Ever since 1845 it’s been known that material circumstances such as poor housing and sanitation and over-crowding make life not only hard, but also unhealthy. That was when sociologist Friedrich Engels uncovered the shocking conditions of daily life for working class people in English cities like Manchester, notes Nick J Fox.
Many studies since then have confirmed an association between social position (or ‘social class’) and health, with large differences in both mortality and illness rates between the affluent and the poor. Right now, these health inequalities mean poor people are getting sick and dying from coronavirus far more often than the rich.
But there’s a key aspect of material advantage or disadvantage that has been repeatedly overlooked: the daily interactions that people have with a whole load of non-human stuff.
Consider the material differences between the daily lives of someone in a professional or managerial job, and another working in a factory, construction or shop work. Here’s Alexei (not his real name), a railway maintenance engineer, talking about his work-life, in an interview that my colleague conducted in 2019, during our research on the material conditions of work in Russia.
At our workplace, apart from the depot, the offices are very small and angular. You feel like in a cage inside them. I hate them. I can’t stand them. And there’s no air to breathe there at all. They stink with either oil or fuel or hell knows what else. [In the cafeteria] there’s a fat woman at the checkout, with a credit card reader. But the device sticks. We are always standing, waiting. There are many tables in the room. They are plastic, round or square, but very light-weight, so it’s hard to sit down at them. You lean on it accidentally and everything slides. My soup spilled on me twice this way.
By contrast, professionals and managers usually work in good-quality, well-regulated and amenable spaces and places: offices, boardrooms and laboratories and pleasant indoor and outdoor communal spaces. This is what Konstantin, head of the corporate sales department at a regional car dealership, said.
Well, if you take my workspace as a whole, it’s an office of about 25, maybe a little more, 30 square meters. In addition to me, three more people work in it. … Everything is standard, office equipment. The room is fairly bright. We recently had a good renovation, it became lighter, brighter, more comfortable to work in, more enjoyable.
And here’s Natalia, a well-qualified social science teacher at a technical school. She described her working environment, emphasising the importance of having appropriate spaces and furnishings to enable her to work effectively.
I visit the library of our school very often because my subject area requires working with computers. And our library is well equipped technically, computers with an Internet connection. Everything is quite new. The building where I now work, where I conduct most of the training sessions, is new. It was completed three years ago and all equipment was purchased then, so no PCs, projectors or screens are more than three years old. Quite convenient and comfortable conditions have been created for me.
For professionals and managers, these positive aspects of the non-human environment don’t stop with the office furniture. They may have a designated car-parking space for their own or a company car. And when they travel for work, it’s with a business class airfare or a first class train ticket. This quality doesn’t end at work either. A good salary can mean a well-appointed and spacious home equipped with comfortable and comprehensive facilities; holidays abroad; maybe even a second home.
Manual workers’ interactions with non-human stuff can be very different. Workspaces may be noisy and dusty, requiring them to use protective clothing through the work day. In place of roomy offices and executive dining rooms, there are production lines, canteens, time-clocks and basic sanitation facilities. In place of a company car, it’s a bus ride home from the industrial estates at the end of the day.
But home life may be different too. Shop worker Pavel shared a city apartment with his girlfriend. He complained that it was not really large enough for the two of them.
There’s a bedroom, a living room and a box room. But the rooms are very small. The bathroom is so tiny one can hardly turn around there. We have a huge bed in the bedroom, but I still hardly fit in it with my height of 189 cm. We have three cupboards in this small house.
Recent inequalities theories have moved away from a strict focus on the links between social position and material resources. These theories suggest social opportunities can depend on how well you are networked with others, and with whom (for instance, with the socially powerful or with the socially disempowered), or even whether your taste is for operas or soap operas! It’s been suggested that these social and cultural ‘capitals’ affect how social advantage or disadvantage are passed on from generation to generation.
I think this move away from a ‘materialist’ emphasis is mistaken. We need to return to the concern with material conditions that Engels disclosed, especially for developing policy to reduce social disadvantage and improve health. But it’s not just about how much you earn. The lengthy interviews we did with Alexei, Natalia and the others we quoted suggests that social divisions emerge not only from people’s income or possessions, but also from the material conditions that are the backcloth to all our lives. The streets we walk, the buildings where we work, our access to green spaces, public and private transport, facilities for leisure and sport, the furnishings in our homes. All this material stuff contributes to our daily experiences of living.
But considering non-human stuff at work is about more than ensuring safe and healthy working conditions. The research showed that daily encounters with the physical world of stuff affect what people can do: in other words, what are the opportunities and constraints they experience on a daily basis, and the dis/advantages that result.
Poor quality or inadequate matter in workplaces can make it hard for workers in less skilled occupations to excel in their occupations, with consequent limits on career progression; while those in professional or managerial posts are more likely to work in beneficial and good-quality conditions that enhance opportunities for productivity and job satisfaction.
And because children often follow their parents into similar work, these interactions may pass on from generation to generation. In this way, social divisions and inequalities in life opportunities between occupational groups are sustained.
What then of the link between material conditions and health? A second recent research study has revealed how dis/advantages associated with living conditions impact well-being. We found that once again non-human stuff was important for what people could do. For example, one of the respondents: Laura (not her real name) described interactions with outdoor spaces and their contents, as well as good quality housing as the most significant positive aspects of her daily life. Katherine was able to enjoy a good lifestyle by taking holidays, eating out and generally enjoying a materially comfortable life-style.
These interviews showed a powerful association between health status (for instance, living with a chronic condition or days off sick) and the numbers of capacities that respondents described. Those in good health had more opportunities in their lives, while those in poor health had more constraints on what they could do. For ‘Cath’, life had closed down substantially as a result of her mental health issues, diabetes and other problems, limiting what she could do both domestically and in employed work. Similarly, daily life for ‘Andrea’ had been constrained by weight problems and multiple physical and mental health issues.
This suggests a complex interaction between social advantages or disadvantages and health. Sometimes life opportunities contribute to better health. But sometimes poor health means fewer opportunities. So we can’t simply talk about social dis/advantage as a ‘cause’ and health as an ‘outcome’. Rather, both are aspects of people’s material capacities, and when we talk about dis/advantage, we are often talking about their relative health or well-being too.
Living conditions have improved for many people in the global North since Engels’ day. But wealth inequalities and health inequalities remain in every corner of the globe. However, I’d argue that we need a more sophisticated perspective on dis/advantage and inequalities than simply talking of a ‘social class’ gradient in health. The research we’ve done on non-human stuff, social position and health reveal the variability in how people interact with material; things, and the ways these connections link to health and well-being.
So acknowledging how non-human stuff plays a role in producing both dis/advantage and health inequalities is important. Places and spaces, goods, transport and all the other stuff that surrounds us on a daily basis are significant generators of dis/advantage. They affect not just what we may achieve in our lives, but also how long that life may be. Improving everyone’s daily experiences of the material world can make a real difference.
Note
The study of Russian workers was conducted with Dr Tanya Gavrilyuk of Tyumen University, Western Urals. My associate on the study of disadvantage and health is Dr Katie Powell of the University of Sheffield.
Unpublished blogpost written 29 May 2020.