1 JHU-UPF Public Policy Center, Barcelona, Spain.
2 Health Policy and Management BSPH-JHU, Baltimore, MD, USA.
Int J Health Serv. 2019 Apr;49(2):197-203. doi: 10.1177/0020731419832236. Epub 2019 Feb 26.
This article analyzes critically the most recent scientific bibliography on the causes of the growth of mortality and morbidity in the white working class of the United States. The methodology used in these studies, and also the insufficient conceptualization of the variables used (such as social class), limits the understanding of the increment of the "diseases of despair" in that sector of the population. This article emphasizes the need to analyze the evolution of the social classes in the United States, and the political determinants that have changed not only the character and composition of that class, but also the power differentials between this class and other classes in the United States.
本文批判性地分析了关于美国白人工人阶级死亡率和发病率增长的最新科学文献。这些研究中使用的方法,以及对所使用变量(如社会阶级)的概念化不足,限制了对该人群“绝望疾病”增加的理解。本文强调需要分析美国社会阶级的演变,以及改变不仅改变了这个阶级的性质和构成,而且改变了这个阶级与美国其他阶级之间的权力差距的政治决定因素。