Fundamental Sources of Health Inequalities

071-Part 2-Chapter 5.pdf (application/pdf Object)
Fundamental Sources of Health Inequalities

BRUCE G. LINK AND JO C. PHELAN
The primacy of social conditions as determinants of health has been observed for centuries. The idea was forcefully articulated by nineteenth-century proponents of “social medicine,” who noted strong relationships between health and the dire housing circumstances, poor sanitation, inadequate nutrition, and horrendous work conditions that poor people encountered at that time. This social patterning of ill health led to Virchow’s famous declaration that “medicine is a social science” and “politics nothing but medicine on a grand scale” (1848). The idea is also prominent in the work of McKeown, who focused attention on dramatic secular trends toward improved population health (1976). The McKeown thesis, as it has come to be called, states that the enormous improvements in health experienced over the past two centuries owe more to changes in broad economic and social conditions than to specific medical advances.