School of Social Sciences, University of Adelaide, North Terrace, Kaurna Country, Adelaide, South Australia 5005, Australia.
Brain and Mind Centre, The University of Sydney, Gadigal Country, Camperdown, New South Wales 2050, Australia.
Health Promot Int. 2024 Aug 1;39(4). doi: 10.1093/heapro/daae093.
The COVID-19 pandemic and current cost of living crisis have highlighted socioeconomically patterned health disparities, bringing renewed focus on equity in public health. Despite political rhetoric invoking cultural narratives of egalitarianism and opportunities for class mobility, social class remains a significant factor in health outcomes in the Australian context. For social scientists, class (despite robust critiques) is a key analytical concept that has been theoretically broadened to encompass social and cultural practices (habitus). In public health, however, concepts of social disadvantage have expanded toward frames such as health equity and socioeconomic status in ways that can obscure 'class' and habitus. Understandings and operationalization of concepts of class and equity not only impact collaborative and interdisciplinary relationships, but also the framing of public health problems and health promotion interventions and policies. In this article, we draw on our experiences as anthropologists conducting ethnography in and of Australian health promotion programs to map and re-evaluate the intersection of concepts of social class and equity. We trace how representations of class emerged in these programs, and the versions of class and equity that materialized across different public health contexts. We argue for a conceptual repositioning of class that recognizes its shape-shifting qualities and of its materializations in different politics, disciplines and everyday contexts. In doing so, we highlight 'class' as a salient dimension of the design, implementation and evaluation of health promotion programs.
COVID-19 大流行和当前的生活成本危机凸显了社会经济模式下的健康差距，使人们重新关注公共卫生中的公平问题。尽管政治言论援引了平等主义和阶级流动机会的文化叙事，但在澳大利亚，社会阶级仍然是健康结果的一个重要因素。对于社会科学家来说，阶级（尽管受到强烈批评）是一个关键的分析概念，这个概念已经在理论上得到了扩展，包括社会和文化实践（习惯）。然而，在公共卫生领域，社会劣势的概念已经扩展到了诸如健康公平和社会经济地位等框架，这些框架可能会模糊“阶级”和习惯。阶级和公平概念的理解和操作不仅会影响合作和跨学科关系，还会影响公共卫生问题的框架以及健康促进干预措施和政策的制定。在本文中，我们借鉴了作为人类学家在澳大利亚健康促进计划中进行民族志研究的经验，以绘制和重新评估社会阶级和公平概念的交叉点。我们追溯了阶级观念在这些项目中是如何出现的，以及在不同的公共卫生背景下出现的阶级和公平观念的版本。我们主张对阶级进行概念上的重新定位，承认其多变的性质及其在不同政治、学科和日常环境中的体现。通过这样做，我们强调了阶级是健康促进计划的设计、实施和评估的一个重要维度。
