Theorizing health inequalities: The untapped potential of dialectical critical realism

Abstract

We here extend our previous contributions to a neo-Marxist sociology of health inequalities via an engagement with Roy Bhaskar’s dialectical critical realism (DCR). We argue that Bhaskar’s re-grounding of the philosophies of Marx and Engels has the potential to re-invigorate sociology’s input into: (a) explanations of health inequalities and (b) interventions to reduce health inequalities. We also show that DCR provides rationale and opportunity for an action sociology beyond current professional, policy, critical and public sociologies. We briefly summarize current sociological models of health inequalities before protesting their lack of theoretical ambition. We then proffer a professional-cum-critical theory that emphasizes the continuing causal efficacy of social class in general, and of Britain’s ‘governing oligarchy’ in particular, for any credible sociological account of health inequalities. Bhaskar’s basic and dialectical critical realism are then introduced and the frame supplied by the latter commended for a deepening of the neo-Marxist theories of health inequalities being developed by us among others. The article concludes by drawing on this same frame to insist on a logical and moral commitment to an action sociology beyond any institutional constraints faced by practitioners of the discipline.