Three perspectives on the efficacy of social capital have been explored in the public health literature. A "social support" perspective argues that informal networks are central to objective and subjective welfare; an "inequality" thesis posits that widening economic disparities have eroded citizens' sense of social justice and inclusion, which in turn has led to heightened anxiety and compromised rising life expectancies; a "political economy" approach sees the primary determinant of poor health outcomes as the socially and politically mediated exclusion from material resources. A more comprehensive but grounded theory of social capital is presented that develops a distinction between bonding, bridging, and linking social capital. It is argued that this framework helps to reconcile these three perspectives, incorporating a broader reading of history, politics, and the empirical evidence regarding the mechanisms connecting types of network structure and state-society relations to public health outcomes.
It continues to be generally accepted that the iconoclastic research work of Professor Thomas McKeown and associates conclusively demonstrated that the medical establishment-including all the efforts of the public health movement-played only a minor role in the grand historical and demographic drama of the period, the secular decline in national mortality levels. According to McKeown's apparently authoritative analysis and interpretation of the available epidemiological statistics, the mortality decline in England and Wales can be primarily accounted for by the benevolent 'invisible hand' of gradually rising living standards, particularly in the form of increases in per capita nutritional consumption. The coherence of this view is brought into question by a critical re-examination of the supporting evidence and arguments presented by McKeown el al. It is anticipated that for many of those not closely acquainted with the 'McKeown thesis', the fragility of the case may come as something of a surprise. An alternative interpretation of the same epidemiological evidence then forms the basis for a revisionist account which directs attention to the leading role played by the public health movement and its locally administered preventive health measures in combating the urban congestion created by industrialization.
This book offers an original interpretation of the history of falling fertilities in Britain between 1860 and 1940. It integrates the approaches of the social sciences and of demographic, feminist, and labour history with intellectual, social, and political history. It exposes the conceptual and statistical inadequacies of the orthodox picture of a national, unitary class-differential fertility decline, and presents an entirely new analysis of the famous 1911 fertility census of England and Wales. Surprising and important findings emerge concerning the principal methods of birth control: births were spaced from early on in marriage; and sexual abstinence by married couples was a far more significant practice than previously imagined. The author presents a new general approach to the study of fertility change, raising central issues concerning the relationship between history and social science.
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