1st Edition

Living with Health Inequalities Upstream–Downstream Connections

By Anne Rogers, David Pilgrim Copyright 2024
    186 Pages
    by Routledge

    186 Pages
    by Routledge

    This book explores how people encounter, understand, live with and respond to health risks associated with social, economic and political inequality. Complementing a traditional public health approach, the book moves beyond a focus on categories of morbidity and their structural causes. Instead, it focuses on everyday understandings and actions for people living in unequal social conditions. Making use of a variety of case studies related to physical and mental health, the authors emphasise interpersonal relationships, biographical meanings and the daily tactics of ‘getting by’. These are recurrently linked to the social-structural aspects of particular times and places.

    The book:

    • Draws upon, applies and extends the biopsychosocial approach, which is well known to students of public health.
    • Respects and gives due weight to the experience in context of people who live with health inequalities, in domestic and local settings.
    • Explores notions of personal agency and the contingencies of everyday life, in order to offer a focused psycho-social compliment to a public health tradition dominated by top-down reasoning.

    This is an important read for all those seeking to understand the complexities of health inequalities holistically in their studies, research and practice. The book brings together thinking in the fields of public health, sociology, mental health and social policy.


    1.People who need people: A relational approach to living with inequalities

    2.Living in the middle and living optimally

    3.Feed the poor, eat the rich: Ingestion and inequality

    4.Takes your breath away: Inequalities in respiratory health

    5.Running up that hill: Living unequally with the meaning of sport and exercise

    6.Ordinary distress and loneliness

    7.Normal and abnormal suffering

    8.Tired of living and scared of dying. 

    9.Pandemics: The great un-levelling.



    Anne Rogers is Professor (Emeritus) of Medical Sociology at the University of Southampton, UK. Her research interests are in the sociological aspects of mental health and illness, self-care and management of long-term conditions, people’s experiences of health care, health need and demand for care, and how patients adapt to and incorporate new technologies into their everyday life. Her most recent interests are focused on addressing how social ties and relationships operate in domestic and community settings and act as a conduit for accessing resources and support for managing wellness, social isolation and mental health.

    David Pilgrim is Honorary Professor of Health and Social Policy at the University of Liverpool, UK, and Visiting Professor of Clinical Psychology at the University of Southampton, UK. He has had a long-term interdisciplinary interest in mental health policy, which draws upon psychology, history, sociology and philosophy.