Health inequity in a neoliberal society : lifestyle choices or constrained practices?

• Main Author: Montero, Maria L. M.
• Published: University of Warwick 2015
• Subjects: 362.1; RA Public aspects of medicine
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.698748

Background: Strong evidence has been provided by several researchers on the influence that structure and social factors have on health. However, there is relatively little information about the mechanisms by which the structure shapes health-related practices and the place there is for agency in this process. Therefore, this thesis explores the mechanisms through which the structure influences the space for agency that men and women from different social groups have over their health-related practices in their daily lives in a strongly neoliberal economically high-income country such as Chile. Design and objectives: Following a critical realist approach, this thesis uses mixed methods to answer the research question. The contextual analysis aims to comprehend the wider political and economic forces related to the Chilean neoliberal regime that underlie people’s health-related practices. It is based on a bibliographical review and quantitative analysis of secondary data. The extensive analysis focuses on the extension of health-related practices and their statistical association with structural variables. Finally, the intensive analysis explores the meanings and values people give to health and to their health-related practices. It is based on the analysis of fifty-seven in-depth interviews conducted with twenty-nine people living in Santiago de Chile. Results and conclusions: By combining intensive and extensive approaches with a contextual analysis of Chilean society, this thesis concludes that there are different mechanisms through which the structure influences the space for agency that people have over their health-related practices in Chile. These mechanisms affect people differently according to their socioeconomic level and gender. They are related to people’s economic, social and cultural capital, all of which are unequally distributed in Chile. The analysis shows that these mechanisms are a consequence of a structure with high levels of inequalities consolidated by the Chilean neoliberal policy regime.