This explanation equates risk-taking or illness-related behaviour from the individual as the primary cause of poor health and health inequality. This explanation sees those behaviours as a matter of agency but excludes social contexts, relationships, and structures which may restrict an individual’s choice. The cultural/behavioural perspective consequently blames the victim. It doesn’t take into consideration living or working conditions in which individuals cannot exercise control over. For example, a study conducted by Sverdlik () investigates ill health in slums where ill health was present at birth and persisted throughout the entirety of the residents’ life - this reflects both the limited agency over one’s health especially for those lower down the hierarchy and David Blane’s idea of ‘process of social accumulation’ in which class circumstances become transgenerational (). Therefore behaviour should be seen as being generated by the organisation of social structures that surround the individual. An example that shows the short-coming of the cultural/behavioural explanation of class is presented in ‘The Black Report’ where in the nineteenth century, poor health of working class families was due to lack of hygiene, in addition to poor nutrition, frequent pregnancies and chronic exhaustion due to overwork (). …show more content…
This explanation highlights the role of social structures or material factors in the production and distribution of health including working conditions such as the level of danger or risk potentially faced by the employee or even the nature of the job itself. This becomes more complicated when looking at the sexual division of labour in classes (). Statistically men in working classes are more at risk of physical injuries in comparison to women who are more prone to injuries related to repetition due () Marxist perspectives have highlighted that the exploitation of workers and the pursuit of profit can create dangerous work environments and poor living conditions resulting in higher mortality rates among the working class. With the growing dependency of technology in the workforce, the proletariat class are de-skilled resulting in unemployment and driving down wages – which serve to benefit the upper class. Subsequently employers exploit the rate of unemployment to their employees to ensure loyalty (). Unemployment leads to what Marx refers to as the ‘industrial reserve army of labour’ whereby employed workers feel pressured by competition for jobs and weakens their bargaining power for wage rises and better working conditions (). In ‘The Life Course, the Social Gradient and Health’ by David Blane, he writes “… sees a person’s biological status as