West P
MRC Medical Sociology Unit, Glasgow, Scotland.
Soc Sci Med. 1991;32(4):373-84. doi: 10.1016/0277-9536(91)90338-d.
As one of several explanations for class differentials in health, health selection has received remarkably little systematic attention in the inequalities debate. It is widely regarded as having (at best) a very minor role in the production of inequalities, and a theoretical debt to social Darwinism. This paper examines the validity of those assumptions in terms of the evidence which has emerged since the publication of the 'Black Report'. It is suggested that it is too easy to write off health selection as of little or no significance, and that reconceptualising the issue within a specifically sociological perspective owing much to labelling theory offers much greater potential for understanding the processes involved. From this perspective, health selection has many of the features of discrimination of the sort that characterises race and sex.
作为对健康方面阶级差异的几种解释之一，健康选择在不平等问题的辩论中受到的系统关注少得惊人。人们普遍认为它（充其量）在不平等的产生中只起非常次要的作用，并且与社会达尔文主义存在理论关联。本文根据《布莱克报告》发表后出现的证据来审视这些假设的有效性。有人认为，轻易将健康选择视为几乎没有意义或毫无意义是过于草率的，而且从很大程度上归因于标签理论的特定社会学视角重新审视这个问题，对于理解其中涉及的过程具有更大的潜力。从这个角度来看，健康选择具有许多类似种族和性别歧视的特征。
