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Social theory and health inequalities: Critical realism and a transformative activist stance?

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Abstract

The failure successfully to project evidence on health inequalities into the policy imagination is likely related to the fact that the research community is yet to provide an appropriate critical theory of health determination – integrating different social phenomena through identifiable mechanisms and pathways across different levels and scales, and opening up a realistic perspective on how unjust outcomes might be subject to change. On what social-theoretical basis might this task most usefully be addressed? This article critically explores the utility of the work of Archer which has been applied to health inequalities by Scambler, and argues that it is quite problematic in relation to the task of theorising health inequalities. It then proceeds to explore the relevance of a longer-standing tradition of work deriving from the early twentieth century Soviet school of ‘psychology’ led by Lev Vygotsky and coalescing today under the heading of Cultural-Historical Activity Theory. Within this tradition, we highlight the particular contribution of Anna Stetsenko. We argue that this tradition, and the contribution of Stetsenko in particular, merits our close attention in developing a basis for a more expansive critical theory of health.

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Notes

  1. Here we make use of a presentation on reflexivity given by Archer at a launch event for the Critical Realism Dictionary in 2007 – which can be accessed at: https://www.youtube.com/watch?v=bMpJ5wnuB64&list=PLEF607C6AC6495D76&index=8.

  2. Transcribed from source cited at note 1, above.

  3. Available at: http://www.pass.va/content/scienzesociali/it/multimedia/videogalleries/archer.html

  4. ‘The way we are organically constituted, and the way in which the world is, together with the fact that we have to interact with the world in order to survive, let alone to flourish, means that an important part of being human is proofed against language’ (Archer, 2000, p. 3).

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Authors and Affiliations

  1. School of Media, Culture and Society, University of the West of Scotland, Paisley, PA1 2BE, UK

    Chik Collins & Gerry McCartney

  2. School of Education, University of the West of Scotland, Paisley, PA1 2BE, UK

    Marjorie McCrory

  3. School of Social & Political Sciences/Institute of Health & Wellbeing, University of Glasgow, 27 Bute Gardens, Glasgow, G12 8QQ, UK

    Mhairi Mackenzie

  4. Public Health Science Directorate, NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK

    Gerry McCartney

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  1. Chik Collins
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  4. Gerry McCartney
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Collins, C., McCrory, M., Mackenzie, M. et al. Social theory and health inequalities: Critical realism and a transformative activist stance?. Soc Theory Health 13, 377–396 (2015). https://doi.org/10.1057/sth.2015.13

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