The theories of Karl Marx and Max Weber

It was the belief of Karl Marx that social class plays an integral role in society. It was his theory that social class is important to understanding capitalism and other social systems. He asserted that the history of all hitherto existing in society is the history of class struggles (Marx 1848).

Marx theorised social classes are defined by the relationship between capitalists and their workforce. For Marx economics is the driving force of modern society and social class. It is the view of Marx that in the past although society did have strata, such stratum was based on titles and occupation rather than purely economics.

The bourgeoisie and the proletariat are the main social classes that Marx purposes. The Bourgeoisie are the capitalists. They purchase and exploit the labour power. Marx notes that someone who merely owns capital cannot be sufficiently defined as a capitalist. It is the means of using capital as a means to exploit labour which characterises the capitalist.

The proletariat are the labour force. They work in order to earn income for themselves and their families in order to survive. Marx purposes that the existing relationship between bourgeoisie and the proletariat is an exploitive relationship which is based on inequality.

Weber’s definition of class is not unlike that given by Marx. Weber defines class as a category of people who, “have in common a specific causal component of their life chances in … this component is represented exclusively by economic interests in the possession of goods and opportunities for income, and it is represented under the conditions of the commodity or labor market.” Webber held a view close to Marx’s that class position does not necessarily lead to class-determined economic or political action. Weber argued that communal class action surface after “connections between the causes and the consequences of the ‘class situation’ ” become apparent. Marx however proposes it is when a class becomes conscious of its interests, that is, of its relation, as a class, to other classes.

In modern day Britain there is evidence that class inequality present in society. Wide disparities in health between the classes illustrate this fact. However it should be noted that inequalities in health based on class is not a new sociological occurrence. Chadwick took note of a disproportionate difference in life expectancy between the classes in 1842.

“Gentlemen and persons engaged in professions and their families…45 years; tradesmen and their families…26 years; Mechanics, servants and labourers, and their families … 16 years’

(Chadwick 1842).

Reports have been carried out that suggest an obvious link between social class and health. Such studies find that lower social class groups have a higher chance of illness and a sorter light expectancy.

“At the start of the 21st century, all European countries are faced with substantial inequalities in health within their populations. People with a lower level of education, a lower occupational class, or a lower level of income tend to die at a younger age, and tend to have a higher prevalence of most types of health problems.

(Mackenbach 2006)

The Acheson Report took a systematic review of research of health inequalities in the UK. The report found that overall the mortality rate for people aged 35 -64 years had fallen in the period studied; however there was an increased variation in mortality between the classes. The Acheson report also uncovered that within particular areas of the UK the inequalities in Health between the classes manifest its self greater. In Scotland for example, male life expectancy in the 10 percent most deprived areas is 13 years lower than in the 10 percent least deprived areas. Such difference between the classes is increasing; the life expectancy gap between the best and worst constituencies was 7.8 years in 1991. In 2001 this gap had risen to 13.7 year (Scottish Government 2007).

Mackenbach noted in mortality in patterns that:

Rates of mortality are consistently higher among those with a lower, than among those with a higher socio-economic position. Not only is the size of these inequalities often substantial, but inequalities in mortality have also increased in many European countries in the past decades.

(Mackenbach 2006)

It is proposed by Mackenbach that inequalities in mortality; start early in life and persist in to old age, affect both men and women but its influence is more prevalent in men and are found for most but not all specific causes of death.

The Acheson report presented that in terms of enduring illness has strong link to “socioeconomic differences”. It was reported that in 1996 the 45-64 years age group, 17 percent of professional men reported a limited long standing illness compared with 48 percent of unskilled men. The Acheson Reported that among women, 25 percent of professional women and 45 percent of unskilled women report long standing illnesses.

Mackenbach articulates that people with lower socio-economic positions not only live shorter lives nit also but spend a larger number of years in ill health.

Why does that pattern of health inequality exist in modern society? The influential Black Report 1980 examined five explanations of health inequalities. These five explanations are; the artefact explanation, the social explanation, social selection exploitation, the cultural explanation and the social deprivation explanation.

An artefact approach to understanding Health inequality suggests that such health disparities are statistical fiction. Critic’s debate what is the best way measuring such it is also argued by Bury (1997) suggests that comparing the bottom social class (V) is not longer effective as the number of people in this class has declined greatly.

The social selection theory argues that good or bad health determines class position rather than vice versa. For example, having a long term health issue may limit a person’s career opportunities. Critics counter this theory that although illness plays a role on life chances it not always the case that illness leads to downward social mobility. The explanation is also contrary to a Marxist thought. Marx would argue it is class that determines health.

A cultural explanation of health inequalities suggests that the social classes behave in different ways. The less well of social classes are more likely to have poorer health because of diet, smoking or alcohol consumption. Shilling (1993) proposes that different social classes view their bodies in different ways. Shilling asserts that the lower social classes tend to see the body in terms of what it enables them to do, for example for work and looking after children. According to Shilling health is not considered an issue until problems arise for the lower classes until the body cannot function normally. Higher social classes treat the body as an end in its self and have higher focus on preventing illness from occurring. Such an explanation for Health inequalities in contemporary Britain based on social class harmonises with the theories’ of Marx and Weber. The explanation the lower classes (the proletariat) regard their bodies as a machine used for means of work is compatible with the sociological assertions of Marx and Weber. Marx would say such a view of the body is a result of class struggle. The proletariat must view their body as machine for work. Marx submits that proletariat must work in order to survive. This is why for the lower class health only becomes an issue when they are unable to work because of illness.

Is also argues the material situation of a person and the conditions that they live and work in conditions which they work and live is an important factor in determining their health. Issues such as poverty, employments, housing and access to care are influential factors to be considered.

The Acheson report in order to address the issues involved adopted a socioeconomic model of health and inequalities, combining the above theories. The socioeconomic model however does go as far to address a connection between its different layers.

The Black Report reported a growth of health inequalities across Britain. These widening inequalities in health have been observed, in socio-economic terms. However findings demonstrated that overall health had improved since the creation of the welfare state.

Although the standard of health has increased in equilibrium with an improvement in standard in living it is conclusive that inequalities in health based on class still exist in Britain. Marx would note the improvement of living standards for proletariat but would note the of Bourgeoisie exploiting the work of the proletariat to create excess capital. It is conclusive from the findings of the Black Report and Acheson that need for Marx’s proletariat to work is what constructs their attitude towards health. In contemporary Britain there have been improvements made in health over all but class in equalities have not been reduced.