Читать книгу Health Psychology - Michael Murray - Страница 67

Health inequalities can be considered from an ecological approach or systems theory approach. Bronfenbrenner’s (1979) ecological approach conceptualized developmental influences in terms of four nested systems:

 microsystems: families, schools, neighbourhoods;

 mesosystems: peer groups;

 exosystems: parental support systems, parental workplaces;

 macrosystems: political philosophy, social policy.

These systems form a nested set, like a set of Russian dolls: microsystems within mesosystems, mesosystems within exosystems and exosystems within macrosystems.

Ecological theory assumes that human development can only be understood in reference to the structural ecosystems. The ‘Health Onion’, a general systems framework for understanding the determinants of health and illness, was presented in Chapter 1 (Figure 1.5). Of key importance is the perceived environment, not the so-called ‘objective’ environment. In Box 5.1 we list some of the characteristics of low SES using Bronfenbrenner’s (1979) systems approach. The box shows the many different disadvantages across all four systems of the social, physical and economic environment. In addition, we can add the high levels of perceived injustice that many people with low SES may feel.