Five of us studied sociology at university while the sixth only demurred because her early artistic talent shone brightly. We think and act as one across a range of social and political domains. Moreover we share the view that ‘doing sociology’ makes no sense unless this is oriented to, and produces outcomes for, those ‘publics’ that comprises our society. We have researched and/or written in ‘twos’ or ‘threes’ and have marched and protested as a family. Our views on apposite engagement are illustrated here in relation to health inequalities.
Health inequalities are discernible in all societies and in our neo-liberal present are increasing rather than decreasing. In a nutshell, being born into the ‘wrong’ segment of society – that is, into an impoverished or low-income family – mitigates against both longevity and prolonged good health. The mechanisms – biological, psychological, social – that combine to cause this patterning are clearly complex, dynamic and not readily accessible to disciplinary as opposed to genuinely interdisciplinary enquiry; but social mechanisms are a part of this explanatory process, and a part irreducible to other parts.
Given the indisputability of (1) the patterning of health inequalities in the UK and elsewhere, and (2) the causal salience of social mechanisms, we will skip on to what can/ought to be done. This will involve calling into question what Burawoy called ‘policy sociology’ and offering an alternative position, via his ‘professional’, ‘critical’ and ‘public’ sociologies, to what we will call ‘action’ sociology. Action sociology, we contend, represents an important and neglected fifth type of sociology. We have nothing against policy sociology except that it has proven largely ineffective. Sociologists have been among those who have striven mightily to influence policy regarding health inequalities, yet these inequalities have increased rather than decreased of late, most startlingly since the birth of financial capitalism in the early to mid-1970s. This failure itself warrants professional-cum-critical analysis. In the UK, notwithstanding a generation’s worth of evidence, we are seeing more ‘policy-based evidence’ than we are ‘evidence-based policy. We are of the view that Parliament, even should Labour be returned to office after a collapse of the ConDem coalition, would not act effectively to redistribute those asset flows most salient for health and longevity.
Since the ‘Arab spring’ resistance has been in the air. In common with most other western governments the ConDems have been enthusiastic about revolutions in foreign places while quickly condemning dissent at home. Meanwhile inequalities are underwritten and allowed to grow under the aegis of an ‘age of austerity’. The pulling in of belts, however, does not apply to the ‘banksters’ whose profligacy caused the crisis. The amount lost to the economy because of ‘benefit fraud’ (about which we hear a great deal) is dwarfed, by a factor of 70, by that lost through tax avoidance/evasion on the part of the wealthy. Worldwide in excess of £13 trillion is nestling in tax havens (more than the combined GDPs of the USA and Europe’s best, Germany).
This comprises a challenge for sociologists. Action sociology acknowledges that parliamentary democracy has formal merits but substantive failings. ‘Parliamentary democracy’, Ralph Miliband showed, cannot deliver social change that withdraws the privileges attendant on wealth and power in favour of the mass of low-income families. It does not presage regime change (to coin a phrase) but rather regime tweaking.
So what might action sociology deliver? It has a number of discernible properties:
- It is intrinsic to the sociological project: in any era sociologists will find themselves contesting ideologies (that is, erroneous worldviews or theories that sanction or provide cover for financial, business or political interests). Sociology’s very rationale is to oppose forces that suppress truths about the societies we inhabit: pace Habermas, it is necessarily oriented to justice and solidarity. It is active not passive: it lives or dies as a form of intervention against – Habermas again – ‘distorted communication’.
- It therefore contests the ‘taming’ of the discipline in the post-1970s neo-liberal era, including a shying away from contentious or ‘risky’ issues.
- Its focus is the study and theorizing of what Comte called society’s ‘statics’ and ‘dynamics’ in general, and of collective action to accomplish change in particular. This encompasses recruitment, context, and the dialectics of framing and implementing strategies.
- Its brief extends to forays into Giddens’ ‘utopian realism’, involving the mapping of alternative futures. This may well involve challenging or superceding the discourses or narratives for change on offer at any given time. An example of utopian realism would be a model for an NHS beyond the truly iniquitous Health and Social Care Act.
The Health and Social Care Act, designed to re-commodify health care in England, will accentuate health inequality. It is a paradigmatic example of policy-based evidence. The data do not speak loud enough for elite politicians, let alone their financial and business masters, to bend their ears in fear of a crisis of legitimation. So how to remove from the statute book an Act inimical to the wellbeing of most citizens?
An action sociology cannot shrug its shoulders. It has to dwell on and exploitation and oppression. It is the actions of the wealthy and powerful that condemn those in low-income households to suffer more than their share not only of long-term but of acute illness and to die prematurely, as the likes of Engels and Virschow who charged rulers with ‘murder’ recognized in the 19th century. And health inequalities afford but an illustration here: we could have pinpointed welfare as a whole, education, housing and so on with the self-same consequences. Action sociology offers resistance to ‘formal’ democracy in the name of ‘substantive’ democracy. It underwrites ‘effective’ as opposed to symbolic resistance.
It is appropriate to make a family reference to conclude. None of us has a strong record of action sociology/resistance, so there is no hubris; but we have come to see a need for a sociology that identifies and engages with the poor and powerless to confront class-based exploitation and state or command-based oppression. What is sociology for if it does not give voice to its publics? What action sociology explicitly requires is that sociology itself becomes a form of intervention.
About the authors: The corresponding author, Graham Scambler, is sociologist at UCL who has come slowly and late to the realization that it is not enough to give lectures and publish. None of the other Scamblers ever thought it was.