Do social comparisons matter in relation to health and wellbeing?

HT Communities. Classes. Races;HM Sociology;RA0421 Public health. Hygiene. Preventive Medicine

Kasengele, Kalonde Mwango ; West, Patrick

University:University of Glasgow

Department:Institute of Health and Wellbeing

关键词: social comparisons, class, status, community studies, health inequality, psychosocial hypothesis, lay perceptions, stigma, consumerism, parenthood;   

Others  :  http://theses.gla.ac.uk/3298/1/2011KasengelePhD.pdf

来源: University of Glasgow

【 摘 要 】

This thesis explores the relationship between social comparisons and health and wellbeing as a possible explanation for health inequalities. This is because, although inequalities in health have been observed in Britain since occupational and mortality statistics were first published in 1851 (Macintyre, 1997), the underlying reasons remain a subject of much debate. This thesis adds to the debate by focusing on one of the most influential arguments in recent decades; that, in developed countries, perceptions of place as a class context in the socioeconomic hierarchy is a psychosocial risk factor related to ill health (Wilkinson, 1992; Wilkinson, 1996). However, despite being implied as the central mechanism in his psychosocial pathway, surprisingly, Wilkinson has given little attention to the process of social comparisons. His reliance on large scale epidemiological data to make inferences at an individual level is unsatisfactory since it offers no understanding of the dimensions of people’s social comparisons and how this may be linked to health and wellbeing. The main aim of this study was, therefore, to investigate the scope and nature of social comparisons amongst people living in proximal socio-economically contrasting neighbourhoods, their perceptions of class and inequality and how this might impact on health and wellbeing. In-depth interviewing was the main methodology, supplemented with media analysis and participant observation in order to gain an understanding of the study areas. A total of 33 interviews were conducted with parents from Drumchapel and Bearsden. These areas were chosen because they were strikingly different class contexts, Drumchapel representing a working class area and Bearsden a middle class area. As Wilkinson focuses on between-class comparisons, the selection of these proximal neighbourhoods provided a good opportunity to investigate the extent to which people make comparisons between classes.Insofar as lay theories map on to explanations of health inequalities, this study found little support for Wilkinson’s assertion that perception of place in the social hierarchy is the determining factor in relation to health and wellbeing. Firstly, unlike his suggestion that social comparisons are more common with decreasing social class, the process was found to be a widespread social phenomenon which people across the hierarchy utilise for both self-evaluation and self-enhancement. Secondly, in contrast to Wilkinson’s focus on a single economic hierarchy, this study found compelling evidence that people often utilise complex multiple status hierarchies that can include material and non-material factors like speech, social mannerisms, moral respectability, education, and family upbringing when making social comparisons. In this respect, though Wilkinson’s call for income redistribution policies is admirable, it would not necessarily eliminate feelings of relative deprivation because status differences can exist even in the most economically equal societies. Thirdly, whilst factors like globalisation, the rise in consumerism, and expansion of the mass media have made people more aware of inequalities in society, comparisons with ‘similar others’ like neighbours, friends, family members, and work colleagues were found to be still the most salient reference groups. Further support for this was that status distinctions within classes (e.g. between ‘old’ and ‘new’ money in Bearsden and ‘rough’ and ‘respectable’ in Drumchapel) were more important than those between classes. Lastly, and most importantly, there was little indication that a psychosocial explanation is at the forefront of people’s minds in accounting for health inequalities. To begin with, none of the participants spontaneously suggested a psychosocial mechanism; instead, those in Drumchapel were more likely to suggest material/structural factors whilst Bearsden participants tended to advocate behavioural/cultural explanations. Furthermore, although there was evidence to suggest that ‘some’ people may be vulnerable to similar negative effects of social comparisons they perceived as impacting on others (including anxiety, stress, pressure and depressive state), such effects appeared to be minimal since they were reported to occur only at particular periods in people’s lives. The fact that this thesis was centred on Wilkinson’s psychosocial hypothesis is testimony to the enormous contribution he has made to the health inequalities debate. However, in examining the association between social comparisons and health and wellbeing, the conclusion drawn from this study is that the role of social comparisons in the psychosocial mechanism may have been exaggerated.