What can alienation theory contribute to an understanding of social inequalities in health?

Association of children's oral health and school environment on academic performance in 12-year-old schoolchildren of Quito, Ecuador

OBJECTIVES

The primary aim of this study was to evaluate if children's oral health and oral health-related quality of life (OHRQoL) were associated with school performance. Moreover, the study aimed to examine whether school environment factors influenced this association.

METHODS

This cross-sectional study was based on a population-based sample of 998 12-year-old schoolchildren from 31 public schools in Quito, Ecuador. Trained and calibrated examiners conducted clinical exams for dental caries, dental trauma and malocclusion. Furthermore, children completed the Spanish version of the Child Perception Questionnaire (CPQ11-14 ), and their parents answered questions about socio-economic status. School coordinators provided information on the physical environment, promotion of health practices and the occurrence of negative episodes in the school. There were three outcomes: grades obtained in Spanish language and mathematics and the number of missed school days. Multilevel linear and Poisson regression models were conducted using a hierarchical approach to include the variables guided by a previously created direct acyclic graph.

RESULTS

Children with dental trauma and higher CPQ11-14 scores showed lower grades and school attendance. Schoolchildren from schools with episodes of vandalism had more school days missed.

CONCLUSION

The school performance of 12-year-old children is affected by dental trauma and by a worse OHRQoL, as well as a negative school environment. Therefore, supportive environments and promoting health measures in schools could overcome this worse academic performance in children with oral health problems.

On the bullshitisation of mental health nursing: A reluctant work rant

This discussion paper offers a critical provocation to my mental health nursing colleagues. Drawing upon David Graeber's account of bullshit work, work that is increasingly meaningless for workers, I pose the question: Is mental health nursing a bullshit job? Ever-increasing time spent on record keeping as opposed to direct care appears to represent a Graeberian bullshitisation of mental health nurses' work. In addition, core aspects of the role are not immune from bullshit. Professional rhetoric would have us believe that mental health nursing is a therapeutically beneficent occupation organised around ideals of care and compassion and providing fulfilling work for practitioners. Yet, there are some key characteristics of the experience of mental health nursing work that afford alternative judgements on its value and meaningfulness. Not least of these is the fact that many mental health nurses feel quite existentially unsettled in the practise of their work and many service users do not recognise the professional ideal, especially when compelled into increasingly coercive and restrictive services. In this context, Graeber's thesis is explored for its applicability to mental health nursing with a conclusion that many aspects of mental health nursing work are commensurate with bullshit but that mental health care can possibly be redeemed from bullshitisation by authentically democratising reforms. Engaging with posthumanist ideas, this exploration involves a flexing of aspects of Graeber's theory.

Alienation: A useful concept for health inequality research

AIMS

While Marxist class analysis has strongly influenced the development of health inequality research, other aspects of Marx's theory have received less attention. Among the most relevant of Marx's theoretical contributions for social inequalities in health is the theory of alienation. As empirical applications of the theory of alienation are currently scarce, the purpose of this commentary is to invigorate interest in alienation theory within the field of health inequality research by demonstrating its potential to illuminate the relationship between social inequality, psycho-social affects and health outcomes.

RESULTS

Alienation theory describes how the class structure of capitalist societies creates experiences of powerlessness, estrangement and isolation. These experiences are further posited as emerging from the exploitation of labour, thus connecting social inequality to psychological wellbeing. Alienation theory is particularly compatible with psycho-social explanations of health inequalities, which similarly posits that social inequality affects health through psychological mechanisms. We argue that alienation theory contributes in three ways to health inequality research: a) by suggesting potential mechanisms and offering predictions that may be put to use in empirical research, b) by providing a potential explanation of the welfare state paradox, and c) by situating the psycho-social determinants of health within a critical analysis of the sources of social inequality in capitalist society.

CONCLUSIONS

Alienation theory may provide a more textured understanding of the relationship between inequality and psycho-social health, while also foregrounding issues of class, power and exploitation that are often absent from psycho-social explanations.

Does the Union Make Us Strong? Labor-Union Membership, Self-Rated Health, and Mental Illness: A Parametric G-Formula Approach

Union members enjoy better wages and benefits and greater power than nonmembers, which can improve health. However, the longitudinal union-health relationship remains uncertain, partially because of healthy-worker bias, which cannot be addressed without high-quality data and methods that account for exposure-confounder feedback and structural nonpositivity. Applying one such method, the parametric g-formula, to US-based Panel Study of Income Dynamics data, we analyzed the longitudinal relationships between union membership, poor/fair self-rated health (SRH), and moderate mental illness (Kessler 6-item score of ≥5). The SRH analyses included 16,719 respondents followed from 1985-2017, while the mental-illness analyses included 5,813 respondents followed from 2001-2017. Using the parametric g-formula, we contrasted cumulative incidence of the outcomes under 2 scenarios, one in which we set all employed-person-years to union-member employed-person-years (union scenario), and one in which we set no employed-person-years to union-member employed-person-years (nonunion scenario). We also examined whether the contrast varied by sex, sex and race, and sex and education. Overall, the union scenario was not associated with reduced incidence of poor/fair SRH (relative risk = 1.01, 95% confidence interval (CI): 0.95, 1.09; risk difference = 0.01, 95% CI: -0.03, 0.04) or moderate mental illness (relative risk = 1.02, 95% CI: 0.92, 1.12; risk difference = 0.01, 95% CI: -0.04, 0.06) relative to the nonunion scenario. These associations largely did not vary by subgroup.

Community perceptions of Nigerian oil companies commitment to social and environmental concerns

Purpose

This paper aims to identify factors influencing and shaping community perceptions of oil companies which present fertile ground for a better understanding of their actions.

Design/methodology/approach

A qualitative methodology is adopted where primary data were collected through semi-structured interviews from members of three communities in the Niger Delta: Ogbunabali community in Port Harcourt (Rivers State), Biogbolo community in Yenagoa (Bayelsa State) and Ogunu community in Warri (Delta State). The interview data were recorded, transcribed and qualitatively analysed using content analysis with NVivo software.

Findings

Perceptions regarding negative and positive aspects of the oil companies were identified. These included environmental concerns; lack of compensation; health effects; lack of social development; neglect of communities; not creating employment opportunities; and providing community and educational support.

Research limitations/implications

A major limitation regards the small number of respondents selected from the communities. The sample of the interviewees was constrained by their availability and accessibility, which might have injected some bias. Gathering data from other stakeholders such as non-governmental organisations, consumers, investors and creditors may provide a deeper understanding of social and environmental practices. Another approach would be to extend this study by examining the perceptions of relevant government officials towards social and environmental concerns in developing countries.

Originality/value

The qualitative research methodology utilised in this study uses content analysis to examine views of communities about oil companies’ commitments to their social and environmental concerns. An understanding of social and environmental commitments allows diverse stakeholders such as communities to become more engaged with issues affecting them.

Forgetting and remembering alienation theory

Alienation theory has acted as the stimulus for a great deal of research and writing in the history of sociology. It has formed the basis of many sociological "classics" focused on the workplace and the experiences of workers, and has also been mobilized to chart wider social malaise and individual troubles. Alienation theory usage has, however, declined significantly since its heyday of the 1960s and 1970s. Here, the reasons why alienation theory was "forgotten" and what can be gained by "remembering" alienation theory are explored. to realize this ambition this article proceeds by (1) briefly visiting differing definitions of alienation theory, before charting its high point, and the various debates and tensions of the time, during the 1960s and 1970s; (2) analysing the reasons why alienation theory fell from grace from the 1980s onwards; (3) elaborating how and why alienation theory is still relevant for sociology and the wider social sciences today.