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Social Class for Collective Health Research: A Conceptual and Empirical Challenge

机译：集体卫生研究的社会阶层：概念和实证挑战

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摘要

Social Determination of Health (SDH)/Collective Health is a Latin American framework that sees the Marxist core concept of social class as fundamental for understanding health inequalities. In contrast to social stratification approaches, Marxist proposals seek to understand health as part of the historical transformations of capitalism's mode of production. In this article we aim to analyze the relationship between social class and health inequalities using data from the IV Oral Health National Study in Colombia. We conducted hierarchical cluster analyses to classify the population in five class positions and three living conditions clusters, which reflect how the spheres of production and social reproduction relate to social classes in Colombia. To measure oral health we use DMFT, as well as care and treatment needs indexes. Through variance analysis models we found that people from more exploited class positions and worse living conditions have more active disease and higher treatment needs. Despite technical and conceptual challenges, we conclude that a social class analytical framework can be operationalised via the interrelated spheres of production and social reproduction, which sheds light on the relationship between health inequalities and the class structure of the capitalist system.
机译：健康的社会确定（SDH）/集体健康是拉丁美洲的一个框架，该框架将马克思主义的社会阶级核心概念视为理解健康不平等的基础。与社会分层方法相反，马克思主义的建议力图将健康理解为资本主义生产方式的历史转变的一部分。在本文中，我们旨在使用哥伦比亚IV口腔健康国家研究的数据来分析社会阶层与健康不平等之间的关系。我们进行了层次聚类分析，将人口分为五个阶级位置和三个生活条件聚类，这反映了生产和社会再生产领域与哥伦比亚的社会阶级之间的关系。为了衡量口腔健康，我们使用DMFT以及护理和治疗需求指数。通过方差分析模型，我们发现来自阶级地位更高和生活条件更差的人患有更活跃的疾病和更高的治疗需求。尽管存在技术和概念方面的挑战，但我们得出的结论是，社会阶级分析框架可以通过生产和社会再生产的相互关联的领域来运作，这揭示了健康不平等与资本主义制度的阶级结构之间的关系。

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