‘To good health!’ we say when sharing a drink. Sadly, all too often that good health is not shared. Many people do not enjoy the conditions needed to live healthy lives.
Health authorities around the world now recognise the social determinants of health as a major concern. That is an important advance. Recognising a problem, however, and understanding it, are different things. And doing something effective about it is another matter again.
In this book Toni Schoi eld and her colleagues move us towards understanding and action. They give the facts about health and society, mapping the realities of class, gender, ethnicity, indigeneity, the state and health care. The facts are tough. There is grim evidence here about violence, abuse and exclusion; and about the less-dramatic, grinding effects of poverty and stress.
The book does much more. It takes us beyond describing the social dimensions of health to the ‘causes of the causes’ – the social dynamics of health. The chapters consider carefully the major structures of inequality in contemporary societies, explaining how they operate and how they have changed. They place health in the context of economic change, colonisation, migration and changing reproductive practices.
How do social inequalities get under the skin and become health effects? That’s a key question, and in this book we see the multiple answers. They range from socially caused malnutrition, to social pathways of viral infection, to physical injury in the workplace, to genetic damage and environmental pollution. All are bound up in the operations of social power. All have an impact on bodies, but unequally so.