality hypothesis: class, neo-liberalism, and health inequalities. Social science & medicine, 58(1), 41–56.
Additional readings:
Palència, L., Malmusi, D., De Moortel, D., Artazcoz, L., Backhans, M., Vanroelen, C., & Borrell, C. (2014). The influence of gender equality policies on gender inequalities in health in Europe. Social science & medicine, 117, 25–33.
Bambra, C. (2011). Health inequalities and welfare state regimes: theoretical insights on a public health ‘puzzle’. Journal of Epidemiology & Community Health, 65(9), 740–745.
Bergqvist, K., Yngwe, M. Å., & Lundberg, O. (2013). Understanding the role of welfare state characteristics for health and inequalities–an analytical review. BMC public health, 13(1), 1–20.
14
May 31
Concluding discussion