ABSTRACT
This paper reviews the principal concepts of social class, occupation, and social stratification, and their contribution to the analysis of the social determinants of health (SDH), and reviews empirical studies conducted in Latin America that use employment relations as an SDH. The review focuses on studies of the relationship between health and social class based on neo-Weberian or neo-Marxist perspectives. A search of the BIREME Virtual Health Library and the SciELO database found 28 articles meeting these characteristics. This relative dearth contrasts with the profusion of papers that use these approaches written in Europe and in the United States, with a long tradition in the analysis of SDH. In this regard, the political and programmatic implications of research on social class and employment relations are different from and complementary to studies of health gradients associated with income and education. Globalization of employment relations requires the development of new concepts to explain and measure the mechanisms of action of the SDH going beyond what is strictly labor related; in particular, the importance in the current Latin American reality of the impact of informal work on health.
Subject(s)
Health Status Disparities , Social Class , Humans , Latin America , Socioeconomic FactorsABSTRACT
Se repasan los principales conceptos de clase social, ocupación y estratificación social, y su contribución al análisis de los determinantes sociales de la salud (DSS), y se revisan los estudios empíricos desarrollados en América Latina que utilicen las relaciones de empleo como DSS. La revisión se ha enfocado en los estudios sobre la relación entre salud y clase social basados en las perspectivas neoweberiana o neomarxista. La búsqueda en la Biblioteca Virtual en Salud de BIREME y en la base de datos SciELO permitió localizar 28 artículos de esas características. Esta relativa escasez contrasta con la abundancia de trabajos con tales enfoques realizados en Europa y en los Estados Unidos, con una larga tradición en el análisis de los DSS. En tal sentido, las implicaciones políticas y programáticas de la investigación sobre clase social y relaciones de empleo son diferentes y complementarias de los estudios de gradientes de salud asociados a los ingresos y la educación. La globalización en las relaciones de empleo exige nuevos conceptos para explicar y medir los mecanismos de acción de los DSS trascendiendo lo estrictamente laboral; en particular, la relevancia en la realidad latinoamericana actual del impacto del trabajo informal sobre la salud.
This paper reviews the principal concepts of social class, occupation, and social stratification, and their contribution to the analysis of the social determinants of health (SDH), and reviews empirical studies conducted in Latin America that use employment relations as an SDH. The review focuses on studies of the relationship between health and social class based on neo-Weberian or neo-Marxist perspectives. A search of the BIREME Virtual Health Library and the SciELO database found 28 articles meeting these characteristics. This relative dearth contrasts with the profusion of papers that use these approaches written in Europe and in the United States, with a long tradition in the analysis of SDH. In this regard, the political and programmatic implications of research on social class and employment relations are different from and complementary to studies of health gradients associated with income and education. Globalization of employment relations requires the development of new concepts to explain and measure the mechanisms of action of the SDH going beyond what is strictly labor related; in particular, the importance in the current Latin American reality of the impact of informal work on health.