Department of Geography, Wolfson Research Institute, Queen's Campus, Durham University, Stockton on Tees TS17 6BH, UK.
J Epidemiol Community Health. 2011 Sep;65(9):746-50. doi: 10.1136/jech.2009.102103. Epub 2011 Jan 30.
This essay argues that work, and the socioeconomic class polarities it creates, plays a fundamental role in determining inequalities in the distribution of morbidity and mortality. This is by means of uneven exposure to physical hazards and psychosocial risks in the workplace, as well as by inequalities in exclusion from the labour market and the absence of paid work. Furthermore, this essay shows that the relationships between work, worklessness and health inequalities are influenced by the broader political and economic context in the form of welfare state regimes. This leads to the development of a model of the political economy of health inequalities, and how different types of public policy interventions can mitigate these relationships. This model is then applied to the case of work and worklessness. The essay concludes by arguing that politics matters in the aetiology of health inequalities.
这篇文章认为,工作以及工作带来的社会经济阶层差异在很大程度上决定了发病率和死亡率分布的不平等。其影响途径包括工作场所中物理危害和社会心理风险的不均衡暴露,以及被劳动力市场排斥和没有有酬工作导致的不平等。此外,本文还表明,工作、失业与健康不平等之间的关系受到福利国家体制等更广泛政治经济环境的影响。这就形成了健康不平等的政治经济学模型,以及不同类型的公共政策干预如何缓解这些关系。然后,该模型被应用于工作和失业的案例。本文最后得出结论,政治在健康不平等的病因学中具有重要作用。