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Social prescribing and classed inequality: A journey of upward health mobility?

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  • Gibson, Kate
  • Pollard, Tessa M.
  • Moffatt, Suzanne

Abstract

Social prescribing, characterised by a link worker connecting patients with local groups and services, is currently being widely implemented in the UK. Taking clients' experiences of a social prescribing intervention in the North of England between November 2019 and July 2020 as its focus, this paper employs ethnographic methods to explore the complex social contexts in which social prescribing is delivered. Building on Bourdieusian approaches to class, we concentrate on four case studies to offer a theoretically-grounded analysis which attends to the relationship between everyday contexts and the classed processes by which health capital may be accrued. By following clients' experiences and trajectories through shifting positions across time - often entailing moments of tension and disjuncture - we explore how processes of classed inequality relate to engagement in the social prescribing intervention. Our results show how structural contexts, and relatedly the possession of capital, shape clients' priorities to invest in the cultural health capital offered by the intervention. Importantly, while inequalities shaped participants’ capacity to engage with the intervention, all participants recognised the value of the health capital on offer. We conclude by arguing that inequalities cannot be tackled through focusing on the individual in the delivery of personalised care and therefore offer a counter narrative to socio-political assumptions that social prescribing reduces health inequalities. Crucially, we argue that such assumptions wrongly presuppose that people are homogenously disposed to engaging in their future health.

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  • Gibson, Kate & Pollard, Tessa M. & Moffatt, Suzanne, 2021. "Social prescribing and classed inequality: A journey of upward health mobility?," Social Science & Medicine, Elsevier, vol. 280(C).
    • Handle: RePEc:eee:socmed:v:280:y:2021:i:c:s0277953621003695
    DOI: 10.1016/j.socscimed.2021.114037
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    References listed on IDEAS

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    1. Shiell, Alan & Hawe, Penelope & Kavanagh, Shane, 2020. "Evidence suggests a need to rethink social capital and social capital interventions," Social Science & Medicine, Elsevier, vol. 257(C).
    2. Morris, Stephanie & Guell, Cornelia & Pollard, Tessa M., 2019. "Group walking as a “lifeline”: Understanding the place of outdoor walking groups in women's lives," Social Science & Medicine, Elsevier, vol. 238(C), pages 1-1.
    3. Warin, Megan & Zivkovic, Tanya & Moore, Vivienne & Ward, Paul R. & Jones, Michelle, 2015. "Short horizons and obesity futures: Disjunctures between public health interventions and everyday temporalities," Social Science & Medicine, Elsevier, vol. 128(C), pages 309-315.
    4. Mackenzie, Mhairi & Skivington, Kathryn & Fergie, Gillian, 2020. "“The state They're in”: Unpicking fantasy paradigms of health improvement interventions as tools for addressing health inequalities," Social Science & Medicine, Elsevier, vol. 256(C).
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    Cited by:

    1. Gallan, Andrew S. & Helkkula, Anu & McConnell, William R., 2024. "Why did this happen to me? Causal attributions of illness and cultural health capital," Social Science & Medicine, Elsevier, vol. 350(C).
    2. Wildman, John & Wildman, Josephine M., 2023. "Impact of a link worker social prescribing intervention on non-elective admitted patient care costs: A quasi-experimental study," Social Science & Medicine, Elsevier, vol. 317(C).
    3. Morris, Stephanie & Wildman, Josephine M. & Gibson, Kate & Moffatt, Suzanne & Pollard, Tessa M., 2022. "Managing disruption at a distance: Unequal experiences of people living with long-term conditions during the COVID-19 pandemic," Social Science & Medicine, Elsevier, vol. 302(C).

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