The development of politics of public health is historically dated. As Foucault noted, it appeared with the broader emergence of the idea of population which provides, in the modern era, the conceptual framework of health policies. The existence of a common concept, however, should not hide the evolution of public health and public health policies during the modern and contemporaneous eras. Indeed, Public health in the twentieth century does not face the same problems as in previous centuries. In the 19th century, infectious diseases were a central problem, closely related to that of cities. Cities were modified for questions of hygiene: Haussman's works in the 1860's in Paris for instance. In the 20th century, we might say to a certain extent that cities do not occupy the same centrality in hygiene questions, for public health issues changed: degenerative diseases are substituted to transmitted infectious diseases. The spatial question is to be taken differently then, for the issues of proximity and contamination largely disappear.
[...] “norms of respect and networks of trusting relationships between people who are interacting across explicit, formal or institutionalized power or authority gradients in society.” How can this multidimensional notion of “social capital” be applied to public health policies in the twentieth century city? One could be suspicious of the very concept. For instance it has been criticized by Navarro for being the mainstream product of the dominant ideology, with mainly conservative consequences if ever used at the political level. I will first present the interest of the use of the concept of social capital, and then explain why its use is necessarily limited II The interest of bonding social capital Materialist theories of health issues tend to focus only on economic and technological determinants of health. [...]
[...] An important illustration of the impact of bonding social capital on city health policies is the question of homicides. In “Social capital, income inequality, and firearm violent crime”, Kennedy, Kawashi, Prothow- Smith, Lochner and Gupta discuss the issue of firearm violence as related to social capital and therefore to health inequalities. Firearm violence is a significant sociological phenomenon: violent behavior is the first cause of death among young black males and females (15-34 years old), and among the whole society, it constitutes the second cause of death for teenagers (10 to 19 years old). [...]
[...] Now the real question is: does the objective unequal situation prevail on the subjective bridging social capital? This issue obviously has many political and ideological consequences, and therefore directly implies very different political actions. Szreter and Woolcock assume that a strong bridging capital helped for the set up of a health system in Great Britain at the end of the 19th century. But Wilkinson's “Social relations, Hierarchy, and health” clearly contradicts this idea. Wilkinson and Szreter and Woolcock would agree that what is at stake is not only the objective amount of resources or education. [...]
[...] Navarro's critique that the concept of social capital should be rejected for it promotes the liberal ideas of individualism and above all negates the materialist base of health inequalities and policies is probably right and in any case interesting, but is not sufficient at all, for Navarro's critique is largely based on an a priori ground, the origins of the concept (such as the IMF and the World Bank). Muntaner is very useful here, for he offers a similar critique of the very notion of social capital without remaining on the ground of presupposes. [...]
[...] Despite the critiques, the cases of firearm homicides and Roseto town show that bonding capital has a certain importance for health policies. A tied community is more careful with the elderly, is less violent and so on, which seems to imply higher life expectancy and quality of life. However, one could raise some objections. For instance, when we observe the health evolution of immigrants, the longer they have been in the US which is I guess a good proxy to evaluate their integration in communities, and therefore the strength of their social capital– the worst their health. [...]
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