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Social Determinants of Health$
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Michael Marmot and Richard Wilkinson

Print publication date: 2005

Print ISBN-13: 9780198565895

Published to Oxford Scholarship Online: September 2009

DOI: 10.1093/acprof:oso/9780198565895.001.0001

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The life course, the social gradient, and health

The life course, the social gradient, and health

(p.54) Chapter 4 The life course, the social gradient, and health
Social Determinants of Health

Michael Marmot

Richard G. Wilkinson

Oxford University Press

This chapter discusses the life course perspective on health and its social determinants. This perspective views a person's biological status as a marker of their past social position and, through the structured nature of social processes, as liable to selective accumulation of future advantage or disadvantage. A person's past social experiences become written into the physiology and pathology of their body. The social is, literally, embodied; and the body records the past, whether as an ex-officer's duelling scars or an ex-miner's emphysema. In turn, the duelling scar, as a mark of social distinction, predisposes to future advancement and social advantage, while the emphysema robs the employee of their ability to work and predisposes to future deprivation and social disadvantage. From a life-course perspective, the social distribution of health and disease results from these processes of accumulating advantage or disadvantage.

Keywords:   social structure, life course, health, social determinants, social advantage

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