A social epidemiologist looks at health inequalities in terms of the upstream factors that produced them. A political sociologist sees these same inequalities as products of institutions that unequally allocate power and social goods. Neither is wrong—but can the two talk to one another?
In a stirring new synthesis, Political Sociology and the People's Health advances the debate over social inequalities in health by offering a new set of provocative hypotheses around how health is distributed in and across populations. It joins political sociology's macroscopic insights into social policy, labor markets, and the racialized and gendered state with social epidemiology's conceptualizations and measurements of populations, etiologic periods, and distributions.
The result is a major leap forward in how we understand the relationships between institutions and inequalities—and essential reading for those in public health, sociology, and beyond.
A new focus within both social epidemiology and political sociology investigates how political systems and priorities shape health inequities. To advance—and better integrate—research on political determinants of health inequities, the authors conducted a systematic search of the ISI Web of Knowledge and PubMed databases and identified 45 studies, commencing in 1992, that explicitly and empirically tested, in relation to an a priori political hypothesis, for either 1) changes in the magnitude of health inequities or 2) significant cross-national differences in the magnitude of health inequities. Overall, 84% of the studies focused on the global North, and all clustered around 4 political factors: 1) the transition to a capitalist economy; 2) neoliberal restructuring; 3) welfare states; and 4) political incorporation of subordinated racial/ethnic, indigenous, and gender groups. The evidence suggested that the first 2 factors probably increase health inequities, the third is inconsistently related, and the fourth helps reduce them. In this review, the authors critically summarize these studies’ findings, consider methodological limitations, and propose a research agenda—with careful attention to spatiotemporal scale, level, time frame (e.g., life course, historical generation), choice of health outcomes, inclusion of polities, and specification of political mechanisms—to address the enormous gaps in knowledge that were identified.
Snyder and Kick’s (1979) measure of world-system position continues to serve as the premier trichotomous network indicator of a state’s location in the capitalist world economy. In this study, we identify several problems with this orthodox measure concerning its age, informal construction, and incorporation of inappropriate networks. We introduce a trichotomous network measure of world-system position that addresses these concerns, applying Borgatti and Everett’s (1999) core/periphery model to a three-tiered partition using international trade data. Our trichotomous measure of the trade network identifies an expanded core, consisting of an old orthodox core joined by a set of upwardly mobile states. We estimate the effect of world-system position on economic growth and find that our trade measure significantly outperforms Snyder and Kick’s orthodox measure. When controlling for human capital, the strong effects of our trade measure persist, while the weaker effects estimated by the orthodox measure largely disappear. Moreover, our models with human capital reveal that states economically converge within world-system zones, while continuing to diverge between zones.
Most studies find that the substantial cross-national variation in women's legislative representation is not explained by cross-national differences in socioeconomic development. By contrast, this note demonstrates that economic development does matter. Rather than looking for across-the-board general effects, we follow Matland (1998), and analyze developed and developing nations separately. We find that accepted explanations fit rich nations better than poor nations, and obscure the effects of democracy on women's representation in the developing world. We call for new theoretical models that better explain women's political representation within developing nations, and we suggest that democracy should be central to future models.
A growing body of research demonstrates powerful effects of international organizations on national policy, and the literature on international conflict is increasingly adopting a network perspective on international organizations, but we still know little about the network structure of the world polity itself. This is surprising in light of the theoretical implications of world polity theory, world systems theory, and the world civilizations approach to the structure of the world polity. Using data on a set of prominent intergovernmental organizations (IGOs), along with a comparison to the complete population of IGOs, this study examines the world polity as a network structured by symbolic and material conflict. Network analysis reveals a contradictory duality in the structure of the world polity: while states are densely interconnected through international organizations, these international organizations are only sparsely interconnected. Contrary to world polity theory, world system position and world civilization predict position in the world polity. These results show that, in neglecting the network structure of the world polity, previous research has underestimated the extent of structural inequality in the world polity. Because embeddedness in the world polity has such powerful effects on state policies, international trade, and international conflict, the centralization and fragmentation of the world polity may have disintegrative implications for world politics.
This paper demonstrates the utility of a sociology of regional integration by addressing two central questions that have sparked much debate over the welfare state. Is there evidence of long-anticipated retrenchment? Does globalization cause that retrenchment? I redirect these debates by showing that there is evidence of retrenchment in Europe, and that regional integration—not globalization – accounts for it. Regional integration is conceptualized as the construction of supranational political economy in negotiated and bounded regions through political institutionalization and market expansion. I develop the argument that regional political integration should constrain the welfare state through policy feedbacks, the politics of blame avoidance, and the diffusion of classical-liberal policy scripts, while regional economic integration should constrain the welfare state by expanding labor markets and undermining labor unions. I assess these arguments with time-series cross-section models and data from 13 European Union (EU) and non-EU states. The results show that (1) there is evidence of retrenchment, (2) regionalization is significantly associated with retrenchment, and (3) the effect of regional integration is dampened in the strongest welfare states. I draw the general conclusion that regional integration is a new and consequential part of the social context that should receive more attention from sociologists.
Research on the determinants of inequality has implicated globalization in the increased income inequality observed in many advanced capitalist countries since the 1970s. Meanwhile, a different form of international embeddedness—regional integration—has largely escaped attention. Regional integration, conceptualized as the construction of international economy and polity within negotiated regions, should matter for inequality. This paper offers theoretical arguments that distinguish globalization from regional integration, connects regional integration to inequality through multiple theoretical mechanisms, develops hypotheses on the relationship between regional integration and inequality, and reports fresh empirical evidence on the net effect of regional integration on inequality in Western Europe. Three classes of models are used in the analysis: (1) time-series models where region-year is the unit of analysis, (2) panel models where country-year is the unit of analysis, and (3) analysis of variance to identify how the between- and within-country components of income inequality have changed over time. The evidence suggests that regional integration remaps inequality in Europe. Regionalization is associated with both a decrease in between-country inequality, and an increase in within-country inequality. The analysis of variance shows that the net effect is negative, and that within-country inequality now comprises a larger proportion of total income inequality.
This paper is prepared for the conference on "Inequality Beyond Globalization: Economic Changes and the Dynamics of Inequality," sponsored by the World Society Foundation and the Research Committee on Economy and Society of the International Sociological Association (RC-02), and convened in Neuchatel, Switzerland, June 2008. Please direct comments to Jason Beckfield.
The world polity is conceptualized as a network of international organizations and states. A rapidly growing sociological literature argues that many policies of modern states, such as educational expansion, environmental protection, human rights, and economic liberalization, are shaped by embeddedness in this network, and yet the structure of this network itself is rarely examined. This absence of empirical analysis of the social structure of the world polity is surprising, given that world polity theory, in contrast to traditional realist approaches, argues that the world polity should be an increasingly dense, even, flat field of association. This paper tests these structural claims using a formal network analysis of the complete population of intergovernmental organizations as it has evolved since 1820. The world polity is a bipartite network: States are interlinked through memberships in organizations, and organizations are interlinked through their member states. Analysis of this network structure reveals growing fragmentation—not integration—in the world polity driven by intergovernmental organizations that have become less densely connected by common member states, increasingly centralized around a few prominent organizations, and increasingly heterogeneous in structural position. This fragmentation reflects a recent rise in the regionalization of the world polity.
This paper extends contemporary theorizing on national income inequality to the possible role of regional integration in explaining the recent increase in income inequality in Western European countries. Regional integration is conceptualized as the construction of regional political economy through intensified political and economic interaction and exchange. It is argued that political integration increases inequality through welfare state retrenchment, while economic integration increases inequality by exposing labor to international competition but later decreases inequality as welfare states adopt social protections to compensate for this competition. These arguments are assessed with data from 12 Western European countries for the 1969-1999 period. Results from random—effects and fixed—effects models support these arguments. Also consistent with these arguments are the findings that the welfare state dampens the effects of political and economic integration, and that the effects of political integration weaken at higher levels of economic integration. This study suggests that European integration is an important factor in understanding income inequality in Western Europe.
The construction of a European political economy through regional integration is a dramatic social change that raises critical challenges for the study of markets. Does regionalization drive convergence among integrating national economies, or does regionalization deepen existing macroeconomic inequalities? The dominant theoretical approaches are at odds: orthodox economic theory and the political-institutionalist approach to markets predict convergence, whereas world systems theory and its interpretation of integration as exploitation suggest divergence. Economic theory highlights market mechanisms, whereas the political-institutional approach privileges rules and scripts of the new regional social order. Existing evidence on the convergence debate is marked by contradictory findings and a general failure to measure regional integration. This paper reports results from a time series analysis of income dispersion among the 15 countries of the European Union for the 1950-2000 period. The central finding is that regional integration is associated with convergence. The effects of political integration are especially powerful, lending support to the political-institutional approach to regionalization.
The existence of social inequalities in health outcomes is well established in social science research. One strand of research focuses on inequalities in health within a single country. A separate and newer strand of research focuses on the relationship between aggregate inequality and population health across countries. Despite the theorization of (presumably variable) social conditions as "fundamental causes" of health (Link and Phelan 1995), the cross-national literature has focused on population health as the central outcome. Controversies currently surround macro-structural determinants of overall population health such as income inequality (Wilkinson 1996), the welfare state (Conley and Springer 2001), and economic development (Firebaugh and Beck 1994). We argue that these debates would be advanced by conceptualizing inequalities in health as cross-national variables that are sensitive to social conditions. Using data from the third wave of the World Values Survey, we examine cross-national variation in inequalities in health. The results reveal dramatic variation in variations in health according to income and education. We conclude by discussing the policy implications of significant cross-national variability in the socioeconomic gradient.
Recent research reveals strong effects of involvement in international organizations on state policies, but much of this research downplays inequality in world political participation, and there is only a limited understanding of what explains world-polity ties. Using data on memberships in intergovernmental and international non-governmental organizations (IGOs and INGOs) for 1960 through 2000, this study analyzes inequality in the world polity. IGO ties are fairly evenly distributed, but the level of inequality in INGO ties is as high as the level of world income inequality. Since 1960, inequality in ties to IGOs decreased sharply, but inequality in ties to INGOs remained more stable. A conflict-centered model of the world polity is developed here that explains world political participation as a function of material and symbolic conflict. Rich, core, Western states and societies have significantly more ties to the world polity than do others. Powerful states dominate IGOs less now than they did in 1960, but rich, core, Western societies have grown more dominant in the INGO field.